Tuesday, June 9, 2009

WSJ publishes op-ed falsely equating "ObamaCare" with Canadian "single-payer" system

Media Matters for America


http://mediamatters.org/items/200906090030

In a June 9 Wall Street Journal op-ed, headlined "Canada's ObamaCare Precedent," Dr. David Gratzer, a senior fellow at the conservative Manhattan Institute, falsely equated "a new public insurance program" that "Congressional Democrats will soon put forward" to the Canadian "single-payer" system, which he suggested was "government health care" that is neither "compassionate" nor "equitable." In fact, President Obama and key congressional Democrats -- such as Senate Health, Education, Labor, and Pensions Committee chairman Ted Kennedy and House Energy and Commerce Committee chairman Henry Waxman -- have stated that they support the creation of a federally funded "public plan" as one of many insurance options available in the health care market, not as the sole option, as in "single-payer" systems such as Canada. Moreover, Obama has explicitly rejected a Canadian-style system.

Gratzer wrote:

Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.

Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.

My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.

According to the National Library of Medicine's Medical Subject Headings thesaurus, a single-payer system is:

An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company. The proposed advantages include administrative simplicity for patients and providers, and resulting significant savings in overhead costs.

In a June 2 letter to Kennedy and Senate Finance Committee chairman Max Baucus, Obama wrote: "I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest." When asked during a March 26 online town hall discussion, "Why can we not have a universal health care system, like many European countries, where people are treated based on needs rather than financial resources," Obama replied, "I actually want a universal health care system," adding that instead of adopting a "single-payer system" like Canada's, "what I think we should do is to build on the system that we have and fill some of these gaps."

Moreover, Gratzer cited criticism of the Canadian system by Canadian orthopedic surgeon Dr. Brian Day, a former president of the Canadian Medical Association, to falsely suggest that Day is in favor of the U.S. health care system. Gratzer wrote: "Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction," and went on to cite Day's "[growing] increasingly frustrated by government cutbacks that reduced his access to an operating room and increased the number of patients on his hospital waiting list" as evidence of the support from the Canadian "medical establishment" for these changes. However, as Media Matters for America has documented, Day has said he favors the health care systems of several Western European countries, not the current U.S. system of health care.

In an April 27 Politico blog post, Ben Smith reported that, during an October 9, 2008, interview with the Fraser Institute, Day stated: "I think this is what people tend to forget. They equate alternatives to the Canadian health care system with 'Americanization,' which is not what we're talking about. We're talking about countries like Belgium, and Switzerland, and France, and Austria." In an October 22, 2007, op-ed for Canada's National Post newspaper, Day similarly wrote that "the goal of the Canadian Medical Association (CMA) -- of which I am President -- is to help improve our universal system, not destroy it." Day went on to note in the op-ed that he is not in favor of the U.S. system:

Let me be clear: I am not for an American-style system in Canada.

It is true that I believe in competition. But not the type of unhealthy competition that seems to exist between Canada and the United States in health care. As two of the world's richest countries, we seem to be in a race to the bottom when it comes to health. Canada's health system has been ranked 30th by the World Health Organization, and the U.S. was ranked 37th. Why would anyone copy a system that ranks substantially below ours?

From Gratzer's June 9 Wall Street Journal op-ed:

Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.

Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.

My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.

[...]

Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction. In 2005, Canada's supreme court struck down key laws in Quebec that established a government monopoly of health services. Claude Castonguay, who headed the Quebec government commission that recommended the creation of its public health-care system in the 1960s, also has second thoughts. Last year, after completing another review, he declared the system in "crisis" and suggested a massive expansion of private services -- even advocating that public hospitals rent facilities to physicians in off-hours.

And the medical establishment? Dr. Brian Day, an orthopedic surgeon, grew increasingly frustrated by government cutbacks that reduced his access to an operating room and increased the number of patients on his hospital waiting list. He built a private hospital in Vancouver in the 1990s. Last year, he completed a term as the president of the Canadian Medical Association and was succeeded by a Quebec radiologist who owns several private clinics.

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.

In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.

Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?

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