Newsflash: Canada is NOT America

Sigh.

I really did not want to discuss this health care bill. I imagined the fights that would break out between my two different political persuasions of friends, both of whom can be quite, um, passionate. It makes me uncomfortable when they argue even about something as harmless as sports, because I WANT EVERYBODY TO BE HAPPY. But, you know. I mean, I said that I didn't want to talk about it, and then people started emailing because "Hey! You already live in totally socialized health care. You MUST have an opinion." And frankly, this is just easier than answering email.

Ok, here's the thing. There are three very prominent comments people make about the U.S. health bill and Canada. And I'm here to set you straight on them. Now, just to be clear. I don't like the U.S. health care bill AT ALL and think it really will create more problems than solutions and is kind of just a bunch of WTF. However, if you forced me into a corner and said, "Did you want it to pass or didn't you?" I would say that I'm glad that it passed because at least in theory children, unemployed people, chronically ill people who change jobs and the general disenfranchised of America *should* be able to get access to health care. And honestly, beyond anything else you may think, we should have been embarrassed that we're one of the wealthiest nations on earth and people can't go see a doctor. So, I guess, if pressed, I'm happy about the bill.

Now, let me correct you. The key message you need to remember her is that CANADA IS NOT AMERICA. If they did not make that clear to you with that festival of pride and Nickleback known as the Olympic opening and closing ceremonies, they they will certainly make it clear to you with this. (stick it out past the first 30 seconds, it's worth it)¹

The other thing you need to understand is my status in Canada. I have permanent residence status, which means that I have every right, privilege and responsibility of a Canadian citizen. I pay their taxes, use their social services and I guess eventually will take my required French course (blah). My bonus is that I also get to pay my taxes in the U.S. to maintain my citizenship there. But I'm like a real Canadian as far as health care access is considered.

That said, here's where you're wrong.

During the Health Care Debate, You Screamed: "Everybody's talking about how Canada is a land where everybody gets health care, but their health care is totally crappy!"
Well, I'm here to tell you that you're 100% right on that. In my life, I have had the "luck" to be critically ill in both the U.S. and Canada. In the U.S., I was diagnosed in a reasonable time frame, treated, cured and released. In Canada, I got to spend two months being frustrated while nobody could properly diagnose me (even though I TOLD them what was wrong). Then another month while nobody would treat me because they couldn't decide on the best course of action. Then I said "fuck it" and went over the border for a week, and by the time I got back to Canada, I was well on the way to getting healthy. Mind you, by the way, while all this was going on, I had BOTH private and public health coverage in Canada. Not only was it nearly impossible to get quality treatment, one of the medications I needed WASN'T EVEN AVAILABLE IN CANADA and one of the procedures usually used to treat me for this particular ailment was only performed at one place in Montreal, and they performed it badly.

And, no joke, at one point I had a blood transfusion and they gave me the wrong kind of blood. This could probably have just as easily happened in the States though, to be fair. Let's not use it as an example. I'm sorry I even brought it up.

Absolutely, 100%, you get a better quality of care below the border.

Is that because Canada's public health care policy decreases the quality of care a person receives? Yes. Partially. You're going to experience it in the States as well. For better or worse, when you remove massive profit margins as a motivation for achievement in certain elements of health care, you reduce competitiveness and the rate of innovation. That's just math. It's how it works. HOWEVER...

Canada is 1/10 the size of the U.S. Some of the "lack of impressiveness" in their health care is nothing more than that they don't have the same resources as the U.S. across the board. Or the same need. If you had 1/10 as many sufferers of most diseases, you wouldn't plug as much effort into curing them either - in terms of money or research.

So, here's the take away. For sure, at least in my experience, the quality of health care in Canada is not as good as in the States. But this is not exclusively linked to nationalized health care. If "Canada's health care is crappy" is your argument for why U.S. nationalized health care will destroy your ability to get quality treatment, you need to revisit that theory.

During the Health Care Debate, You Screamed: "Canadians are healthier because they have access to health care."
Sure. To a degree this is true. The fact that people can get preventative care, don't go for excessively long periods of time without getting doctor or dental check ups, don't have to stress about paying for things (thus causing them to utilize health care more frequently) and are ENCOURAGED to use their health care benefits by their country certainly contributes to the fact that folks are generally healthier up here.

Contributes, does not cause.

There are a lot of other differences up here, guys. Dare I say it again? Canada is NOT America. Canadians do not eat like you eat. There is not a fast food option every five feet. They eat more seasonally appropriately. They don't consider it socially acceptable to be really, really over weight. I cannot think of a single adult male I know up here who doesn't participate in some kind of rec sport like volleyball or hockey or ball hockey or flag football. Ok, that's not true. I can think of a few. But it's the minority, not the majority. That is not true for the States, and you know it. They don't over medicate every little thing. They just...they live more healthily up here. Which is not to say that they are a bunch of freaky vegan hippies. They just don't take things to excess the way that it rolls in the lower 48. They make fun of the portion sizes at TGIFridays EVERY chance they get.

