Single-payer health care—an approach used in Canada and in 28 other industrialized countries—means that care is delivered by the private sector but paid for from a publicly administered trust fund. Like so many other issues in the United States, the single-payer approach has become a political football that each side has repeatedly kicked beyond recognition. Advocates have set it up as a miracle cure for America’s health-care ills. Opponents have demonized it to the point single-payer health care seems more the cause of disease instead of the cure.
As an American transplanted into the Canadian health-care system, I have experienced the fallacies and truths of both positions. As you might expect, the reality is more nuanced than the sound bites either side would have you believe. Below are some of the myths about single-payer health care offered by opponents of the system, along with a dose of reality from north of the border.
Myth 1) Single-payer health care is more expensive. Compared to what? About 40 percent more per capita is already spent in the United States on health care than in other industrialized countries (most of which have some form of universal health care). In fact, other countries with single-payer health care spend 50 to 100 percent less on administrative costs for health care.
Myth 2) It would raise taxes. Single-payer health care would likely bring some higher taxes for many Americans—the question is how that would compare to their current health care costs. Assuming that expenses would be spread among employers, the government, and individuals as they are in most countries with universal health care, most people would find any tax increase to be similar to their current health care costs—with the added benefit that they can sleep at night knowing their neighbors have access to the same medical care as they do.
Myth 3) Wait times are longer. Yes, wait times for some medical procedures may be longer under a single-payer system for some people. But for other people, especially those in the U.S. currently without health insurance, wait times would be preferable to never getting health care at all. In fact, greater accessibility to routine medical care for more Americans could help free up resources currently used to address preventable health problems.
Myth 4) The government would limit patients’ freedom of choice and dictate to doctors how to practice medicine. It’s hard to imagine a situation where patients have less influence than with U.S. HMOs and insurance companies. In Canada, medical decisions are made by patients and their doctors, not by an employee of an insurance company sitting behind a desk. Government limits to the types of health care available in a single-payer system are guided by need and the democratic process—not by profit margins.
Myth 5) People will overuse the system. Generally, people go to the doctor when they are sick, not as a diversion. Per capita, more people use health care under a single-payer system because they are sick and have access to it. That’s the point, right?
Myth 6) People won’t have access to services they need. It’s true, Canadians sometimes have to wait longer than some Americans for commonly needed medical services such as MRIs and some cardiac treatments. It’s also true that Canada’s universal health care isn’t equally accessible to all Canadians—those who live in rural areas have fewer health-care options, for example. But the overall statistics, such as life expectancy (81.6 years in Canada, 78.14 in the U.S.) and infant mortality (4.7 deaths per thousand in Canada vs. 7.1 in the U.S.), all point to a health-care system that is taking better care of all of its citizens than is the U.S. system.
The type of health care offered by a society will always be contentious because it provokes fundamental—even primal—moral questions. When it matters the most, what do I put first, myself or the common good? Though single-payer health care such as is found in Canada is as imperfect as the human bodies it serves, I’m still thankful to live in a country that has chosen to stand for the common good.
Aaron McCarroll Gallegos is producer for The United Church of Canada’s Emerging Spirit campaign and the WonderCafe.ca Web site.