Dear America: Costly complexity is baked into Obamacare, and although it has improved access to healthcare for some, tens of millions of Americans still cannot afford basic medical care for their family. No healthcare system is without problems but Canadian-style single-payer—full Medicare for all—is simple, affordable, comprehensive and universal for all basic and emergency medical and hospital services.
In the mid-1960s, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months. There were no websites. They did it with index cards!
Below please find 25 ways the Canadian health care system—and the resulting quality of life in Canada—is better than the chaotic, wasteful and often cruel U.S. system.
Replace it with the much more efficient Medicare-for-all: everybody in, nobody out, free choice of doctor and hospital. It will produce far less anxiety, dread, and fear. Hear that, Congress and the White House!
In Canada, everyone is covered automatically at birth—everybody in, nobody out. A human right.
In the United States, under Obamacare, 28 million Americans (9 percent) are still uninsured and 85 million Americans (26 percent) are underinsured. Obamacare is made even worse by Trumpcare restrictions. (See Trumpcare by John Geyman MD (2019)).
In Canada, the health system is designed to put people, not profits, first.
In the United States, Obamacare has done little to curb insurance industry profits and in fact has increased the concentrated insurance industry’s massive profits.
In Canada, coverage is not tied to a job or dependent on your income—rich and poor are in the same system, the best guaranty of quality.
In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage.
In Canada, health care coverage stays with you for your entire life.
In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you only for as long as you can afford your insurance.
In Canada, you can freely choose your doctors and hospitals and keep them.
In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking—thus restricting freedom of choice—and if you want to go out of network, you pay dearly for it.
In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in insurance premiums directly and indirectly per employer.
In the United States, under Obamacare, for thousands of Americans, it’s pay or die—if you can’t pay, you die. That’s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time. The survivors are confronted with very high, often unregulated drug prices.
In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill.
In the United States, under Obamacare, hospital and doctor bills are terribly complex, replete with massive billing fraud estimated to be at least $350 billion a year by Harvard Professor Malcolm Sparrow.
In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone.
In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 17.9 percent of its GDP and still doesn’t cover tens of millions of people.
In Canada, it is unheard of for anyone to go bankrupt due to health care costs.
In the United States, health-care-driven bankruptcy will continue to plague Americans.
In Canada, simplicity leads to major savings in administrative costs and overhead.
In the United States, under Obamacare, often staggering complexity ratchets up huge administrative costs and overhead.
In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?”
In the United States, the first thing they ask you is: “What kind of insurance do you have?”
In Canada, the government negotiates drug prices so they are more affordable.
In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases. As a result, drug prices remain exorbitant and continue to skyrocket.
In Canada, the government health care funds are not profitably diverted to the top one percent.
In the United States, under Obamacare, health care funds will continue to flow to the top. In 2017, the CEO of Aetna alone made a whopping $59 million.
In Canada, there are no required co-pays or deductibles in inscrutable contracts.
In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans. Fine print traps are everywhere.
In Canada, the health care system contributes to social solidarity and national pride.
In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.
In Canada, delays in health care are not due to the cost of insurance.
In the United States, under Obamacare, patients without health insurance or who are underinsured delay or forgo care and put their lives at risk.
In Canada, nobody dies due to lack of health insurance.
In the United States, tens of thousands of Americans will continue to die every year because they lack health insurance or can’t pay much higher prices for drugs, medical devices, and health care itself.
In Canada, health care on average costs half as much, per person, as in the United States. And in Canada, unlike in the United States, everyone is covered.
In the United States, a majority support Medicare-for-all. But they are being blocked by lawmakers and their corporate paymasters.
In Canada, the tax payments to fund the health care system are modestly progressive—the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent.
In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.
In Canada, people use GoFundMe to start new businesses.
In the United States, fully one in three GoFundMe fundraisers are now to raise money to pay medical bills. Recently, one American was rejected for a heart transplant because she couldn’t afford the follow-up care. Her insurance company suggested she raise the money through GoFundMe.
In Canada, people avoid prison at all costs.
In the United States, some Americans commit minor crimes so that they can get to prison and receive free health care.
In Canada, people look forward to the benefits of early retirement.
In the United States, people delay retirement to 65 to avoid being uninsured.
In Canada, Nobel Prize winners hold on to their medal and pass it down to their children and grandchildren.
In the United States, a Nobel Prize winner sold his medal to help pay for his medical bills.
Leon Lederman won a Nobel Prize in 1988 for his pioneering physics research. But in 2015, the physicist, who passed away in November 2018, sold his Nobel Prize medal for $765,000 to pay his mounting medical bills.
In Canada, the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story.
In the United States, Obamacare’s 954 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”
In Canada, the majority of citizens love their health care system.
In the United States, a growing majority of citizens, physicians, and nurses prefer the Canadian type system—Medicare-for-all, free choice of doctor and hospital, everybody in, nobody out and far less expensive with better outcomes overall.
It’s decision time, America!
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Ralph Nader is a consumer advocate, lawyer, and author. His latest books include: To the Ramparts: How Bush and Obama Paved the Way for the Trump Presidency, and Why It Isn’t Too Late to Reverse Course, How the Rats Re-Formed the Congress, Breaking Through Power: It’s easier than we think, and Animal Envy: A Fable.