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Not So Fast: Don't Write Off Canada's Single-Payer Health System

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When free-market alarmists who oppose U.S. health care reform storm Congress with their horror stories about Canada's public health insurance system, I don't know which system they're talking about.

It can't be the one that saved my daughter's life, keeps our family out of bankruptcy, or delivers a more consistent standard of care and higher life expectancy than the private system in the U.S., at lower cost per capita and as a share of gross domestic product (GDP).

In May, 1996, just a few weeks after her second birthday, our daughter was in the midst of her first serious asthma attack. She was too young to tell us what was wrong. We didn't yet understand what we were looking at. When she couldn't stop wheezing and wouldn't stop crying, my wife suggested taking her to the hospital.

I'll never forget that ride. Rachel's head was lolling back in her car seat, and her eyes were rolling back in her head. By the time we reached the Children's Hospital of Eastern Ontario (CHEO), her blood oxygen was dangerously low, at about 80 percent, and she was turning blue.

Karen carried Rachel into the emergency room while I parked the car. By the time I caught up with them, just a few minutes later, a medical team had assessed the situation, grabbed Rachel, and rushed her to the resuscitation room, where she received the oxygen, cortisone, and Ventolin that saved her life.

Nothing about this story should be extraordinary. The system responded just the way it's supposed to -- efficiently, compassionately, and with all due haste. Just two things were missing: the supposedly endless delays that are touted as legendary whenever the U.S. Congress debates Canadian health care, and the private insurance coverage that would have been our price of admission if we'd been living 500 miles to the south.

Detractors of Canada's single-payer system, up to and apparently including Senate Finance Chair Max Baucus (D-MT), don't seem to realize that sound health care backstops a sound economy.

As far back as the early 1990s, before it became a mark of shame to be the chair of Chrysler Corporation, Lee Iacocca understood the private health care costs that have now crippled the U.S. auto industry.

"We save maybe 15, 20 percent by building a car in Canada because the Canadian government's paying that 15 percent for workers' health insurance," Iacocca told AARP's online magazine earlier this year.

"The United States has the most expensive health care in the world," he said, "and we don't have the best record, whether it's infant mortality or whatever. We're just not there with the rest of the world."

Decades earlier, United Auto Workers (UAW) President Walter Reuther fought for federal health insurance for all. But GM's Charlie Wilson and other titans of industry "fought Reuther tooth and nail," according to the Huffington Post's Robert Creamer.

"They believed that these programs would undermine the 'private market,'" Creamer wrote last November. "To head him off, they offered a program of employer-based health and pension benefits. Sixty years later, those privately funded health and pension benefits have become an economic albatross."

And for what it's worth, it's doubtful that my small business, The Conference Publishers, would be celebrating its 25th anniversary this fall if we'd had to cover our employees' private health care costs -- or if I'd had to make the drastic job choices that would have been needed to finance our family's intermittent health problems.

You'd think I'd be used to it by now, but I get the same sense of startled unreality whenever I hear about someone in the U.S. losing their health care when they lose their job...or being grateful to work overtime hours at an impossibly low wage because health care is part of the package. I've heard of people postponing retirement to hold their benefits, delaying life-saving treatment because they don't know how they'll pay for it. And then I hear U.S. politicians of all stripes rule out a practical, proven alternative, never bothering to explore the details behind the label.

None of this is to suggest that the Canadian health system is perfect.

We wrestle with long wait times.

We have a shortage of family physicians, especially in rural areas.

Health conditions in Aboriginal communities are often appalling.

We've been slow to adopt health promotion and disease prevention measures that save lives and money.

We've equivocated on tobacco control and dithered on harm reduction. Our system still hasn't accepted the overwhelming evidence that a supervised injection site in Vancouver's Downtown East Side is a resounding success.

And our governments have spent decades underfunding public health programs that define their success by the illness and injuries they prevent -- with the inevitable result that the system is most visible when it fails.

But two things are true about these limitations. The difficulties our system faces are not unique to Canada. And some of our biggest challenges result from a sustained effort to fund European-style health care on a tax system shaped in part by political and fiscal trends in the United States.

Since that first scary ride to the hospital, we've learned how to keep Rachel's asthma under control. When she runs into problems, we read the signs and bring her in for treatment before it's an emergency. Sometimes, as a result, we have to wait minutes or hours to see a doctor. And on occasion, while we're waiting, we hear other parents mutter about the inefficiency, the stupidity, the annoying unfairness of a public health system.

That's when we tell them about a little girl with her blood oxygen at 80 percent, her head lolling back in her car seat and her eyes rolling back in her head. We remind them that they'd be more hesitant to seek care if they knew it would cost them thousands of dollars, that health care of any kind might be beyond their reach in a private system if they didn't have a job. And from personal experience, we assure them that if they've been asked to wait, it's because someone else's need is even more urgent.

No health system is flawless. But ours is far better than the caricatures that roll out across the United States, whenever your country seems to have a serious shot at health care reform.

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