Where could Americans go?

Advocates of single-payer health care overlook the fact that people in single-payer countries often have a safety valve “• a place they can go when their government health care system fails them.

Canadians who need services they can’t get, or can’t get quickly enough, often come to America. Watch this 5 minute video:

A Short Course in Brain Surgery

and then ask yourself: where could Americans go if we had the same system? What would be our safety valve?

Steve Buckstein is Senior Policy Analyst and founder of Cascade Policy Institute, a Portland-based think tank.

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Posted by at 11:00 | Posted in Measure 37 | 31 Comments |Email This Post Email This Post |Print This Post Print This Post
  • Jeff

    The Bahamas?

  • devietro

    You may actually see a black market of private “cash only” doctors. It seems like a demand might be created for that when you need an organ transplant in 6mnths but the waiting list is 3yrs.

    • Catalyst Administrator

      The comment that was here was removed due to innapropriate language. Swearing is not part of Catalyst protocol. Please visit other blogs that relish in people’s opportunity to curse.

      • Steve Buckstein

        The comment that was removed for inappropriate language included the following statement. It was responded to below:

        “And of course, we currently have Canada and Mexico when our system fails us; the extent we go to them has been thoroughly documented.

        “I am a mid-thirties healthy male who was recently denied health insurance because I went to a chiropractor six times two years ago (costing the insurance company about $360, when I’d put in $250/month).

        “What……am I supposed to do in our system?”

        by Anonymous

  • John Fairplay

    Anon, you are a perfect example of how misuse of the health care system causes problems. Are you telling me that you submitted insurance claims to cover $360? Do you know how ridiculous it sounds that you would not just pay that out of pocket? It’s $60 per visit!!! I don’t blame them for canceling your policy.

    Insurance is for catastrophic circumstances, not run-of-the mill expenses.


      Exactly John! Thank you for pointing that out!

    • Jerry

      Plus, chiropractors shouldn’t even be covered. Pay your own way for stuff like that…including accupuncture and aromatherapy.

  • Ted Kennedy’s Liver

    Either your story is simply not true, or there is something you are not telling us. I went to a chiro for over a year several years ago and have NEVER had a problem getting health insurance – even when I smoked two packs a day.

    • Anonymous

      I was denied insurance because I have high blood pressure that sits at 120/69. Yeah, I believe he waas denied because of the chiropractor

      • CRAWDUDE

        120/69 is not high blood pressure, its just barely in the pre-hypertension range and your diastolic of 69 is 6 points below average.
        I think there is probably a little more to your story than you’re letting on. Body weight, cholestorol levels, exercise habits, smoking habits ( thats always a biggy for insurance companies, go figure, its also a major reason for elevated blood pressure), drinking habits, etc….

  • Tim Lyman

    Where will they go?

    Well, if they’re rich they’ll go wherever they want. If they’re poor they’ll go to the morgue.

    • dean

      Pretty much as it is for many today Tim. Where do 50 million Americans without insurance go now? And there are probably 50 million more of us who could lose our coverage after loss fo a job.

      • Chris McMullen

        What a crock, Dean. Please dispense with the histrionics. 50 million uninsured (which is a bloated number) still go to the doctor — they just pay for it out of pocket. Like I did many times before I had insurance. It’s the deadbeats who skip out.

        Why do you liberals insist on placating the irresponsible?

      • jim karlocik

        *Dean* And there are probably 50 million more of us who could lose our coverage after loss fo a job.
        *JK:* Good reason to separate health care and jobs.


      • Bad Biy Brown

        And how many of these people are ILLEGALS that seem to NEVER pay a dime for health care; yet bring their little brats into the ER for every little sniffle or scrapped knee?

  • dean

    Steve…i meant to ask…who in America today is proposing that we have a single payer health system modeled on Canadas? And if no one (of substance) is, why do you even bring up this false scenario?

    The choices in front of us this year are to:
    A) elect either Clinton or Obama and get an expanded health insurance system that increases access, reduces costs for most of us, and increases taxes on the wealthiest 2% or so to help pay or
    B) elect McCain and continue to watch our system decompose due to high costs and lousy access.

    Kucinich is out of the race.

    • Anonymous

      So are you

    • Steve Buckstein

      Dean, I believe Obama has stated that if we could start over he’d prefer a single payer system. He may understand that we can’t start over, but others assume we can.

      Specific candidate plans may avoid modeling themselves after the Canadian system, but it is talked about all the time in the health care debates I hear, including discussions in the Oregon legislature. It’s also the closest single-payer system to us, and therefore worth looking at as we consider the pros and cons of such a system.

  • dean

    One added point: According to a study by the Kaiser Family Foundation, the percentage of companies with 200 or more employees that offered retiree health benefits declined from 66 percent in 1988 to 33 percent in 2005.

    • John Fairplay

      “companies with 200 or more employees that offered retiree health benefits declined from 66 percent in 1988 to 33 percent in 2005.”

      Ever hear of Medicare?

      • dean

        John…it sems to me I have heard of medicare. Your point?

        Steve…but there is no need to set up a straw man here. Why not focus on the actual Democratic proposals and show us how those are flawed, instead of Canada’s system, which is flawed but overall still has superior results to our system at 60% of the cost.

        • Chris McMullen

          Superior to our system? In what way? Long lines and wait times for crucial surgeries? Yeah, Canada has us licked there!

          And please quit quoting that selective WHO and Commonwealth Fund studies.

