More Debate on Obama's Health Care Plan: Canada Dragged into the Fray Yet Again

Here's an opinion piece from the Globe and Mail.

Now I'm proud of our health care system and I'm happy to be working within it. I have said before that I feel free to practice medicine in a way that is in line with my values. I don't feel restricted in any way at this point. Maybe that would be different as an independent doctor (rather than as a surgical trainee), but I doubt it.

One thing that I do want to point out from this article though is the lack of any reference to the Social Determinants of Health. I have talked about them in a previous blog. It's the whole idea that we should be looking upstream for the causes of medical issues rather than devising ways to treat the problems that result.

The article doesn't give Canadian government programs, education and support as a reason for improved life expectancy, child mortality and decreased health care costs. It's not just the medical system doing a great job...it's also the ability of our society to avoid a lot of the problems that come from a lack of programs that knit a safety net for members of society.

I think this may be a way to focus our future efforts too. We, as a society, should take on the challenge of identifying ways to further improve our support systems and see if we can further the inconvenient truth the republicans fear.

Canadian Healthcare: Universal ->Socialized ->Unconstitutional?

I was checking on a favorite blog (Plain Brown Wrapper by Kishore Visvanathan , a Saskatoon urologist) and notices a link to an article in the Wall Street Journal. His tongue-in-cheek title to the post was Tales from the Crypt, which is appropriate to describe the impression that more conservative Americans would have of our 'Socialized' Healthcare system in Canada.

It seems to me that our system is a real enigma to some people. The fact that there is no direct link between payment (income tax) and the provision of service looks to a lot of outsiders like a free system. Many of those same people would grumble, 'I don't trust anything that's free'. I think that the more important thing to look at is how one experiences the system when it's needed.

I would argue (without having used the American healthcare system(s)) that, from a patient perspective, there would be little difference in the feel inside the hospital. I was just in some US healthcare facilities and noticed the same polished concrete floors and same sterile smell that pervades Canadian hospitals. There was the same bustle of people and the same crammed waiting rooms. Outside there were a similar mix of playing children and sombre adults.

I would be that similar stories to the ones recounted in the Wall Street Journal article exist in the US. I have heard of people left behind by the system, only they don't have the money to pay for their treatment, let alone the connections to find a lawyer to challenge the unconstitutionality of their dispair. Even retired Bank of America executives are forced off-shore to be treated (Based on a NYTimes article published yesterday).

With that mirth out of the way, I think that exchanging information across the border could provide a means to enhance both of our systems. I hope to spend at least a year in the US seeing how things function. I would recommend coming up here if you don't believe that Canadian healthcare is doing the job. You might be surprised at the results we're getting, despite the word on the street about a few unfortunate cases.