Universal Health Care

The Success & Future Success of Universal Health Care Frederick Ding

Canadian History CHC2D Mr. Manuel Sanchez July 28, 2008 Revised April 2009

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The Success & Future Success of Universal Health Care Universal health care, with all its flaws and limitations, is a viable system that has been proven successful by

Medicare in Canada and that will continue to succeed well into the future. It is a simple matter to quantify the positive effects Medicare has had on health since the 1960s — both statistically and socially — and these far out-

weigh the few overrated downsides. In addition to the positive and visible effects, the system in Canada recognizes

the principle that affordable health care is a basic right, and that the government must take care of its citizens. Indeed, its founding by Tommy Douglas has shaped the Canadian society in ways no other event has. Looking forward into the future in an ever-changing world, the Canadian implementation of universal health care is one

that is both economically sustainable and wide in coverage, making it a suitable model for the United States and other such nations in their futures. The founding of the Canadian health care system, and its present-day exist-

ence, are some of the most significant events in Canada’s modern history, and influence more than thirty million Canadians every single day.

Certainly, Medicare is an important social program for every Canadian, whether ill or well, and statistics

are the first and easiest way to see its benefits. Alexandra Shimo (2008) noted that the life expectancy of men and women are greater in Canada than in the United States. Also, a smaller percentage of Canadians suffer from

heart disease, diabetes, and obesity than Americans (Shimo, 2008). The (statistically) better health in Canada is

sometimes attributed to healthier lifestyles and food choices, not necessarily the health care system. Conversely, the federal government is still responsible for preventative care and public education campaigns such as Canada’s

Food Guide (Shimo, 2008). The only thing that sets Canada apart from the United States in this area of health is government involvement in the well-being of its citizens, which clearly has had positive impacts.

However, there are notable flaws with the system that shows its limitations as compared to the American

market-oriented system; waiting times and technology are two of the most commonplace problems. Waiting time

issues begin at a basic level: sick Canadians generally wait more than four hours while waiting for emergency room treatment (Shimo, 2008). Those with life-threatening diseases such as cancer could wait for weeks or months on

end before undergoing complex procedures (Shimo, 2008). John Goodman (2005), writing for a publication of a libertarian think tank, claimed that fewer U.S. seniors perceived long waiting periods — for both serious and non-

emergency surgery — as compared to seniors in Canada. (However, that argument was based on data from 2000, whereas Statistics Canada (2006) estimated about 60% of those needing cardiac or cancer surgery waited less than

a month.) Those who complain about waiting periods are often those electing to receive non-emergency surgery; admittedly, the perception of long waiting times exists in Canada. Also, when it comes to technology, Canadians receive less high-tech medical procedures per capita compared to Americans, such as in coronary bypass surgeries (Goodman, 2005). Simply, health providers in the United States have good income and can afford loads of great

technology, while “Canadian hospitals can’t invest in medical equipment or new technology as easily” (Halvorson, 2007, p. 83); the United States had nearly three times as many CT scanners than in Canada per million people

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(Canadian Institute for Health Information [CIHI], 2005). Evidently, Canadians face longer waiting periods than Americans for the same treatment, and Canadian facilities have less high-tech equipment than American hospitals

and clinics; these facets of universal health care convince some, such as John Goodman, that the Canadian system is inferior to a capitalist approach.

On the other hand, those flaws are far outweighed by social benefits. The Canada Health Act, which deliv-

ered universal health care to all citizens, contains many important messages, perhaps most notably “that continued

access to quality health care without financial or other barriers will be critical to […] the health and well-being

of Canadians” (Canada Health Act, 1984, preamble section). This assurance is well embodied in Canadians’ will-

ingness to seek care without being impeded by fear of medical costs. Typical Canadian citizens and permanent

residents do not concern themselves with finances when it comes to treating common ailments and injuries, and it is a foregone conclusion that they will seek professional care; only 12% of Canadians, compared to 31% of insured

Americans and 68% of uninsured Americans, choose not to seek treatment (Shimo, 2008). Though Medicare is

only obligated to provide basic care (CBC News, 2006), that basic care makes a big difference; in other systems where even basic care is not covered, potential patients often decide whether to go to a hospital or doctor based

on their ability to pay, as illustrated in Uninsured in America, when “[t]he cost of the emergency room sometimes

deters her [a woman with migraines] from going, even when she is in terrible pain” (Sered & Fernandopulle, 2005, p. 67). (It is important, though, that Canadians have basically the same health as insured Americans with good coverage, and that Canadians are only truly advantaged over the tens of millions who are uninsured or whose insurance policies do not cover much (Shimo, 2008).) Goodman (2005) argued that the Canadian system doesn’t allow those who can pay and “need” the care to get it first, but the universality ensured by the Canada Health Act

was specifically intended to prevent people from receiving different care based on financial status; for instance, one cannot pay more to jump to the head of the waiting list (CBC News, 2006). Thus, the Canadian health care system has improved the general health of Canadians by treating everyone, including poorer persons, leading to a better perception of health and the health care system overall as well as visible consequences.