          The problems with the U.S. healthcare system is due to departures from the free market system.

          I’d like to see how many people would pick Canada over the U.S. for cancer treatment.

      • carol

        Just make sure that you don’t retire until you are 65!

  • Anonymous

    You sure are a dedicated progressive.
    If you think,

    “Canada’s system, which is flawed but overall still has superior results to our system at 60% of the cost”

    you’vre never lived there and don’t know anyone who does.

    That’s an amazing claim you make.

    • dean

      Its not my claim. Its the analysis of the World Health Organization, which ranks nations on health care access, outcomes, and costs. The US comes out number 37, with Canada number 33. France, also a single payer system but with supplimental individual insurance, ranks numero uno.

      Chris…I’m not sure, but how many people in each country actually get cancer? It may be we do better at cancer treatment but worse at things that are more common.

      • Chris McMullen

        There’s that pesky WHO report again that employed inconsistent data and statistics. You seem to have a problem looking beyond that pablum spoon fed to you, Dean.

        Moreover, it’s great news that Canadians have better treatment for hangnails than cancer. They should be proud.

  • Tim Lyman

    I grew up in Canada. It is NOT a superior system. It is a disaster.

    • dean

      Chris…was the data they used on how long people actually live “inconsitent?” I mean…did some Americans manage to be brought back from teh dead? And if Canadians are living on average 3 years longer than us, does that imply that their focus is on hangnails?

      The larger point should be that in the US we are great on doing everything we can to cure an other wise fatal disease asuming one has the insurance that will cover the treatments. You seem to make that assumption, but a whole lot of Americans lack that insurance.

      • NotYourDaddy

        There could be any number of reasons the average life expectancy in Canada is longer than in the U.S., including healthier lifestyles, genetic factors, etc. We also have a much more diverse population than Canada, and different demographic groups have different life expectancies. For example, the average life expectancy for black males in this country is much lower than for any other segment of the population. The reason is not because of healthcare.

        The point I’m making is not that black males are lowering our stats for average life expectancy. The point is that there are many factors affecting average life expectancy other than health coverage. You keep pointing to that as evidence that healthcare in Canada is better than here, but it seems like a red herring to me.

      • Chris McMullen

        “A whole lot of Americans lack that insurance….”

        Why is that Dean? Could it be the vast majority are to lazy to pay for insurance? Could it be the vast majority made bad decisions all their lives which put them in the position they’re in — ergo “poor?”

        Time and time again Dean, you defend the perfectly able ne’er-do-wells who refuse to take responsibility for their own lives. Furthermore, if the US gummint deregulated insurance companies, there would be more all-encompassing insurance programs for high-risk and catastrophic care. Why is it you can’t buy insurance out of state, Dean? What have the Dems done to address that?

        And did you know the U.S ranked first in responsiveness to patients needs in your beloved WHO report? Way over France, Italy and Canada.

        You can’t have affordability, quality and responsiveness. You have to give up one to get the other two.

        • dean

          Yes NYD…it could be this or it could be that. But Canada is not the only nation ahead of us on life expectancy. Just about every member of the first world is ahead of us. Some, like Britain, also have very diverse populations and COMPLETELY socialized medical care systems.

          Health care in Canada statistically is better than in the US overall, and at 60% of our cost. There are things we do way better than they do, including most cancer care. If you are rich or well insured, it is probably way better in the US. And if you are a doctor, you earn more money here.

          Chris…let me try to explode the myth that our health insurance problem is due to laziness, bad decisions, and so forth by looking at broad economic measures.

          First, median incomes in the US DOUBLED from 1947 to 1973. Beginning in the 1980s and right up to today (the next 30 plus years) median incomes in the US have stagnated…flat lined, while those at the top (5-10%) have done very well.

          Households have done what they can, but jobs in America simply pay way less than they once did, accounting for inflation. When I was a kid one breadwinner, like my dad, a high school dropout earned enough for our family, but starting in the 70s women went to work in large part because their husband’s incomes stagnated. Gradually people worked more and more hours. Americans now work more hours per capita than any other industrialized nation. Lazy? I don’t think so. And what are the options for a high school dropout today?

          What changed? Union membership peaked in 1955 at 39% of the total private sector work force. American companies began fighting against unions in the 70s, were given a boost by Reagan, and now we are down to 9%. Right here in Portland carpenters made much more in the 70s than they make today, adjusted for inflation. We have shifted from a unionized industrial economy to a non-unionized WallMart economy. We now have plenty of low paying, dead end jobs with no or few benefits, including health insurance, pensions, and so forth. People work those jobs, but get little for it.

          Globalization, the freedom of capital to go where labor is cheap, had a lot to do with this. It has now made its way up into the professional classes, particularly software engineering, which is headed to India and China. Financial services won’t be far behind.

          And it is getting worse, accelerating, and inching up into higher incomes. We managed to maintain the illusion of prosperity by borrowing against over inflated house values. That game is up, and we are in far deeper trouble than Bush and Pelosi are letting on. $600 each is going to do diddly squat.

          So no Chris…i don’t buy your rationale. The majority of our fellow Americans are not stupid, lazy, or any more prone to bad choices than our parents generation were. The bad choice we made was Reaganomics, and we are just beginning to understand the consequences, one of which is increasing number of us with no health insurance provided through employment.

          Call me a liberal, call me any name you want. It won’t change reality.

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