Canada, once considered the bedrock of national health care systems, is in the beginning stages of change toward free-market health insurance.
But in a country where free health care is an afterthought, change comes slowly.
For the first time, private health care clinics are proliferating throughout Canada and arguments forallowing private physicians to practice freely are being heard.
“You are seeing the Medicare orthodoxy of the last 30 years being questioned in Canada,” said Dr. David Gratzer, a registered physician in Canada and the U.S., and senior fellow at the Manhattan Institute, a nonprofit public-policy think tank. “Over the last two years, the health care system has dramatically changed to allow more private health care.”
The Supreme Court of Canada, widely viewed as among the most liberal in the world, nearly two years ago allowed a man in Quebec to buy health care on his own — striking down 30 years of precedent and giving advocates for private health care a major victory.
The case is known as the Chaoulli decision, after Dr. Jacques Chaoulli, who took action against the system after a patient was forced to wait nearly one year for a hip replacement.
Chief Justice Beverley McLachlin and Justice John Major wrote in the decision: “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”
But the high court’s decision is only a springboard for change — a major privatization wave won’t occur until each of the 10 provincial governments and three territories moves to align its legislation with the Chaoulli decision and insurance companies step into the arena with new products, said Dr. Zoltan Nagy, executive vice president of the Canadian Independent Medical Clinics Association.
South of the border
In the United States, the buzz for a national health care system isat a fever pitch as Democraticpresidential contenders talk about implementing some form of a universal health care program, and Michael Moore’s new documentary, “Sicko,” shines the spotlight on inefficiencies in the U.S. health care model by comparing it with, among others, Canada‘s.
The U.S. system, considerably more costly and innovative, stands in sharp contrast to its Canadian counterpart in many ways. The Canadian system’s universal coverage with its lower costs and its public, nonprofit administration has been a subject of fascination to many Americans, particularly during periods when Congress flirted with the enactment of national health insurance legislation.
The U.S. and Mexico are the only developed countries in the world not to have some form ofguaranteed health insurance for all citizens. Federal and state government funding of medical care for U.S. citizens is limited to senior citizens and poor or disabled people through the country’s Medicare and Medicaid insurance programs, respectively.
In part because of the U.S. tax code, which gives individuals and businesses deductions for medical care, health insurance is uniquely tied to a person’s employment status. Without a job, health insurance can be difficult to obtain. As a result, an estimated 45 million people have no coverage, according to the Centers for Disease Control and Prevention.
Not only are there millions of uninsured, but also health insurance premiums for businesses continue to increase annually at double-digit rates, twice that of the rate of inflation, putting a drag on employers’ ability to compete domestically and abroad.
“Whether one agrees or disagrees with Michael Moore, the public interest in his new film demonstrates the growing anxiety that exists throughout the United States about health care costs and coverage. It is for this reason that health care reform has become the top domestic priority for America’s voters,” said Ron Pollack, executive director of Families USA, a national organization for health care consumers.