Healthy, Wealthy, Wise
Ben Franklin’s formula
for happiness reminds me of bookends: “healthy” and “wise” support—indeed, make
possible— the “wealthy” in the middle, clarifying the wisdom of investing in
healthcare and education as the foundations of a good life. This brings me to
the heart-warming topic of Canada, and you don’t often find a reference to
anything warm in a sentence about Canada.
My Wife the English
Teacher and I recently traveled to the Canadian Rockies and Vancouver, driving
the six hundred spectacularly scenic miles between. Along the way, two coyotes
inspected our car stopped on a quiet mountain road, we joined a dozen people
closer than we should have been to a black bear and two cubs eating roadside
berries (after concluding that we could outrun at least one of the other spectators),
and my wife (who talks with animals) spoke with a large male elk sporting an
impressive rack.
But the heart-warming
part wasn’t scenery or wildlife. It was the fact that wherever Canadians
gather, every one of them—man, woman, and child—has full health insurance
sponsored by the federal government and the provinces. Imagine it: stand on a
balcony overlooking a crowded mall or on a busy street corner or, for that
matter, in a national park, and every citizen you see is insured with no co-pays
and no deductibles for medically necessary care. Mauled by a bear? Covered. And
some provinces provide limited dental and vision insurance.
Ask Canadians, as we did,
and they’ll almost certainly brighten right up on the subject of their
healthcare. They love it! One woman in her twenties talked enthusiastically about
regular checkups since childhood, prompt visits to her doctor when ill, and the
fact that she has “never paid a cent” out-of-pocket. A seventy-six-year-old Vancouver architect expressed dismay at the failure of the U.S. to care about its people.
He called universal care “a no-brainer” and clearly felt sorry for Americans.
To Canadians, healthcare,
like education, is a basic human right and has been for more than half a
century. Tommy Douglas (1904-1986), a Baptist minister-turned-politician, was
the father of Canada’s Medicare, as it’s called, and is considered by a large
majority the greatest Canadian ever. Douglas is the Abe Lincoln of the nation
who freed its people from unnecessary suffering and the fear of financial ruin.
Costs are funded by part
of a federal progressive income tax ranging from 15 to 29 percent and
provincial/territorial income taxes of from 5 to 15 percent (figures vary
annually depending on revenue needs). The quality of care is excellent, patient
and physician satisfaction is high (better than 90 percent and 75 percent,
respectively), and wait times are little different from the U.S., though
service in remote areas can be problematic.
Among its many
virtues, Medicare is cost-effective, consuming about 10.1 percent of GDP while
insuring everyone. Healthcare in the States consumes about 16.8 percent of GDP
while leaving forty-five million uninsured. Per capita costs in 2009 were
approximately $4200 in Canada and $7900 in the States (cited in AARP.org).
Finally, help is
arriving here. The Patient Protection and Affordable Care Act (known as ACA or
Obamacare) has been phasing in and will be mostly effective by late next year. Because
of resistance in Congress, the ACA is more complicated and less efficient than
Canada’s Medicare, but has eliminated lifetime caps and denial of coverage for
pre-existing conditions, allows children to remain covered in parents’ plans to
age twenty-six, eliminates higher premiums for women, and will eventually extend coverage to more than thirty million uninsured.
The rise in healthcare costs has already slowed significantly and is projected
to reverse after the ACA takes full effect.
Canadian healthcare is
a public service; U.S. care has been about private profit. That’s now changing
for the better. People first.
