U.S. should adopt Canada's public health care model

NUPGE president James Clancy contrasts advantages of Canada's single-payer system with America's failure to insure all and curb soaring costs

9.5% in Canada vs. 14% in U.S.

"Before medicare was introduced in my country forty years ago, Canada and the United States paid about the same for health care. Today, Canada spends about 9.5% of gross domestic product (GDP) to provide universal health care for all citizens while the U.S. spends 14% and provides no coverage at all for 43 million of its citizens, and inadequate coverage for 100 million Americans," Clancy said.

"Moreover, the U.S. costs are rising while Canada devotes a smaller portion of our GDP to health care today than we did a decade ago.

"The administrative costs of the U.S. system have been estimated to be about three times Canada's.... If the U.S. was to adopt Canada's single-payer model, the savings would be so large as to allow America to provide coverage for those 43 million plus citizens."

Clancy noted that when it comes to critical health outcomes, such as infant mortality and life expectancy rates, Canada rates better than America and is among the best in the world.

"So, in comparison to the American system, Canada spends less and gets more in terms of coverage, quality and outcomes."

Economic sense

Clancy said that adopting a single-payer system in the U.S. is also the smart thing to do because it makes economic sense.

"Though it seems to cut against common sense, the more people with coverage, the less the costs go up. That's because, for insurance to work efficiently, you have to spread the risk among as many people as possible. In a single-payer system, the costs are spread over the whole community and over lifetimes."

"Moreover, under a single-payer model there's no need for rating or discrimination when it comes to patients. Everyone has the same entitlement. So, large administrative savings occur. The system is paid for through general tax revenues. So, there's no need for the multiple collection practices that come with a multi-payer system. And payments are provided directly to physicians and hospitals by the government. So, there's no expensive multi-stage billing."

Clancy also pointed out that Canada's single-payer system provides patients with the highest level of choice.

"I know there is a popular myth in America that choice of doctors is limited in Canada. But the reality is that in Canada, we're free to choose whatever doctor we want," he said.

"We also choose which hospital we stay at. We go to the emergency room when we want and need to. We choose who our specialist will be. And we decide what our treatments will be too. There are no 'physician gag clauses in insurance contracts'. We don't have to worry about reading the fine print. There's no 'renewability clause'. There's no need for doctors to seek 'prior authorization' from our insurance company before proceeding with a diagnosis and treatment. In Canada, all decisions about care are left up to patients and their doctors."

Take a stand

Clancy told the audience that with a presidential election campaign underway, it's the perfect time for leaders in America to take a stand, to acknowledge the sizeable, strategic advantage businesses in Canada have, and to work to put the issue of single-payer, universal health care at the top of the U.S. political agenda.

"I don't expect them to do this out of moral strength or a sense of public spiritedness. But I would expect they would come to their senses and do it because it has a strong bottom-line appeal."

Clancy noted six distinct benefits that a single-payer system offers businesses:

• a healthier and more productive workforce.
• less labour relations strife.
• more spending money for consumers to purchase private goods and services.
• less job lock and increased labour mobility because workers that don't have to worry about losing basic health benefits are more willing to switch jobs and move to where the work is.
• lower administrative costs for businesses because they don't need to hire expensive HR consultants to explain, negotiate and administer the ins and outs of private insurance schemes.
• the creation of new businesses because, for potential entrepreneurs, quitting a job would not mean forgoing health insurance, which would most likely be a risk too big to take.

Clancy also pointed out that Canada's single-payer system also offers big advantages to unions and their members:

• there's one less item employers can threaten to take away from workers;
• there's one less item employers can use to push down, or hold back, wage increases;
• health care is usually incidental in labour negotiations in Canada; in contrast health care costs are a large and growing pitfall in contract negotiations in the U.S., being the key factor in over 50% of recent strikes and lockouts;
• striking or locked-out workers don't lose health care coverage in Canada;
• and medicare frees unions in Canada to concentrate their resources on other important fights.

"I think all of us in the trade union movement should recognize that a single-payer health care system is like a win at every bargaining table," said Clancy.

Clancy ended his remarks by reminding the activists that "civilization happens because we don't leave things to other people."

"The eight hour day, the minimum wage, the protection of our air, water and natural resources, women's rights and civil rights, social security, and medicare in Canada - these 'good things' were no accident. They didn't fall from Mars onto Earth. They were the invention of creative and determined men and women back in the 1960s.

"Unions and their members and citizens movements in Canada and the U.S. fought hard and won the endorsement of the political class for these 'good things' only after long struggles. The lesson is clear: if you are going to get a single-payer system in the U.S., and if we're going to protect it in Canada, then we have to stand up and fight for it - as if the cause depends on each one of us, because it really does." (NUPGE)

Web posted by NUPGE: 22 September 2004