US Health Reform – Blame Canada?

Canadians must wonder how bad our health care system is if President Obama has to defend his health reform bill by saying “Don’t worry, it’s not the Canadian system.” Sure we have our complaints, but are we really the Dark Side?

The US House and Senate have not conformed to the President’s will that they pass a bill before the August recess, so he will have to spend the next six weeks convincing the American people that his proposals will benefit them.

Yet his proposals are relatively modest compared to what is already available in Canada. The main plank appears to be to create a new public health insurance body to compete with all the private sector companies out there—and that is the main source of the opposition. One of the defining aspects of the President’s proposed reforms is the concept of a one-stop shopping marketplace. Under this plan, Americans would be able to compare the benefits, cost and track records of various insurance plans, including a newly created public insurance option that will add to their choices and make the other plans more competitive.

Obama also proposes to end insurer practices such as yearly caps or denying new members because of pre-existing conditions, and promises that Americans will not lose their insurance if their job changes or disappears.

The ideology behind better health care coverage is fairly universal. The World Health Organization principles for improving health financing are: reduce large out-of-pocket payments at point of service; increase the accountability of institutions that manage health care and insurers; improve pooling of health fund contributions across the rich and poor, healthy and sick; and do all these things through administratively efficient means.

These principles, taken together, are the same ones that underlie the 1984 Canada Health Act. It clearly articulates the ideals of our public health insurance system: universality, accessibility, portability, comprehensiveness and public administration. The Act enshrined the First Ministers’ dedication to these principles as well as their commitment to increase transparency and accountability, while promoting sustainability.

Obama wants to create efficiencies through a large new public plan that will present his constituents with a competitive alternative to private plans. This sounds like a lot like adherence to the Canadian principle of public administration, and is already present in the U.S. system through Medicare for the elderly. The President also wants to reduce barriers to access and enhance portability: again, sound familiar?

Even the President has to Talk that Talk

Given the obvious parallels, it’s no surprise that in the past few weeks our health care system has been subjected to intense American scrutiny. Commentators on this side of the boarder have drawn a parallel with Tommy Douglas’ health care reforms in the 60s, which were vehemently opposed by vested interests. Many Americans seem to be living in fear that these reforms will bring them a system like ours. While those who oppose reforms are trumpeting so-called Canadian “horror stories” like that of Shona Holmes, other Americans are genuinely trying to understand our system.