I’ve been following the American health care debate, somewhat — it’s like watching a slow-motion train wreck, except less fun. The chances of any substantial legislation passing appears now to be derailed for another 20 or 30 years, or maybe forever, because it’s hard to imagine a more auspicious conjunction of the political stars. So Americans must now make themselves believe (again) they have the best health care system in the known universe, with infant mortality rates higher than Cuba, and Canadians can still retain their annoying moral superiority about our system, which frankly, has vast swaths of suckiness. Just ask any Canadian RN or physician.
Several shifts ago, I was assigned to an area with five rooms. In one of the rooms was a homeless man who was being treated for cellulitis and hyperglycemia. He was eventually discharged to a community care centre where home care nurses would take over. After the room was scrubbed clean, another patient was brought into the room. The second patient was a fairly well known celebrity. I thought that it was remarkable that two people with completely opposite socioeconomic backgrounds were treated in the same hospital, in the same room by the same team of doctors and nurses. The Canadian health care systems may have its problems, but it was nice to see it actually working as intended.
And also this comment on another post of mine by At Your Cervix gave me pause for reflection: her boyfriend potentially faces an expensive course of IV treatment for an MRSA infection. Maha points out that for all of the flaws in our system, there is equality of access. At Your Cervix worries about cost. Here, you would go on Home Care, with RNs visiting you daily.
I’ve worked in both systems. The bottom line is that unless you have gobs of cash and/or a gold-plated health insurance scheme, American health care will suck you dry and spit you out.
I am often severely critical of our health care system for wastefulness and stupidity. As we all should be. Money spent on exorbitant management salaries, consultant’s fees, catered lunches, duplication, inefficiencies and all the rest undermines public trust and confidence in the system, and worse, is money directly taken out of front-line patient care. It is inexcusable.
Yet I would take our system over the American without thinking about it twice. The reason: in terms of crude outcomes, like infant mortality, five-year childhood mortality, life expectancy, cost as a percentage of GDP, access to primary care and the like, the Canadian system consistently outperforms the US. And everyone is covered, without exception. We can argue about the middle and particular cases, like wait times for hip replacements or time to cancer treatment. But we also tend to forget (sometimes too conveniently) that health care in the US is rationed as well. Forty or fifty million people, depending on what statistics you hear, go without insurance, and millions more are grossly underinsured. Here you wait for elective orthopaedic surgery.
The point remains: overall, Canadians are actually pretty healthy. Despite our socialized, horrible, bureaucratized, death-panelized system.