The Truth About Canadian Health Care
Part 1 of a 3-Part Series

First of all, we don't euthanize our infirm or elderly.  Most Canadians would cringe at the thought.  Yes, Canadians do have universal access to necessary health care, but this benefit has never led to a push for euthanasia, as the two issues are different concepts.

My wife, who works as a broadcast producer, shared a humorous anecdote with me a few days ago.  Her managing editor, just returned from a family vacation in Virginia.  He said that the locals really wanted to talk with him as soon as they heard that he was a Canadian broadcast executive.  And the topic on everyone's mind was – you guessed it – health care.  Sadly, a lot of the folks he conversed with were sorely off the mark or, worse yet, perhaps purposely misinformed about the reality of the Canadian health care experience.  The fabricated gem about euthanasia is just one example he shared.

It sure does sound plausible, though.  Think about it.  Canadian taxpayers' dollars directly and indirectly fund a mammoth and complex system of family practitioners, specialists, surgeons, nurses, clinics, hospitals, lab work, assisted care and convalescent care facilities.  It would reason then (given some well-timed propaganda) that the administrators of this mammoth system would authorize cutting the lifeline, quite literally, of those whose care costs the most, have no hope of getting better and have no likelihood of contributing to the very system that pays for their expensive care.  Sounds believable, but it is not reality.

Many well-publicized court cases underscore Canada's aversion to any form of assisted suicide or euthanasia.  In 1993, a farmer from Saskatchewan named Robert Latimer, carried-out a mercy killing on his twelve-year-old daughter.  She suffered from severe cerebral palsy, could not walk, talk or feed herself and was in chronic, excruciating pain.   A year later, Latimer was convicted of second-degree murder and sentenced to ten years in prison with no chance of parole.  Further cases have upheld the court's objection to those who have aided in others' suicide or active cessation of life.  In other words, Jack Kevorkian could not have gotten away with it in Canada either.

The ‘Canadian Health Care Plan'
So, how does it work?  Canada's health system is not a federally-administered public health insurance plan.  Instead, what we do have is a fabric of individual provincial plans that mirror a set of national ‘medicare' principles.  That's quite different from what is being floated by Washington.

Here's how it works in a nutshell.  Your average Canadian pays income tax to both the federal and provincial governments, with the federal side taking the lion's share.  The federal government doles out a portion of total revenue from personal and corporate income taxes, along with other sources of income to fund ‘transfer payments' back to the ten provinces and three territories.  These transfer payments are earmarked specifically for health care. Each province or territory is individually responsible to administer and deliver health care services.  Some provinces, such as Ontario, levy an additional health care fee on workers' paychecks to shore-up gaps between available funds and the reality of costs.

There are differences in the precise ways in which each province or territory administers its own health care system.  However, the federal government has an overall responsibility to set principles and priorities through legislation that each province or territory must mirror.  As such, Canadians living in British Columbia on the west coast, Newfoundland and Labrador on the east coast or anywhere in-between, take advantage of similar coverage and services.

You Never Need to Worry About ‘Coverage'
A friend of mine from Florida got an unsolicited lesson in the limits of health insurance ‘coverage' about six years ago.  He and his wife, 'Kate', never questioned the health insurance that she had through her former employer.  That was until she was diagnosed with a tumor in her neck near the brain stem.  After undergoing many nerve-racking tests, Kate's health insurance carrier revealed the extent of treatment it would cover and identified the specific hospital in which she would have to receive that treatment.  Fortunately, the couple was able to explore the best options with their own choice of specialist and hospital.  Had it not been for my friend's persistent badgering and clever negotiation, the carrier's desired course of action would have prevailed.

My friend's experience surprised me.  I had made the assumption that personal choice and access were exceptional in a country with the world's finest medical facilities, practitioners and technology.  The reality of limitation and the decisive power that's necessary to maintain profitability in a private health care system had not crossed my mind.

Take a look at this scenario.  A Canadian cardiac patient is diagnosed with very severe blockage in at least two aortic arteries.  The cardiologist determines that a stent or angioplasty would solve the problem in the near-term, but recommends a double bypass.  Although far more expensive, it's most efficacious for that patient's long-term health.  There is no question that every aspect of the bypass will be covered in full, with no cost to the patient for all necessary tests, consultations, hospital stay, in-hospital medications and the surgery itself.  And it really doesn't matter whether that same patient is the CEO of a major corporation, a politician, a part-time fast food employee or a stay-at-home parent.  The provincial health plan will cover the bill.

That's not to say that Canadian patients have access to every type of treatment in every case, such as cutting-edge, experimental or unproven procedures.  However, the average Canadian will not ever be denied generally accepted treatment, surgery or counsel according to his or her medical needs.  That includes organ transplants as necessary and available.

Where you live does matter.  There definitely is a small town – big city gap when it comes to health care options, choice of practitioner and responsiveness to medical treatment.  However, a Canadian patient from ‘Hickville' can always get subsequent opinions from specialists in a more urban setting.  And when the patient's condition requires the most advanced technology and prominent specialists such as may be available at a major metropolitan teaching hospital, that patient is routinely transferred in order to receive the required surgery or treatment.

Every story has another side and in this case, it's not always quite so rosy.  More Canadians live in Ontario than any other province.  Ontario's Ministry of Health and Long Term Care administers and delivers health care to about 13 million residents.  Ontario has been grappling with a serious doctor shortage; as a result, many Ontarians do not have a family doctor.  In August, 2008 the Ontario College of Family Physicians released results of a poll showing that up to 879,000 Ontarians did not have a family doctor.  Since that time, the province has ramped-up efforts to increase the number of doctors, to implement innovative solutions and to connect those who are without.  Despite the fact that progress has been made, many patients continue to visit clinics or emergency rooms because they still don't have a family physician.  So, the system is not perfect.

Not perfect, but the benefits of universal health care are immense.  Bottom line - medically necessary consultation, treatment or surgery will never be denied to a Canadian in his or her own province or territory.  A Canadian will never hear the words, "Sorry, but even though there is better treatment available, here's the extent of what we'll cover,"  or, "You've reached the maximum pay-out for treatment of this condition," or "Your claim has been denied due to pre-existing conditions."  That just doesn't happen here; if you're Canadian, you're covered.

In general, we choose our own family physician without having to select from a list of HMO approved physicians.  Canadians never have to worry about having their coverage dropped due to pre-existing health conditions or personal habits.  We never have to ask family or friends for money to pay for a medically necessary operation, because it's always covered.  Canadians rarely hear or read about fundraisers to help pay for medical treatment, unless it's to pay for out-of-town lodging expenses for patient's families or for treatment in the U.S.  Canadians never have to send-in claim forms for doctor visits or hospital stays.  When we lose our jobs, become self-employed or simply can't become employed, our basic health coverage does not change.  That is what universal health care looks like and most industrialized countries in the world have it.

Time to Receive Treatment is another story and Part 2 of this series, "Real Life Stories About Government-Administered Health Care" will explore that issue.  See more content by Stephen Kristof at http://themorethingschange.weebly.com/