Ezra Klein: Oy, Canada

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October 17, 2007

Oy, Canada

Joe Paduda discovers what's probably a fake e-mail from a Canadian purporting to warn us about the horrors of his health care system. Then he dismantles it. But expect more of these as the health care debate heats up. You won't see folks defending the current system -- the status quo is too dysfunctional to protect. Rather, you'll see them demonizing the unknown, lying about alternatives, trying to scare Americans into curling up and protecting what they have.

October 17, 2007 in Health of Nations | Permalink

Comments

More and more frequently Canadian citizens who visit the doctor to beg for more of their socialist medical care actually awake later in a bathtub filled with ice... and their kidneys are gone.

This is well known.

Posted by: El Cid | Oct 17, 2007 9:56:51 AM

Kind of interesting that just as the health care debate heats up, every media outlet happens to be trumpeting the same story about a British study which finds people pulling their own teeth due to a lack of dentists. Just an intriguing coincidence.

Posted by: Steve | Oct 17, 2007 10:40:56 AM

Yep, we need healthcare reform in the Great White North, but note three important things:

1 - No one is advocating a move to the American system in Canada. The debate is about opening up service provision to private corporations and individuals; payment will remain tax funded and government distributed per citizen. Some medical procedures may become availble for direct purchase by individual citizens. There is no talk of dropping universal coverage for a private insurance system.

2 - Democratic party policy is NOT going to replicate what is in Canada or England, it will be more like France or Germany.

3 - Despite all Canada's HC shortcomes our health stats look pretty darn impressive. In some cases superior to USA outcomes, and all this with half the cash input.

Posted by: Northern Observer | Oct 17, 2007 10:58:02 AM

I read that story with great amusement. My father pulled all of my loose baby teeth at home. Probably all of my sister's too. And my dad was a well paid plant manager at a textile mill at the time. His beef was "I ain't payin' no dentist a hundred dollars to do what I can just do right here for nothin'".
I'd bet that plenty of Americans pull their own rotten teeth out, or, you know, just show up at the emergency room when it really hurts.

Posted by: chowchowchow | Oct 17, 2007 11:31:05 AM

Northern Observer: You say "The debate is about opening up service provision to private corporations and individuals". This is misleading: as you know, few medical services now are PROVIDED by the government; what the government (more accurately, the state) does is PAY for the services. Perhaps you mean the debate is about allowing patients to be charged extra, direct fees for services that are covered by provincial plans?

In any case, your basic point is correct: few Canadians want to go back to the bad old days of a U.S.-style system. Even Conservative politicians have to talk about strengthening the present system, since any explicit talk of scrapping it would be fatal at the polls.

Posted by: mijnheer | Oct 17, 2007 11:33:04 AM

I'd bet that plenty of Americans pull their own rotten teeth out, or, you know, just show up at the emergency room when it really hurts.

Several years ago, two Harvard researchers, Susan Starr Sered and Rushika Fernandopulle, set out to interview people without health-care coverage for a book they were writing, “Uninsured in America.” They talked to as many kinds of people as they could find, collecting stories of untreated depression and struggling single mothers and chronically injured laborers—and the most common complaint they heard was about teeth. Gina, a hairdresser in Idaho, whose husband worked as a freight manager at a chain store, had “a peculiar mannerism of keeping her mouth closed even when speaking.” It turned out that she hadn’t been able to afford dental care for three years, and one of her front teeth was rotting. Daniel, a construction worker, pulled out his bad teeth with pliers. Then, there was Loretta, who worked nights at a university research center in Mississippi, and was missing most of her teeth. “They’ll break off after a while, and then you just grab a hold of them, and they work their way out,” she explained to Sered and Fernandopulle. “It hurts so bad, because the tooth aches. Then it’s a relief just to get it out of there. The hole closes up itself anyway. So it’s so much better.”
People without health insurance have bad teeth because, if you’re paying for everything out of your own pocket, going to the dentist for a checkup seems like a luxury. It isn’t, of course. The loss of teeth makes eating fresh fruits and vegetables difficult, and a diet heavy in soft, processed foods exacerbates more serious health problems, like diabetes. The pain of tooth decay leads many people to use alcohol as a salve. And those struggling to get ahead in the job market quickly find that the unsightliness of bad teeth, and the self-consciousness that results, can become a major barrier. If your teeth are bad, you’re not going to get a job as a receptionist, say, or a cashier. You’re going to be put in the back somewhere, far from the public eye. What Loretta, Gina, and Daniel understand, the two authors tell us, is that bad teeth have come to be seen as a marker of “poor parenting, low educational achievement and slow or faulty intellectual development.” They are an outward marker of caste. “Almost every time we asked interviewees what their first priority would be if the president established universal health coverage tomorrow,” Sered and Fernandopulle write, “the immediate answer was ‘my teeth.’ ”

http://www.newyorker.com/archive/2005/08/29/050829fa_fact

Posted by: paperwight | Oct 17, 2007 1:03:46 PM

Mijnheer has it about right. I sometimes wonder whether we (I'm Canadian as well) get TOO protective of the current system, so that reasonable ideas to address the problems we do have (wait times, decades of underfunding of infrastructure, availability of specialized services) are lost in the shrieking about "no 2 tier health care!" (a federal conservative even waved about a little handmade sign to this effect during the televised election debate a few years ago). But I doubt there is even clear thinking about what "2 tier healthcare" even means. Already there is user pay for many lab and diagnostic services, and arrange privately for many "non-necessary" procedures. You pay for prenatal ultrasounds but cannot for an MRI. Shrug.

Provided a baseline of quality universal coverage for essential services are there, why not allow individuals to pay for enhanced services? The debate (or lack of) is the flipside of the debate in the states. Adherence to the principal of universal coverage puts the blinkers on when it comes to thinking about practical solutions. Perhaps many of those solutions will not fly politically, but it seems the debate is over before it begins simply because we hold universal coverage so dear.

Posted by: puzzled | Oct 17, 2007 1:49:57 PM

a British study which finds people pulling their own teeth due to a lack of dentists.

As if the regional scarcity of dentists willing to do NHS work hasn't been an issue for years. (It's generally London and the SE where this is a problem.) The reason? Dentists are generally greedy bastards who like their big houses and expensive cars. I only slightly exaggerate.

Where does this leave those people in the UK unable to find NHS dentists? In a situation more or less identical to Americans: they pay fee-for-service, or buy separate dental insurance. But they still have recourse to subsidised NHS dentistry in emergency situations. Oh, and even the greediest dentist will usually accept NHS work for kids.

Posted by: pseudonymous in nc | Oct 17, 2007 1:54:02 PM

The real issue here, as asked by Atrios a few times:

Where do these 'friend of a friend' emails come from? Who seeds them, so that you end up receiving a copy from your Limbaugh-loving aunt?

They're obviously generated from some wingnut welfare shop. I'd imagine that Mort Blackwell's Wingnut Finishing School has a class on how to get the right combination of folksiness, fearmongering and bullshit?

Posted by: pseudonymous in nc | Oct 17, 2007 1:57:05 PM

You know, the last time the Democrats did a big thing in health insurance, they came up with Medicare, which is a super-awesome and popular thing.

Maybe we should just say "hey, so long as we keep the Republicand out of it, it'll end up at least as good as Medicare or social security."

I mean , if your worst case scenario is ensuring affordable access to healthcare for every American in your target group...okay with me.

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