At a fundamental level, health is a basic right that falls under the broad government responsibility of public

welfare. In a nation such as Canada, where “peace, order, and good government” are founding words, “Canadians

want both [federal and provincial] levels of government involved in health care” (Lazar & St-Hilaire, 2004, p. 40). As is the case with nearly every other Western industrialized nation (Halvorson, 2007), Canada provides universal

coverage to all of its citizens as well as permanent residents, and the reasonable care that is afforded to everyone, pre-paid through taxes, satisfies the medical needs of most of the population. For many Canadians, as is the case with many people in the United Kingdom and France, losing Medicare would provoke a vocal reaction as though they had been deprived of a right; after all, Canadians do value the system and consider health care a basic right

(“Health Care”, 2008). It is simply inconceivable to have to pay as much as $12,500 for an appendectomy (Sered

& Fernandopulle, 2005), and as one elderly woman mentioned on Michael Moore’s Sicko (2007), no average Can-

adian family could easily pay that cost. Even John Goodman (2005), who resists the “right to health care”, noted that the general belief is that people in Toronto and London have a right to health care which is not present in

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the United States (although he went on to argue that there is no such thing as a right to health care, a position that does not conform to most of Canada’s population). Finally, doctors perceive for-profit insurance systems as

obstructing good patient care, and recently many American physicians have spoken out in support of universal health care as a system that would benefit the patients as opposed to generate profit for the insurance industry

(Nash, 2008). All things considered, Canadians have developed over the years a vision of the right to health care that has now manifested itself in every class of society, and this right — granted by the population to itself — can hardly be taken away.

Generally speaking, and having considered all of the things that were previously mentioned, it is not easy to

disregard Medicare as one of the most significant schemes in Canada’s history; unquestionably its founding and

record was just as significant in this nation’s history. In 1962, Tommy Douglas, then premier of Saskatchewan, proposed a revolutionary change: Medicare. Before his plan, about 99% of Canada’s population already had access

to hospitals (“Health Care”, 2008), but beginning in 1962, every person would have access to doctors, who would collect their fees from the government. The doctors resisted the plan much the same way as some doctors in the

United States resist universal health care; they protested that they would receive less income (“Health Care”, 2008). However, over time, a number of compromises between the government and doctors led to the Medical Care Act of 1966, by which health insurance extended to doctors, and by 1972, citizens in every province began receiving

universal health care (“Health Care”, 2008). In 1984, the federal Parliament unanimously passed the Canada Health Act to provide federal funding for provincial programs, to equalize the provinces (a duty of the federal

government) and to regulate health care — the last was the reason for its significance, as the bill also prevented

discriminatory practices where doctors charged patients user fees (Lazar & St-Hilaire, 2004). For the first time, all citizens and permanent residents received guaranteed access to basic health care, with assurances of universality and accessibility. The path to universal health care in Canada stemmed from the determination of Tommy Douglas

“to create a better, more humane society” (CBC, n.d.); this is the respected ideology that won Douglas the title of “The Greatest Canadian” (CBC, n.d.).

In addition to the system’s historical significance, it is important to consider that the Canadian system has

been economically sustainable, with each person paying less than their American counterparts, and that the system

not only impacts a large population but also covers most medical expenses. First, the federal government has set out funding for provincial health care systems in the Medical Care Act and Canada Health Act, as well as strict

guidelines that violation of the Canada Health Act would lead to reductions in funding, thus encouraging com-

pliance (Lazar & St-Hilaire, 2004). The combined funding of both levels of government means better and more

equal care in all provinces. Government-mandated and financed health care means that Canadians spend (on taxes, premiums and supplemental insurance) $2,600 less per person than Americans (Halvorson, 2007). While paying less — admittedly decreasing some physicians’ incomes — the health of Canadians is better! Indeed, if Americans are willing to pay less for health care — instead of employers optionally paying for their employees’ insurance, one

pays a low premium to the government — then the present Canadian system which has survived the past two

decades will surely work in the United States. Yet it is not entirely about money; though prescriptions, dental care,

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and such “non-essential” health benefits are not covered by the health care systems of most provinces (Halvorson, 2007), expensive but essential operations are almost always covered. It is just about impossible for a person to opt-

out of the universal health care system, as we all need it; no individual wants to be the ill-fated person who has cancer but no health care, as mentioned in one example in Uninsured in America. (There should be no choice but

to subscribe to the health care system, because it is precisely ill-fated individual choices, such as choosing to not have employer-provided insurance, advocated by Milton Friedman (2001), that lead to catastrophic financial difficulties.) With the Canadian health care system, if one has a life-threatening condition — for instance, coronary

heart disease — that medically necessitates surgery (eg. coronary artery bypass), there’s no worry of a $20,000 cost, as coverage of all medically necessary procedures is ensured (Canada Health Act, 1984), whereas many insurance

companies will try to find reasons to deny coverage. When one considers that all people should have health and health care, Canada’s system is an ideal way to bring health to all North Americans while reducing spending — the only obstacle being the private industries.

Overall, it is clear that Medicare has been and is a beneficial system for Canadians. Statistics and social atti-

tudes clearly represent the universal health care system’s positive benefits on Canadians and Canadian society; these numerous pros outweigh the few cons, and the system is one that citizens have come to value. Canadians have also come to value health care as a basic right, and essentially demand that the government have something to do with providing health care to all citizens. Indeed, the very system from which more than thirty million people benefit

every day is historically significant and based in noteworthy events started by an important person, and the path

that has brought universal health care to Canadians can continue to promote health care for other nations. Indeed, universal health care has succeeded and remains one of Canada’s proudest and most significant social programs. 

Universal Health Care

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