Washington File

Michael Moore makes Soviet style documentaries - i.e. - Propaganda. Anyone who thinks that the Cuban health system shown in the film is what the average Cuban sees is probably on illegal (but discounted) drugs. The average Cuban hospital is no better than most third-world hospitals.

Anyone who believes that the profit motive should be taken out of health care is ignorant of how the profit motive incentives improvements. The expensive drugs and medical procedures that can be paid by the very wealthy eventually turn into affordable procedures. Look at Lasik eye surgery. If drug companies can't make a profit developing newer/better drugs - they stop innovating. After the patent expires (20 years from filing) - then the drugs can become "generics" at lower cost.

In India, Prime Minister Nehru - a total socialist thought that "profit" was evil. But a socialist company that has no "profit motive" can be even more evil, as it has no incentive to find better and lower cost means of doing business. India has become much more successful as profit ceases to be a dirty word.

Socialist systems are doomed to failure because when a sufficient number of lazy people decide to leach off society (10 per cent or more), others decide that they are being taken advantage of, and they either choose to work less hard or to migrate to other countries where they are still able to keep the majority of the fruits of their own labor.

Mike

I'd like anyone who travels outside of their home province to be aware of the limits of our "universal" health care system. Would you believe that AB Health only covered $150 of a $50,000+ out of province medical emergency? If you plan on leaving home, be sure to pick up some travel insurance, even it you're just crossing the provincial border. But what about those who can't afford to buy extra insurance?
Thomas Jefferson said "The care of human life and happiness, and not their destruction, is the first and only object of good government." I'd like to support a good government, if only they could be found...

The reason the Clintons did not get Canadian style healthcare was because Noble Peace Prize nominee, Rush Limbaugh exposed it for what it really is... a lower standard of care for all.

I trust once Americans know what a disaster Canadian health care is, they will reject it en mass.

According to Moore's film, Cuba can provide top-of-the-line medical care for next to no cost, relative to their economy, so why can't we? Why is there a "crises" in this country when we have all the necessary infrastructure in place. We have already fought all the "hearts and minds" battles thanks to Tommy Douglas - our greatest Canadian - and won. We already have socialised medicine, so what's the problem, why can't we keep and improve the system the way it is? Why is there even a debate on adopting an American style system?

Obviously there are those who prefer an American approach to managed care because they see the profit potential while others see it as the ruination of a damn good heath care system, which it is, of course. If Moore's film tells us anything it is "Do not go down the road the Americans are on." The French approach is the most refreshing, although even I would draw the line at government health care workers folding laundry or making dinner - fold your own damn clothes! However, I can also see that there system has evolved out of democratic action where people take to the streets, vote in elections, and generally make their voices heard loudly and clearly. I would love it if Canadians did the same.

A few observations:

1) Health care should be available to all, period. There is no reason why, in a country as wealthy as Canada is, we cannot run a socialist health care system that meets the needs of every citizen.

2) Outsourcing is acceptable in one situation only: if the government covers the outsourcing costs and establishes very clear and unambiguous rules for the use of the system, so that the company we outsource to cannot play games. Slippery slope aside, if a private company can provide more competent and efficient services in terms of lab work or other medical services (but NOT treatment) I think that would be acceptable. Again, only if this falls under the umbrella of the medicare system, where all costs are covered by the government.

I have dscussed this with my business partner who is British. His country makes good sport of blasting the NHS at every turn, but he admits that nobody in their right mind would actually want to see an end to a system that provides free health care and subsidized drugs (7 pounds per order, no matter the type or amount of drug. That is impressive, and I'm sure Mr. Cyr would agree with me on this point.)

As for those who decry the higher taxes such a system might require: you are very likely rich, or have never been sick, or have never seen a family member dying without the means to acquire the treatment they required.

If I had to choose between the two certainties of life, I would choose taxes over death any day.

Michael Moore's movie is worth watching but shouldn't be more than the beginning of a discussion on the issue. There is little mention of Canada, and Henry fails to mention the role Cuba plays within the plot (probably because he hasn't seen himself in the movie). Cuba should open enough eyes. "If they can do it, why can't we (America)?" seems to be the theme.

Dear Friends,

There is a saying : People don't appreciate what they have until they lose it.

I would never wish for our Canadian health care to be lost. As a matter of fact, I urge all of us to act responsibly and defend it.

I was born and grew up outside Canada, I know first hand that if you don't have the the $, don't expect to care for your health and perhaps your life as well.
We should not trade our health and well being for saving and or profit. the private sector primary objectives is to GAIN and PROFIT. is that what we want?
In advanced socitey like ours,we are judged by how we treat our most vulnerable and what values sytem we uphold. Let us be what we say: A caring, tolerant, compassionate society that puts people,YES, People first and foremost.

