Myths and facts about the Canadian vs US health care systems
Myth: The US has a private health-care system, Canada has a state-run health-care system
Fact: The public sector (i.e. the taxpayer) spends more on health care in the US than in Canada. There is Medicare, Medicaid and the VA, for starters. Then there are various state plans, subsidies and public hospitals, not to mention the NIH. In Canada, on the other hand, the health care system is essentially private, unlike systems like the NHS in Britain. What we have up here is not "socialized medicine", but a government health insurance system. Doctors are self-employed professionals. Drugs and various other things are outside the government system.
Overall, the US spends twice as much per capita on health care as Canada, meaning that after you have footed the same tax bill as we do to support the public parts of your health care system, you then have to go out and buy health insurance on top of that.
Myth: The Canadian system is one-size-fits-all; the US system gives people more choice.
Fact: I once applied for a job in the US and was asked to choose between four different health-care plans. All of them were worse than what I have in Canada. Here I have a plan with no limts, no deductibles, no copay, and I can see any doctor I want.
Myth: Because it's cheaper, the Canadian system is inferior. Those waiting lists, for example ...
Fact: A large part of why our system is cheaper is that it's more efficient. You see your doctor, he sends the bill to the government, they pay it, period. The money comes out of your taxes, which you have to pay anyway, so there's no extra paperwork. As to waiting lists, they make for good headlines, but remember William Randolph Hearst's maxim about man bites dog. I needed arthroscopic surgery for my knee last year: I got it within two months, most of the delay being so I could have an MRI scan done. Waiting lists are real, but they're not as much of a problem as they're made out to be.
Truth is, everybody's health care system is in a state of crisis, and for the same reasons: aging populations and the ballooning costs of new technology. Everybody ends up rationing, in one way or another: we do it through waiting lists, the US does it by cutting millions of people out altogether.
Myth: the Canadian system "levels down", so everyone gets stuck with the same level of care even if they can afford more.
Fact: If you've got the money, you can always go anywhere you want and pay for it. In fact, some of our hospitals are among the best in the world, and people come here and pay for it. The Hospital for Sick Children in Toronto has a very big rep; the Montreal Neurological Institue ditto. Conversely, if a Canadian with money wants to go to the Mayo clinic or Johns Hopkins, there's nothing stopping him.
Although I bet those places have waiting lists.
It's true that we could use more doctors. The bottleneck there isn't the government but the doctors' union, which makes it very hard for immigrant doctors to get qualified - even from places like Britain. Also in the 90s we had a right-wing government here in Ontario, the most populous province, which figured that a good way to save money was to close hospitals and cut funding to the med schools. Our federal government also busted its ass to balance the budget in the 90s (we have a budget surplus as a result, imagine that), and skimped on health care to do it.
Even so, we have 3.2 hospital beds per 1000 population, compared with 3.0 in the US. We have 1.9 doctors per 1000 compared with 2.8 - a legacy of the above problems, which will eventually get solved. But lest Americans think that 2.8 per 1000 is shit-hot, consider that Sweden has 2.9 doctors and 4.0 hospital beds per 1000, and spends 9.2% of its GDP on health-care compared with 14.6% in the US. For Germany the numbers are 3.6 doctors, 9.1 beds and 10.9%. France: 3.3 doctors, 8.2 beds, 9.7%. Canada spends 9.6%, and our outcomes (life expectancy, infant mortality, 5-year survival rates for most serious diseases) are better than yours.
In other words, the US spends a lot more and gets a lot less for it.
That's the price of ideology.