Steve Lunetta: On Canadian health care

In 1984, Canada created a form of universal health care for its residents that is, essentially, free at point of use. However, it does not include prescriptions, home care, eye glasses or dental. All those things are still out-of-pocket. Many folks of a blue persuasion in the United States point to Canada and say, “See, they can do it. Why can’t we?” Then other folks of a red ilk say, “Look at all the Canadians fleeing from their arctic homes to get treated here. Their system is a failure.” Which side is correct? If Canada’s single-payer system is indeed a failure, one sign would be Canadians heading south for their medical care. If they don’t, then it seems to point to a good system in Canada that may work here. Many of the examples brought forward by both sides are anecdotal attempts to tug at our heartstrings. One such story is that of Sharon Shamblaw, a 47-year-old stay-at-home Canadian mom who was diagnosed with leukemia (Toronto Star, 4/27/16). Her shot at life seemed to be available only as a procedure in the United States, but delays in Canada in the approval of her treatment allowed for a return of the cancer that she thought was in remission. Thus “socialized medicine” may have resulted in her terminal prognosis. Without a doubt, our hearts go out to Sharon and her family. But shouldn’t we be looking at the system as a whole and not individual cases? I’m sure we can find anecdotal stories on the other side that tell a much different tale. A frequently referenced paper by Steven J. Katz (et al) was written in 2002 called “Phantoms in the Snow: Canadians’ Use of Health Care Services in the United States.” While old, the paper was based on Canada’s 18 years of experience with single-payer health care. In the Katz paper, the authors state “surprisingly few Canadians travel to the United States for health care, despite the persistence of the myth” that they do so. Katz looked at the U.S. health care facilities along the Canadian border. Some 40 percent saw no Canadians; another 40 percent saw 1 to 10 a month. The other 20 percent generally saw 10-75 a month, with no facility seeing more than 100. Not a deluge of Canadians flooding the border. Katz also cited a survey done in 1996 showing only 90 of the 18,000 respondents had gone to the U.S. for medical treatment in the past 12 months. That’s a scant 0.5 percent of the total. Experimental treatments like stem cell therapies are still not widely available in Canada. The Toronto Star reports that as of April 2016, only two hospitals were capable of performing a transplant in Sharon Shamblaw’s province. Canada recently approved $30 million to increase the number of beds available to perform this procedure. Though not conclusive, surveys of Canadian use of U.S. health care facilities seem to indicate the vast majority of Canadians do not travel to the United States for medical treatment, although our northern neighbor’s health care system lacks some specialty treatments.  Let’s keep exploring options and continue our civil discussion on The Signal’s website.