It’s appropriate the week these two great countries share a birthday to compare the front burner interest of every citizen– that being the health care delivery system. I retired as an Ontario family physician on august 25, 2005 and drove to Pass Christian, Mississippi arriving 36 hours prior to the devastation of Hurricane Katrina which demolished the community at ground zero. I also hold an American Board in emergency medicine as well as advanced disaster response and critical care training. I was asked to contribute my expertise and within the constraints of visa regulations, I have continued to do so for the past twelve years. I work with multiple faith base organizations in the two poorest states in the country, bayou Louisiana and the homeless of coastal Mississippi. I have studied the American model for health care delivery in depth from the bottom rung of the ladder– from the perspective of the poorest of the poor– and I am distressed with what I observe daily. I have met one on one with Governors, senior senators, congressmen and state legislators both Republican and Democrat. Always the any proposed improvement divides along partisan lines.
In Canada, we quietly addressed the universal health care issue as long ago as 1964 accepting the fundamental principle that society has an obligation of inclusion of all its members.
Not so in America where over 40 million citizens have no coverage, another 40 million have minimal coverage that includes monster co-pay provisions. Even the employed with “good” plans usually co-pay 20 percent. Obamacare added seven million to the rolls at unacceptable expense but another 80 million saw their coverage drastically altered with the overwhelming consensus not for the better. America has the most expensive health care in the world but ranks 24th in outcome analysis by actuarial standards. Americans pay three times what we do for common medications. My recent MRI in Canada was one eighth the cost of comparable care on the Gulf Coast. Same equipment. The American system is driven by profit tantamount to greed. One third of personal U.S. bankruptcies derive from unpayable health costs – and medical creditors have the legal right and will seize your every asset. I sincerely believe the system is fixable but sadly that is unlikely to happen anytime soon. The collective will just does not exist to correct the blatant flaws. Food stamp fraud is rampant. In Mississippi it is possible to be declared permanently disabled at age 20 for obesity without any programmed attempt at weight control! There are too many special interest groups flogging the fear of Canadian style socialism being one short step removed from Communism. In rebuttal I point out state sponsored Medicaid for the disabled, Medicare at the federal level for all seniors and state provisions for full health coverage for all children under age 18 clearly show America is already half way here. Americans are well known for not allowing the facts to cloud their opinions
The elephants always in the room are race and ethnicity. Black women in childbirth in Mississippi have 9 times the national rate for natal mortality, a number unchanged in a decade. California is bankrupt providing “sanctuary” health care to the agreed 50 percent of the eleven million illegals in the U.S. Living there in the underground untaxed economy.
Nobody as yet has calculated the health costs of the care for the 40,000 eventual gun violence deaths annually and the half million wounded parked in intensive care.
I am not optimistic it will be fixed because it would require major shifts in so many other areas of the society so I give the current system:
- F – for lack of universality
- D – for excessive cost
- D – minus for lack of will to change
- B – plus for care when covered
- A – plus for care for the one percent who can afford everything The United States is proof the grass is not always greener
Editors note: Dave Carll is a retired Canadian family physician based in Mississippi six months of the year; who in addition to helping low-income Gulf State Americans navigate their health system, spends the rest of his time scrounging food and other necessities for poor people.