will they get fooled again? striking back at harry and louise

When I first started this blog, I was besieged by wingnuts alternately offering to help me pack and howling with derision at the wacky country called Canada.

Canada, where you can be hauled off in the middle of the night for saying bad things about the Queen.

Canada, where you can be arrested for not speaking French.

Canada, where it's always cold, and always snowing.

And above all else, Canada, where you will die while you wait for health care.

I am not exaggerating. I heard all this and more.

By now everyone knows the health care non-system in the US isn't working. It's unjust, inhumane, and wildly expensive. The quality of care is great for the wealthy, a crap-shoot for everyone else, and nonexistent for tens of millions. It's also immensely profitable for a few.

There can't be an intelligent person left in the US who thinks it's working. There can only be people who believe that if you can't afford care, that's your own problem, go die on your own; people who fear the government (except when it comes to war and the supposed fight against supposed terrorists, then the government is always right); people who are so defensive and myopic about TGNOTFOTE™ that their brains (such as they are) shut down when the subject comes up; and people who are profiting off the current non-system. Of course there's some overlap among these groups.

We Canadians know the health care system in each Canadian province is not perfect; nothing is. But as I always say, if you want to know what's wrong with the Canadian system, ask someone who uses it. Because, up until very recently, all of what you will hear and read in the US mainstream media about Canada's health care has been lies. Not some, not most: all.

There's a veritable cottage industry of single-payer-bashing in the US media. I'm not talking Fox News. I'm talking New York Times, CNN, Washington Post, AP. Everyone.

I am beyond skeptical that the US will institute universal, single-payer health insurance in my lifetime, but if it's ever going to happen, people have to see a working model. They have to know what is possible. Imagine Tommy Douglas fighting for something he couldn't even prove would work! Fighting to make a dream a reality! Now, some 50 years after Canada's first medicare system was born in Saskatchewan, USians have a bright and shining example of how the whole thing can and does work, right in their own backyard. If only they will be able and allowed to see it.

I don't know how much and what kind of publicity Jack Layton's meeting with Obama garnered. I saw the wingnut blog headlines - "socialist visits US to promote government takeover of your life!!" - but I didn't find much in the mainstream. Any CNN watchers reading this? Did you see anything?

Perhaps this column by Nicholas Kristof in the New York Times is a harbinger of change. The Times was one of the worst offenders of Canadian-health-care-bashing. Could it be that is beginning to change?
Perhaps you've seen those television commercials denouncing health care reform as a plot to create a Canadian-style totalitarian nightmare, and you feel a wee bit scared.

Back in the election campaign, some people spread rumors that Barack Obama might be a secret Muslim conspiring to impose Sharia law on us. That seems unlikely now, but what if he's a covert Canadian plotting to impose ... health care?

Rick Scott, a former hospital company chief executive, leads a group called Conservatives for Patients' Rights. He was forced to resign as C.E.O. after his company defrauded the government through overbilling and is now spending his time trying to block meaningful health care reform by terrifying us with commercials of "real-life stories of the victims of government-run health care."

So here's a far more representative "real-life story."

Diane Tucker, 59, is an American lawyer who moved to Vancouver, Canada, in 2006. Like everyone else there, she now pays the equivalent of just $49 a month for health care.

Then one day two years ago, Ms. Tucker was working on her office computer when she noticed that she was having trouble typing with her right hand.

"I realized my hand was numb, so I tried to stand up to shake it out," she remembered. "But I had trouble standing."

A colleague called 911, and an ambulance rushed her to the nearest hospital.

"An emergency room doctor met me at the door, and they took me straight upstairs to the CT scan," she recalled. A neurologist explained that she had suffered a stroke.

Ms. Tucker spent a week at the hospital. "The doctors were great, although there were also a couple of jerks," she said. "The nursing staff was wonderful."

Still, there were two patients to a room, and conditions weren't as opulent as at some American hospitals. "The food was horrible," she said.

Then again, the price was right. "They never spoke to me about money," she said. "Not when I checked in, and not when I left."

Scaremongers emphasize the waits for specialists in Canada, and there's some truth to the stories. After the stroke, Ms. Tucker needed to make a routine appointment with a neurologist and an ophthalmologist to see if she should drive again. Initially, those appointments would have meant a two- or three-month wait, although in the end she managed to arrange them more quickly.

Ms. Tucker underwent three months of rehabilitation, including physical therapy several times a week. Again there was no charge, no co-payment.

Then, last year, Ms. Tucker fainted while on a visit to San Francisco, and an ambulance rushed her to the nearest hospital. But this was in the United States, so the person meeting her at the emergency room door wasn’t a doctor.

"The first person I saw was a lady with a computer," she said, "asking me how I intended to pay the bill." Ms. Tucker did, in fact, have insurance, but she was told she would have to pay herself and seek reimbursement.

Nothing was seriously wrong, and the hospital discharged her after five hours. The bill came to $8,789.29.

Ms. Tucker has since lost her job in the recession, but she says she's stuck in Canada — because if she goes back to the United States, she will pay a fortune for private health insurance because of her history of a stroke. "I'm trying to find another job here," she said. "I want to stay here because of medical insurance."

Another advantage of the Canadian system, she says, is that it emphasizes preventive care. When a friend was diagnosed as being pre-diabetic, he was put in a free two-year program emphasizing an improved diet and lifestyle — and he emerged as no longer being prone to diabetes.

If Ms. Tucker's story surprises you, you should know that Mr. Scott's public relations initiative against health reform is led by the same firm that orchestrated the "Swift boat campaign" against Senator John Kerry in 2004. These commercials are just as false, for President Obama is not proposing government-run health care — just a public insurance element in the mix.

No doubt there are some genuine horror stories in Canada, as there are here in the United States.

But the bottom line is that America's health care system spends nearly twice as much per person as Canada's (building the wealth of hospital tycoons like Mr. Scott). Yet our infant mortality rate is 40 percent higher than Canada's, and American mothers are 57 percent more likely to die in childbirth than Canadian ones.

In 1993, the "Harry and Louise" commercials frightened Americans into abandoning health reform. Let's ensure those scare tactics don't work this time.

A few notes on the above.

Most US hospital patients do not get private rooms, either. And Canadians with supplemental (private) health insurance may have coverage for a private room.

I also think it's fair to say most USians have never seen an "opulent" hospital! I realize they're out there, but unless you are very wealthy or have amazing insurance, you're not going to get into one.

More importantly, many Americans have a mistaken impression about "wait times," so often talked about here in Canada. They believe it means how long you will wait to see a doctor on any given day, as if there is some central clinic where everyone goes and endlessly waits for care.

Doctors in Canada have their own offices and appointments are scheduled the usual way. There are also walk-in clinics where you don't need an appointment. But "wait times" refers to queues for certain procedures, such as hip or knee replacements, or to see certain specialists. There is a shortage of doctors in many fields, and in many areas.

There's a lot of discussion about how to bring wait times down. But plenty of us don't wait at all. We just make appointments and go to the doctor. We pay nothing, because we pay for our health care with our taxes. My taxes in Ontario are about the same as they were in New York.

And two, as my partner always says, there are millions of Americans who would be thrilled to be on a waiting list, and when their name comes up, get free surgery and rehab.

Instead, they're just left to deteriorate or die.

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