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Americans Fear Canada's Health-Care System, But Not as Much as Canadians Fear America's


Julie Mason has a sharp column in the Ottawa Citizen noting that "for years, Canadians have feared the American health care system; now Americans are being told to fear ours." She does a nice job knocking down Sen. Mitch McConnell's odd characterization of Canadian health care.

The whole exchange reminded me of a fun section from T.R. Reid's book "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," which makes clear that Canadians and Britons view the American health-care system with exactly the same mixture of fear and contempt that Americans reserve for the Canadian and British systems:

The American health care system is constantly invoked by politicians all around the world as a dangerous jungle to be avoided at all costs. Whenever some aspect of a nation's health-care system is criticized, the all-purpose response from those in power is "At least we're not as bad as the Americans." I saw this dynamic at work over and over again when we lived in Britain. Each week in the British parliament, the prime minister has to face a barrage of inquiries and insults known as Prime Minister's Questions: Almost every week, somebody from one of the opposition parties complains about the National Health Service: Doctors are underpaid. Hospitals are leaky and crumbling. Patients have to wait months or even years for surgery. Something must be done!

In reply, the prime minister -- both Tony Blair and his successor, Gordon Brown, used this gambit -- goes on the attack. "The honorable gentleman opposite," the PM declares, "clearly hopes to turn our health-care system into a profit-making corporate enterprise as the Americans have done. This we will never do."

As you can see atop this post, however, there is actual survey data on how satisfied various countries are with their health-care system. The numbers behind that graph come from a 2007 poll conducted by the OECD. As you can see, Americans lead the world in hating their patchwork mess of a health-care system. In that, if in nothing else on health care, we are, indeed, number one.

By Ezra Klein  |  July 28, 2009; 2:24 PM ET
Categories:  Health Reform , Health of Nations  
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Next: The Audacity of Normalcy


This reminds me of what various countries call 2 vs. 1 tennis, when you're missing a fourth. I went to summer camp in Canada, where they call it Australian doubles. In the US we call it Canadian doubles. Then I met an Australian, who of course said they call it American doubles.

Posted by: _SP_ | July 28, 2009 2:51 PM | Report abuse

So what else is new?

Posted by: lensch | July 28, 2009 3:11 PM | Report abuse

Senators McCain and McConnell are obviously totally ill informed about Canada. I suggest they should visit Canada and see patient care first hand rather than propagate third hand stories from friends of friends.

In Canada, we have an excellent health care system run by each provincial government. Every single individual has free access to GPs, hospitals, surgery etc. free of charge. Most hospitals are state-of-the-art. Canadian doctors are some of the best in the world. Hospitals in the US often make lucrative offers to Canadian specialists, but most senior physicians and surgeons prefer to stay even though they earn a great deal less money here because they prefer the freedom to make decisions in the best interest of their patients rather than the insurance companies.

I had cardiovascular surgery a while back and did not have to spend a dime from my pocket. Patients are NOT expected to co-pay or part pay, entire medical facility is free of charge for residents in Canada.

Some problems do exist and these relate mostly to wait times. But in the last few years these have been mostly overcome. No serious patient has to wait for surgery and it is utter nonsense to suggest (as done by some US lawmakers) that patients die because they are too old and not worth saving.

Americans will be fortunate to have a health care system like ours where insurance companies have no role to play except in a very limited way.

Posted by: bcfs | July 28, 2009 3:33 PM | Report abuse

"Senators McCain and McConnell are obviously totally ill informed about Canada."

Why do people assume this? They are lying. Or they are simply content to be ignorant and repeat what is untrue, which is the same as lying.

Posted by: steveh46 | July 28, 2009 4:41 PM | Report abuse

This isn't just the classic "outsider name" thing that _SP_ mentions, where syphilis was the "French disease" in Italy and the "Italian disease" in France.

Even in countries with very little rivalry or antipathy towards the US, there's the common perception, carried on the back of anecdotes, that if you show up bleeding at the hospital, you'll be sent to a billing office before you see a doctor; that if you twist your ankle and get patched up in the ER, you'll get a bill for thousands of dollars; that if you get really sick late in life, you might end up bankrupt.

This is all despite this stuff being largely inivisble from the medical drama TV exported abroad -- the only network show in recent years that ever focused on cost cutting and the uninsured uninsured was Scrubs.

Posted by: pseudonymousinnc | July 29, 2009 11:05 AM | Report abuse

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