To quote my Grandfather, "Thank God for Tommy Douglas". A health care system of passable quality is certainly better than none at all.
During the several health scares in the last few year, particulary the lack of flu vaccine available in the good old USA, it was heart-wrenching to see hundreds of Americans, the old, the young, the infirm, lined up at several walk-in clinics in my area, money in hand ,literally begging for the vaccine that might save their lives. I said a silent prayer of thanks that I was not amoung those tragically fearful people from the "greatest nation on earth".
Give me Canada, warts and all! Although imperfect, an ongoing work in progress.
The USA has the huddled masses she asked for; be careful what you wish for.

Re: Health, Security and Education should be under government control. For me, it wouldn't matter much if the govt., said I could only have one brand of tv. But education & health are too important to be left to the govt. Not sure about security, though private security does abound, especially since governments don't deal with our personal security very well.
Many will disagree with me. That's fine. Please subscribe to your own centrally managed systems, as is your right. You may not deny me the right to choose otherwise and I demand that right.

The only problem I have with private Healthcare is the issues already covered by others. Mainly that the options that are looked at tend to be based on the USAA system, not European systems.

Even in our public system it's not all covered by government. As stated medications tend to be up to the patients though insurance can cover the cost. My insurance covers 90% of the cost. Also we have the option of generics which drop the price even more. This is not an option our southern neighbours enjoy.

Still, all in all when it comes to dealing with Medical insurance I have to say I'd rather have service in the hands of the government. I had to spend large amounts when i was not working in order to get benfits and coverage to take care of things my doctor said I needed because the Insurance would not sign off on them right away.

It's always been my personal opinion that the three areas that should be firmly under government control are Health, Security and Education. The main reason is for the good of the people. You have to be looking at the bottom line for these. If the bottom line is what matters to often the point of these areas is missed.

True, we do wind up paying for them in taxes. Personally I never saw the big deal about paying taxes that some people seem to make it. Taxes go paying all the public services we enjoy. Maybe if people feel they don't want to pay taxes they should be given the option to opt out of public services. See how quickly they miss just what those taxes where bringing them.

Good morning,
I am informing you, we already have a 2-tier healthcare system. Both my wife and I have had delibilitating chronic diseases for well over a decade now,and the meds we require and have prescribed are not affordable to us; Remicade costs about $30,000 anually.20% of our Canadian pop. pays for their meds out of their own pockets.
Wake up and smell the coffee my fellow Canadians.
I wish you good health...Larry

As an Albertan, I've been on the front lines on the public/private health care debate. It is clear that despite any hybrid models in Europe that may be worth exploring, our politicians were only interested in the American-style private version.

In Ralph Klien's time in office, his health ministers only once suggested that "we should take a look at what Europeans are doing" and that was only after Ralph had been in office for 12 years. The two strongest proponents of private health care, Klien and Ontario's Mike Harris, sought to introduce private health care into their provinces by deliberatley starving the public system, thereby creating a demand for service, any service, which would be delivered privately.

At the same time, the gutted public system has come in for piles of abuse. As far as Alberta is concerned, what do people think is going to happen when you lay off 8200 nurses, and close 3 hospitals in Calgary (One of which was blown up, another of which was sold on the cheap to "freinds of Ralph".). Is it any wonder, also, that Klien has wound up with the Fraser Institute, which advocates the absolute privatization of everything in Canada (likely even the armed forces).

In this kind of panicked environment, is it any wonder that most Canadians couldn't think beyond the polar opposites of the Canadian and American systems? We were never given a serious look at any other alternatives.

I'm a Canadian living in the United States and as a moderate to heavy user of services I can honestly say that I do better under the American system. I have sleep apnea and had it diagnosed and brought under control in less than 3 months while my uncle in Winnipeg waited over a year for his first sleep study. My grandfather has a rotator cuff injury that requires surgery and has a 14 month wait for the procedure. Yes, he will receive the surgery without financial cost to himself but there is a heavy quality of life cost for an 87 year old to spend over a year without the use of an entire arm. I fully recognize the enormous problem of the under and uninsured in the United States but there is demagoguery happening in the debate in the US and Canada that keeps us from reaching an equitable solution for all.

Dryden's hospital and clinics serve an area of 15,000 people at the most. I have gone there and waited 2-3 hours for examination. I felt secure that the doctors were taking the time required for each patient to be examined and addressed appropriately. Do the folks who complain about wait times want the doctors to drop everyone else and attend to them ASAP?
Americans have a big battle to remove the present system of health care as it is based on profit, the almighty dollar, the same unit of measure their political system is based on. What politician is going to drive public health care when that position would have a negative affect on the dollars they would have contributed to their re-election campaign? The medical profession in the States care more for their profit margins than for their patients. Give me a system that may be slow and that gives a care for the humans involved. It will be easier to change the rate of medical care delivery than to change the mindset of people whose first concern is if the patient can pay to get better.

