Friday, August 14, 2009

Paralysis By Self Deception

Usually I don’t write about matters relating to my health but I am obliged to do so now because of the erroneous statements made about our Canadian health plan, in addition to the false pronouncements delivered by American politicians and the misleading commercials that emanate from south of the border. And the reason why the Americans are saying bad things about our plan is that they are having a debate as to the kind of plan they want for themselves. By criticizing our plan they compare what they never had with what they never understood, having decided beforehand that they were correct all along for not choosing a plan similar to ours. They seem to believe we were wrong all these years because we neglected to conduct a debate in a style similar to theirs before settling on our plan, and they intend to do all that they can to keep their Republic safe from any influence we may exert on them.

Well then, here is my story. When I was on vacation a few weeks ago, it was more than fun and games for me because I had to mix my leisure moments with a trip to the hospital where I underwent a surgical operation on my hand. And what I can report from experience is that the negative things the Americans are saying about our plan are way out of line. In fact, I have lived with the Canadian plan for nearly 45 years now because, if my memory serves me right, it has been this long since we adopted it in this country. I used it over and over; so did every member of my family and everyone I know without a single complaint being lodged against it. And certainly, I never heard criticism that would come close to what the Americans are saying.

And here are the facts: I chose my doctor, chose the hospital where to operate and chose the approximate date of the operation. No one questioned me, no one telephoned me, no one visited me and no one suggested that I do anything differently. This is how we do healthcare in Canada and this is what they cannot dream of doing in America except for the people who are wealthy enough to buy the so-called gold plated Cadillac plan where they pay something like 2,000 dollars in premium to a private insurance company each and every month for as long as they live or run out of money. Compare this to the one-time parking fee of twelve and a half dollars that it cost me to have my operation and you’ll ask yourself: What’s wrong with these Americans? Why do they want to stay with a plan that is bankrupting their country while delivering less than half what we get in Canada? Are they nuts or something?

What is especially vexing about their view of the Canadian healthcare plan is that because it uses a single payer system, they deceive themselves into believing it rations medical services. The Americans make this accusation without explaining what they mean because they have no explanation to give, not knowing what the hell they are talking about. Of course, the word “ration” means different things to different people but in the context of the debate they are having, it sounds like they are using the word in the most negative of ways. Well, to counter this view, I propose that the following commercial be aired in response to their fraudulent commercials.

A mother carrying her infant daughter enters the emergency of a hospital where she sees a female who looks like an insurance lobbyist talk to a wealthy looking man. Distressed, the mother explains to the two that her daughter swallowed something and has difficulty breathing. The female asks the mother if she has insurance and the mother says probably not but she is not sure if the husband who is a trucker on the road has arranged to buy coverage for the family. The man interrupts the two women and offers to pay the expenses if it turns out that the girl has no coverage; and he pleads that the child be looked after immediately. The female lobbyist protests that this would be rationing healthcare which is bad for America. “But this is an innocent child who could be dying” says the man at which point the female bursts into a hysterical tirade accusing him of being a Canadian style, European trained socialist renegade who is betraying the American way of life. Then, in a slow and dramatic fashion, the infant grows in size while retaining the features of a child. She turns to her mother and says: “Mom, will I live and grow up to be a socialist renegade?”

The problem is not that all governments are inherently incapable of doing something right; the problem is that the Congress of the United States of America swims in a culture of little imagination and a sea of pork. When a bill comes up for a vote and every congressman and his favorite lobbyist want to add an earmark to it, the socialist aura that descends on the bill is due not to the Canadian or the European way of paying for healthcare but to the American way of doing politics. Indeed, nobody has cultivated the idiotic habit of adding earmarks to their legislation but the Americans, and nobody is idiotic enough to make wild accusations about the Canadian plan but those who are sloppy with the truth as much as they are careless with the money of their taxpayers.

The reality is that having a single payer system -- as do the Canadian and most European nations -- has nothing to do with what goes into a health plan. Whether it is the government or the private companies that issue the checks to healthcare providers, what goes into the final bill will be determined by what every house representative will earmark for their district and what every senator will earmark for their state. The difference between the single payer system and the multi-payer system is that the first brings simplicity to the procedure, lack of confusion into your life and the certainty that when you need medical attention you will only have to listen to your body and to the advice of your doctor … absolutely no one else. If this is socialism, give me more of it. And since the American plan requires that you put up with the dim-witted questions of a hysterical stranger from the insurance companies, I say without reservation: If this is the American brand of capitalism, they can take their brand and shove it.

Of course, what is good can still be made better and I am convinced that the Canadian healthcare plan can be improved upon. To this end, I wish to suggest something, having no illusion that it will work well or work at all. But this is something that can be debated, perhaps tested with a pilot project and adopted universally if shown to work adequately enough. Otherwise it can be rejected and forgotten all about with no harm done for having discussed it or tested it.

The plan is this: Determine at the beginning of every fiscal year how much it will cost each individual and each family to pay for the health bill of the nation. Give every taxpayer a tax credit in the determined amount. The individuals or families that exceed the amount in a given year will not be required to reimburse the government. On the other hand, those that cost the government less than the predetermined amount will be allowed to use the unused portion to reduce their taxes. This will make everyone conscious of the burden they place on the system every time they make the decision to seek medical help, and thus refrain from abusing the system. This idea should apply only to adults and not the children who do not make the decision to seek medical attention. And to avoid determining the level of medical care that a child receives based on economic considerations alone, the children will be given unlimited attention and all the care they need without any restriction.

The most important part in the debate about healthcare anywhere in the world is the one that deals with cost. But as everyone knows, you control the cost of something by having enough people watch it to determine what is excessive about it and participate in cutting down on these excesses. Well, if implemented in America, the plan I am proposing will empower nearly 200 million American users to watch what they are doing, make the correct determination, take action where necessary and reduce the cost of healthcare by refraining from abusing the system. In addition, these users will have the incentive to shop around for the best medical practices where they are dispensed. They will reward the good institutions by visiting them when the need arises, and punish the abusive ones by cutting them off. In this way, the users will also help the single payer -- be it the government or otherwise -- monitor how well each practitioner is doing their job. And with little imagination, this feature can be used to cut down on lawsuits; something that seems to have mushroomed into a huge problem in America but not in Canada or in Europe.

It has been our experience here in Canada that the Americans know little about us and say dumb things about our country but we never get upset because we are big enough to take their insolence and keep an Anglo-French kind of stiff upper lip. But what we cannot tolerate and what brings our Franco-Latin blood to a boil is when they use us to hurt themselves. When this happens, we feel guilty and we react like this: “Mais non, c’est stupide!” And we get the feeling it is our duty to let them know they have gone too far. Well, my dear friends in America, I spoke my mind and have thus discharged my duty. It is up to you now to remain stupid and keep on deceiving yourselves or see things our way and adopt a system of healthcare that will not kill your economy or keep you out of step with the civilized world.