Despite its faults, Canada’s health care system remains better than America’s

With the recent approval of "Obamacare" in its entirety by the U.S Supreme Court, extending coverage to more than 30 million Americans, the differences between the Canadian and American health care systems are again in focus.

Universal medicare is seen as one of Canada's most important national institutions, which respects the equality of every Canadian for health purposes.

America until now has handled the health needs of its citizens very differently. For example, a physician friend of mine moved to the northeast of the United States several years ago and began a family practice. Having to treat patients according to widely differing health insurance coverages, rather than their diagnosed needs, troubled her so much that she returned to Canada. A study some years ago indicated that the administrative costs of private health care spending in the U.S. represented virtually a third of all such spending, compared to 16.7 percent in Canada.

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Respect for our health system should not blind Canadians to problems, including availability of services, long waiting times for specialist and emergency care, and shortages of nurses and physicians in many regions of the country.

Consider what happened recently to a 63-year-old widow, who was taken because of very high blood pressure by ambulance to the emergency admitting room of a large hospital in a Canadian city. She reached the emergency admitting about 1 a.m. and was seen by a physician after approximately a two-hour wait. He took her blood pressure, but gave no other tests and told her she should contact her own physician. She replied that she had no personal doctor and lived alone, but he sent her home at about 6 a.m. with no treatment. Understandably, she was unimpressed and worried. Similar experiences probably occur in other communities across Canada.

In 2005, the market-oriented Fraser Institute concluded that Canadians spend more on health care than any other advanced industrial democracy in the Organization for Economic Co-operation and Development (OECD) with publicly funded and universal access, except Ireland and Switzerland. Most of the countries studied charge user fees for access to hospitals, general practitioners, or specialists. Ranked against other OECD members, Canada was only 16^th in healthy life expectancy, 21^st in infant mortality, 24^th in doctors/1000 population and 17^th in MRI and CT machines per million population. Despite our level of public and private spending on health care, we are clearly not a world leader in health care.

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Widespread behaviour modification, which would include reducing smoking, losing weight, more exercise at all ages, minimizing drug/alcohol abuse, avoiding risky sexual behaviour, would foster a healthier Canada. Most of us would live longer — and live better.

Dr. Jeff Turnbull, Past-President of the Canadian Medical Association, notes that about $5,200 per Canadian is now being spent on health care yearly. A major need, aside from more effective illness prevention measures, he says, is to "drain the swamps" through investments in effective social services. He mentions, for example, that about 900,000 Canadians, many of them children and adolescents, now visit food banks monthly, and that about one in 15 Canadians are homeless or living in substandard housing. He rightly concludes, " … the poor pay for their poverty with their health."

Rob Rainer, Executive Director of Canada Without Poverty, adds tellingly that there is now a 21-year difference today in the life expectancies of residents of, for example, Hamilton's wealthiest and poorest communities. The gap between rich and poor Canadians is much greater now than years ago — and growing.

Senators Wilbert Keon and Michael Kirby, both health care experts, have correctly asserted that governments should not be able to legislate themselves a monopoly over health care and then fail to "deliver timely access to necessary care." Among their suggestions to improve service is that medical professions everywhere should provide services through multi-disciplined clinics.

The family clinic I attend sees patients until almost midnight. On a recent visit, the medical staff listened carefully, gave good advice with a caring approach and provided all the time needed to every patient. This is health care that many Canadians can only dream about; it demonstrates again that the attitude of individual physicians and nurses, whether in clinics or hospitals, makes all the difference.