Dear President Obama:
I am taking a break from my normal satirical commontary to offer an opinion on your current mandate.The fall session of Congress is set to re-engage in discussions around Health Care Reform. Both side will undoubtedly be just as far apart in coming to a resolution as they were before the summer. However, this is based mostly on political dogma and not on delivery of a public health care model that is equitable and economically sound.
Sadly, Canadian health care is frequently dragged into the argument for Universal Coverage. I say “sadly” because both sides use it as an example of how it does or doesn’t work. It is true that all Canadians have access to health care, however, it is neither free not quality (for the most part). We have access to universally poor care, long waiting lines, and no choice to pay for better care even if a person has the means. And most of us pay for it twice: once through the basic income tax contribution and second through provincial Medical Service Plans that deduct from your wages. Some places also institute user fees to see practitioners.
Furthermore, adopting such a system in the United States would not solve the problem because throwing more money at it will still do little as long as we have “Sickness” Care in North America, not “Health” Care.
Canada and the United States both contribute the majority of their public funding to health care (when you consider indirect spending in drug R&D and insurance claims in the US) and that figure continues to climb every year. While it’s true both our populations enjoy the highest standards of living in the world (on average) and some of the longest life spans, health care focuses more on illness treatment, not illness prevention. When you consider that more than 60% of deaths this year in North America will be from heart disease, stroke, diabetes and respiratory illnesses, nearly all of which are due to lifestyle and thus, preventable, putting more money into treating people once they are in hospital is a losing cause.
So what is the best option?
- Nothing of value is free; people only appreciate that in which they have invested. Provide an opportunity for every American to purchase a basic “universal” health insurance plan that provides them with access to a family doctor and a basic deduction for prescription drugs. This insurance could be no more than the cost of a case a beer a month. As well, the cost for this should be tax deductible, so it is cost neutral for citizens but don’t make it free.
If someone arrives at the doctor’s without insurance, their first installment can be purchased on the spot.
- Provide tax credits for “Active Lifestyle” investments. One thing Canada does do right is a recent decision to provide up to $500 tax credit per child per year to participate in local sports. This should be implemented in the U.S. and extended to adults to join gyms, take up tennis, etc. The tax credit eliminates the barrier of exercise being “too expensive”.
- Ban the production, import or sale of all tobacco products. Cancer, heart disease, emphysema, stroke etc. Can you imagine trying to introduce cigarettes into the marketplace for the first time now? You would be branded an insane criminal on the scale of Pol Pot. Unlike the prohibition on alcohol in the 20’s and 30’s, small scale domestic growth and distribution of tobacco would be practically impossible. And to all those who say we can’t afford it because tobacco taxes bring in too much revenue, understand that they are a small portion of the cost of treating someone in hospital and the loss of productivity due to ongoing illnesses and death to the economy.
- Train more doctors and nurses. Across North America, communities (especially small or remote ones) are in desperate need for medical practitioners. However, schools maintain relatively small classes. While I understand the need to maintain high entrance standards, taking in an extra 10% every year will not diminish the overall “intellectual” average of the graduating class. Furthermore, the added cost to train more doctors and nurses is easily compensated for by the boost to the economy by having more highly paid professionals in the work force and the subsequent improvement to common health by having greater access to more doctors, nurses, technicians and nurse practitioners.
I’m sure that there are other improvements that can be made. However, as long as we are only focused on how to put more money into the current paradigm, whether it is through government coverage, HMO’s, or “free” insurance plans funded by the government, there will be no solution.
Your Canadian Friend,