I might also consider that the more liberal attitude toward marijuana up here assists with this, but let's not bring that up either because I'm not sure I want to start that debate.

So, here's the take away. For sure Canadians are healthier than Americans. But the fact that they have free health care is only part of that. All that extra health care that's about to be available to Americans? That's going to be an awesome way to spend money on diabetes and heart disease. But ultimately, it's a system that isn't going to require a ton of mutual responsibility from its participants (ie U.S. citizens). Canada's system doesn't really require that either, but this country isn't full of people trying to kill themselves via burger consumption. So that's great that you've got better access to health care down there now, but it's really like sticking a thumb in a dyke (the dam kind, people) unless people a) get educated about the need for preventative care and b) start to make any kind of effort about taking their health care seriously as a personal and individual responsibility. So if your argument for nationalized health care was "But Canada has it, and Canada is much healthier than we are," then that's a fail, too. They are, but health care availability is just a piece of that.

During the Health Care Debate, You Screamed: "Oh my GAWD. Look at Canada's health care! There are so many problems! Getting treatment, getting scheduled, bureaucracy! It's fraught with problems. Just think about all the problems we'll have!"
In fairness, I doubt that you used the word fraught.

Ok, listen. You're both right and wrong. I think, in my experience, there are not as many "crazy problems" with health care up here as you may think. It's not that complicated to get a doctor and get treated for your basic kinds of things and even some more complicated ones, particularly if you can be patient about appointment setting. I mean, many of those things you've heard are accurate. It can be a bitch. But where you're wrong is that it's not the same kind of epic mess you may have heard.

But where you are right is that you will be experiencing a multitude of problems with this program in the States. For sure. You will experience more problems than Canada has ever experienced with their health care plan.

To begin with, let's review the population scenario again. Canada has 30 million people. 90% of those people live within 100 miles of the U.S. border (that's a real statistic). I'm not saying that that's not a lot of people to keep track of and implement a system for, but it's not 300 million people spread out all over 3.5 million square miles. One is a much larger task than the other.

On top of which, it's a much simpler set up in Canada. Everybody gets nationalized health care. Period. That's not how the U.S. plan is. You can have a private plan, you can have a combo of a private plan with government assistance, you can get on a government plan, or you can say "Fuck you, I'll take the penalty and not get any coverage and pay the fine." Big mess to keep track of, right? It's almost like people were so horrified at the idea of socialist medicine, but in the end, this isn't a socialist plan. It's worse. It's a plan that has "socialist elements." And that's way more confusing than just letting the government run some stuff for you.

Here's your take away: Yes, there will be many elements of this health care plan that will be a disastrous mess. That's not really anything like Canada at all, but they don't have the same concerns about government control and possibly paying for the health care of some lazy slacker the way that Americans do. They also don't have the same disparate class structure and a healthier attitude about being charitable, so nobody is going to freak out up here about some extra taxes so that their local grocer can have a health plan option. You're going to battle that type of animosity about not wanting to pay for welfare mammas and gangsters to get health care every day that this plan exists.

Up here, health care is a concept that creates national identity and unifies. This is not what is going to go on (or is going on) in the States.

I said it before, and I meant it, I think the U.S. is too large and complex for a government solution to health care. I think it's about to be a bumpy ride down there. I hope that I'm wrong and the real outcome is healthier children and less preventable disease.

Ok, go for it. You can argue all you want. You just can't do it anonymously on here any more.²

I also did some, I'm sure, polarizing writing on the topic of egg freezing and late-life fertility last week. Maybe I can create two massive rifts between my friends in just one week.

¹ Pookie's response to seeing this video: "Wow, those white people look pissed off. And PROUD. But where are the Black people? Where are the NATIVES? I saw the Olympic opening ceremonies. There should be NATIVES everywhere."

¹ Yes. Sadly, we've had to remove anonymous comments from here. This can be attributed to a former friend who refuses to go away, and failure to respond to emails etc. has led to a periodic trolling of my blog comments. I know. Seriously, right? YOUR IP SHOWS UP IN THE LOGS, MORON. But while I have your attention, here's a clue: If I have not spoken to you in YEARS now, the chances that I have any interest in changing that are, to put it politely, slim to none. I prefer my life without you in it. Some have said that my ability to cut people out on the fly is a character flaw, but I think it's healthy. You should try practicing the same wall building. Then I could open my blog comments back up all the way.