Thursday, August 20, 2009

More on U.S. Healthcare

The Hamilton Spectator had a well-considered article in yesterday's edition written by a Canadian resident who has lived in the United States and experienced their healthcare system. His comparison between our system and the American one makes for some fascinating reading:

Beware the right in health-care fight

Is movement to privatize Ontario's system behind Holmes' battle?

August 19, 2009
John Kneeland

(Aug 19, 2009)

In 1996, through my employer in Sarasota, Fla., I had medical insurance from Blue Cross Blue Shield. Doctors on my short list seemed capable, but I saw them only for basic medical procedures.

Wondering what personal health insurance would cost me now in Florida, I applied online for a quote from Blue Cross Blue Shield. For a man my age (58), the monthly premium was $418.

Copayments for office visits were $20 to $40, with 20 per cent co-insurance (my share of treatment costs for major medical procedures), and a $500 deductible. Perusing the list of exclusions, I noticed a 24-month wait for treatment involving pre-existing conditions.

I called the company and told the insurance specialist I had received laser treatment in Canada for a minor prostate cancer. "Oh," he said, "You'll be declined. There's a 10-year block on any form of cancer." This is a predicament Americans are well acquainted with; more than half of the bankruptcies in the U.S. are due to medical expenses.

In Ontario in the past year, I have received -- besides cancer treatment -- MRIs, blood tests, dermatological treatments and my biennial checkup. I paid for one PSA test. Wait times were insignificant.

In fact, wait times, which were actually worsened in the past by Conservative-inspired tax cuts, have improved in recent years in both Ontario and Quebec. In a 2008 Health Canada study, patients' self-reported median wait times for MRIs and CAT scans were two weeks. Median wait time for a specialist or surgery was a little over four weeks. Most patients waited a maximum of three months.

Currently in the news is Shona Holmes' lawsuit against the Ontario government, which states, "Wait times in the government monopoly health care system are unreasonable and unacceptable by ... medical standards of practice." The suit claims this is a violation of Charter rights.

Holmes had a benign cyst called a Rathke Cleft cyst, which is not life-threatening but can cause blindness in rare cases. On May 27, 2009, Holmes was interviewed by Fox News. She claimed she was suffering from a brain tumour, but could get no medical help in Canada. "I'm just one story," she said. "There's so many out there like me." Holmes told the interviewer that her American friends had advised getting another doctor, then claimed, "that is something we are just not allowed to do here in Canada."

After going on her own to the Mayo Clinic in Arizona and having the cyst removed at a cost of $97,000, Holmes asked for reimbursement from Ontario. The government refused on grounds she did not follow proper procedures.

Holmes' story of distress is compelling; what's questionable is her decision to tell only one side of the story on national television. And her lawsuit, which was prepared by Avril Allen of Boghosian and Associates, goes beyond personal grievances.
Allen sits on an advisory committee to the Canadian Constitution Foundation (CCF), which is funding the lawsuit. CCF describes itself as "a registered charity, independent and nonpartisan ... a voice for freedom in Canada's courtrooms and law schools." Executive director John Carpay, a former Reform Party candidate, has announced the group is funding a constitutional challenge to Alberta's medicare system.

Other CCF advisers have included Ezra Levant, an ultraconservative activist and publisher of the Western Standard ( One of CCF's donors is the Donner Canadian Foundation, which an article in the Western Standard called "the lifeblood of conservative research in this country." Another donor is Atlas Economic Research, whose former president, John Blundell, said his mission was to "litter the world with free-market think- tanks."

When the Supreme Court of Canada decided Quebec could not place an outright ban on a parallel private system of health care, the court majority stated a ban on private insurance "might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness." Accordingly, the Holmes suit is based on a claim that Ontario's services are not timely.

On its website, CCF describes Ontario's "unconstitutional legislative monopoly on health care." In other words, its goal is to bring privatization into the Canadian system.

According to the Romanow report of 2002, privatization, with its unnecessary administrative costs, is both inefficient and a drain on system resources. Dr. Arnold S. Relman, a Harvard professor of medicine and emeritus editor-in-chief of New England Journal of Medicine, states, "The facts are that no one has ever shown, in fair, accurate comparisons, that for-profit makes for greater efficiency or better quality, and certainly have never shown that it services the public interest any better."

Because CCF has charitable status, contributions to it are tax-deductible, which means taxpayers at large are subsidizing its attempts to undermine our single-tier health-care system. That is truly a health care travesty.
Burlington resident John Kneeland was born in the U.S. to Canadian parents. He has lived about half his life in each country.

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