If you are looking for the biggest difference between Canada and the United States, especially these days, both sides of the border would say, "health care."
Canadians are understandably upset that some in the U.S. — for political purposes — are maligning their health care system. And the understandable defensiveness of Canadians doesn't help shine an accurate light on elements of Canadian health care that could be improved, so the U.S. can learn from Canada — good and bad.
In terms of understanding the Canadian system, health care is administered on the provincial level, though there are federal standards. So if you hear a horror story from Ontario, and it's true, the situation might be different in Manitoba or British Columbia or Nova Scotia.
Then there is criticism of a setup for a health care system, and criticism of the funding of the system. Canadians don't have to worry about hospital bills, but because of lack of funding, prescription drugs and dental aren't covered (though Canadians pay far less for prescription drugs than Americans). Canadians may love their system, but imagine how much more they would love it if the system had more money.
Canadians can pick their own doctor, but due to a shortage of doctors, a small percentage can't get a family doctor. Canada does need more doctors and more specialists. Like in most places in the world, those who live in urban areas have more availability to doctors and specialists. The Canadian population can be very spread out, especially in the three territories to the north.
One consistent theme in the horror stories — true or false — the criticism focuses on treatments that Canadians can't get in their country. But there are many examples where provinces have paid for treatment in the U.S. in a scenario where Canada couldn't properly provide the equipment or care.
Canadians could easily argue that they wish their care were as good as that in Great Britain, France, or Sweden. For all the lumping together of "socialized medicine," there are many different variations between other industrialized countries. Other industrialized countries, of course, except for the United States.
One argument from U.S. President Barack Obama is that Americans want their own system. And even if the U.S. were ever to go for single-payer, a far more significant reform than what is currently before Congress, prescription drugs would be covered but probably not dental.
But millions of Americans can't help but wonder if they would be better off in the Canadian health care system. And there are certainly are Canadians who might think the U.S. health care system is a better fit for them.
Perhaps we could create a binational health care system: give those Americans/Canadians who love single payer that option, and allow those who love private insurance to buy and keep that. Even now, Canadians who travel to the U.S., by and large, buy supplemental health insurance in case they get sick or injured while visiting the United States.
Those Americans who have trouble getting health insurance (full disclosure: this reporter is in this group) may not say the Canadian system is perfect, but they do know that they won't lose their health insurance or suddenly won't be covered. They know if they lose their jobs, their health insurance won't be in jeopardy. They won't be in financial ruin and they can keep their houses. And Canadians live longer than Americans, perhaps because they aren't as worried about their health insurance.
"Peace of Mind" is not just a song from Boston's first album, but this is what those Americans see in the Canadian system that they like. The Canadian system isn't perfect, but they do a lot of things right. And the Canadian health care system should be judged on its own merits, good and bad.
But in a study released late last week from the Canadian Institute for Health Information — the largest survey on primary health care ever conducted in Canada — 92 percent would recommend their physician to a relative or friend. Also from the survey, 85 percent of people aged 12 and older have a regular doctor, and two thirds have been seeing the same doctor for five years or more.
Those who bash the Canadian system, and who don't have to live in it, are usually those who oppose it for political reasons. Even though the U.S. government provides health care to its veterans, and runs Medicaid and Medicare, they don't believe the federal government should run health care. There are those who oppose it because their taxes would go up, though there would be an obvious trade-off.
The discussion would be more fruitful if those who opposed Canadian-style health care would have a thorough analysis of what they think is wrong with the system. Until then, they can stop bashing something that could help millions of Americans.