Canada's system is unethical and anti-freedom. To ban private clinics and to bar doctors from working at them is state power coercing individual rights.

It does not matter whether Canada's system is better or worse than any other country's system in its final delivery. It takes government force and threat of fines (and eventual imprisonment if refusing to pay) to make it happen and the ends don't justify the means.

To the Americans in the first comment -- you pay much less taxes than we do in Canada. It may be that if you were forced to pay for your health care insurance that it would cost the same on top of the taxes you pay as it costs us to simply pay our taxes which includes health care. The difference is that we never see that money.

I'm an American who pays $32.12 every two weeks out of her paycheck to have health insurance for myself. If I had a spouse or a child, it would cost much, much more. Unfortunately, I can't afford health care as the co-pays, deductibles, and items not covered are too expensive. You'd be surprised how expensive seemingly simple things are. I think most don't realize that even if you have health insurance, it doesn't mean you actually have health care accessible to you. Basically, my health insurance will simply help limit the damage financially if I ever need to be hospitalised.
My employer had me working in Ireland for 5 years and that's the only time in my entire life I've truly had access to health care as they have a system close to the UK and Canada. I certainly would vote for anyone who could bring a Canadian style system to the USA.

Robert from Montreal says "If there were a parallel system for people who had private insurance or money or whatever, that system would lift a HUGE burden from the public system. Why do people have such a hard time understanding that?"

The many problems with that, Robert, have been well documented. Basically, the private system would be able to charge the highest prices for the best services, so inevitably the best MD's & best facilities would move into the private system & leave the public system. (The private system would not pay MD’s the same or less than the public system; otherwise, why have a private system?) Moreover, only the wealthy could afford this "premium care".

The public system would be forced to compete for the higher salaries that MD's would be able to command in the private system. This would drive up the prices paid by the public system. So our taxes would go up but services (in the public system) would go down. MD’s are already working long hours; how are they going to be able work even more hours, in 2 different systems??

If wealthy Canadians want to spend extra $$$ & go to the US or elsewhere, that is their choice. But let's not make Canada's system worse by allowing the wealthy to poach the best MD's & make all other Canadians' experience worse.

Think you have a long wait to see a doctor now? What if the wealthy were to be able to go the front of the line? That makes your wait that much longer.

Not much of a solution, I'm afraid. Your suggestion would only work if there were a big surplus of MD’s & facilities. Sorry, but there aren’t many (or any) unemployed MD’s in Canada.

The so-called health care system in the US is essentially broken. It does serve, and fairly well, the well-to-do who have excellent employer based insurance, such as Congress or some of the more wealthy industries. Many of us, including my wife and I, are self-employed and uninsured; we operate a sort of lottery that our routine costs will be less than the cost of insurance, which is deplorably high for our middle-age cohort. Thus far, we're ahead, but a significant accident or illness would easily bankrupt us.
The problems include the utterly avaricious "Big Pharma", and of course the exceedingly powerful insurance industries. As the political agenda is dominated by corporate interests as coordinated by the omnipresent lobbies, we are lamentably unlikely to see meaningful change anytime soon.

Canada and the US probably have the two worst health care non-systems in the developed world. For most folks, Canada's system is probably better. But the 20% of insured people in the US who have upper-middle and upper class coverage do have great care and that tends to be the bench mark used for comparison. But the upper-middle style was typical fifteen years ago, now the 80% who have HMO (commercial versions of the UK NHS) generally have it worse than Canadians. I'm not a proponent of having two separate systems but the sort of hybrid system like OHIP plus extra-billing back in the 1980's. That is how France does it, probably the best health care system in the western world.

The Americans will never get public health care...for one thing the issue of gay marriage will trump it as will the abortion issue and the Iraq issue. Americans prefer to deal with the frivolities rather than the issues and the polarization on these and many other issues prohibits compromise that might achieve something

I am an expatriot and proud Canadian living in Italy. The system here is two-tiered and a disaster. Public health care services are shocking, mis-managed and the facilities deplorable. Private health care services are akin to (at their best) our Canadian health care services, though extremely costly. Whilst residing in Canada I too would curse our health care services, this has now changed. My experience here has taught me, whether one must wait for services or not, in Canada we are still privy to descent services provided by well trained, knowledgeable and caring professionals. One must live abroad to discover the privilages that every Canadian is entitled to; good health care, professional service and physicians with respectful bed-side manners.

Building on Rod's comments about the blindness of people in Canada and the US comparing their health care systems and ignoring the rest of the world: I hope that articles like this and movies like Sicko help the population in Canada realise that some countries in the world outside Canada+USA have better systems for all than we have here - These countries have a universal, public system augmented by private care. The US is a terrible example of what happens when health care is handed over to companies for the main purpose of generating income for the interested parties rather than the health and welfare of the population that has no alternative living with it.

We do not have a particularly impressive health care system here - Everyone gets the same mediocre to poor service. But at least everyone can get it.. eventually.

Universal health care was introduced first in 1948 the UK - The NHS. In the UK you have always had the option of private care also - It is not like the US. This is now typical in Europe.

In North America, Mexico also has a national health care system for all which generally works well considering the wealth per capita of Mexico compared to Canada. It is also augmented by private health care.

Look at the world when looking at Canada's system, measuring its effectiveness, value, and ways to improve it - Anyone who does would be stupid to think we should allow Canada to become like the US system and invite US insurers here to do what they do there. It would also be ignorant to think the only way is what we have.

My vote is going for the person or party that has the clarity of mind to offer a public/private system. There are so many people (like Walt, below) who only see things as black/white, or private/public. We can have both together, living happily. Two *completely* separate systems would do us well. [None of this "private practice" stuff going on in public hospitals, as is the case with much cosmetic surgery.] If there were a parallel system for people who had private insurance or money or whatever, that system would lift a HUGE burden from the public system. Why do people have such a hard time understanding that? Private health care is not the Bogeyman, stop treating it as such. There is a LOT of back door healthcare access going on right now already [I know, that's how I get in ahead of many people already]. It's already a system of "who you know."
Legalize private health care and everyone will be better. End the debate, and do something else with all that money: like fixing the crumbling infrastructure across the country, for starters...

The problem with comparing the American health care system with the Canadian one is that people tend to go to extremes simply because the two systems are at extremes compared to what most other industrialized countries are using. It is strange but true that Canada and the US, two neighbours in North America, have health care systems that are at polar ends of what is used elsewhere.

The American system is inefficient, profit-driven and leaves far too many people with no coverage whatsoever. But wait times for practically everything are far lower there than in Canada and medical institutions don't see their staff flocking to other countries like they do here.

The Canadian system is "fair". Everyone gets lousy service and long wait times equally. For procedures that we wait months for in Canada, they wait only a few days (usually less than a week) in Europe.

The best system is one that blends public and private services together. Even the most socialist countries on earth like Sweden and France blend the two together.

Unfortunately in Canada, any time anyone mentions adding a private services dimension to health care, some people bring up plenty of horror stories from the US (which are true)to "prove" that any and all private services must be evil and destructive. Strange you don't hear any examples coming from Europe which offers excellent, affordable, efficient care while using privately delivered services.

In the US, anyone talking about medicare is shut down by horror stories (which are true)of Canadians waiting for months for routine surgery or dying in emergency wards. This convinces them that all forms of publicly administrered health care services are evil and destructive.

The answer is a blend of the two but few people in Canada seem to want to tamper with our "sacred" health care system.

Whatever the problems with our health system, we must force our governments through the ballot box to sustain it at all costs and to eliminate any "for profit' private endeavours. Whatever it's limitations, it certainly is far superior to the US system which engenders huge profits for all who provides the services at the expense of the people and the taxes they pay. If anyone has a chance, go and see Moores "Sicko" and then decide. It will be no contest.

Art B: Bingo. There is a HUGE difference between private health care (such as we see in the US), and privately administered public health care.

In both systems, individuals aren't responsible for paying and can't cue jump. The difference is that in the privately administered system the government has to spend a lot of time creating a pseduo-competitive environment behind the scenes.

Health professionals like to rally against privately administered public health care for three main reasons:

1) They (perhaps rightly so) see it as a slippery slope towards true private health care, which I agree is bad, bad, bad.

2) It could lead to lower wages, fewer health care workers, or other things that would be bad for the unions.

3) It could lead to a lower quality of patient care, due to item 2 above, and because if the government doesn't get the pseduo-compmetitive system right they could make a mess of things.

However, given our governments are full of lawyers and business people, I think its far easier for them to get the pseduo-competitive system right than it is for them to figure out how to administer a health care system. Let the private companies figure out how to operate efficiently.

I'd choose MDC labs where I can walk-in and get my lab work done right away over waiting in the hospital for 4 hours. Especially since I pay the same amount in both cases, nothing.

We need a critical analysis of some of the work H. Clinton did in her studies of their system vs. ours. The U.S. system seems so inefficient economically, and leaves so many citizens badly served (or unserved) that it hardly seems a model for modifications to a Canadian system. Pressures for "private" services seem to assume decidedly non-private payments.

Sicko will have Henry Champ in it? Then I'm definitely going to see it.

his appearence is not being nominated for any award.....too short...editor

I look forward to the regularity, consistency and quality of Mr. Champ's work. Kudos.