Our system is not perfect. It is bloated and inefficient. Canadians report waiting up to 5 times longer than Americans for elective surgeries. With our current system, healthcare has to be rationed in some form as there are only so many doctors and so many MRIs to go around. This rationing typically exhibits as wait times. Hospitals with inadequate financing and overcrowding are also common stories. Doctors in rural areas are hard to get and seniors, especially diabetics, report eroding services as one of their primary concerns. Doctor’s strikes, once unimagined, are much more common as they seek higher fee scales. Patients are increasingly being asked to pay above and beyond for private rooms and other supplemental services.

It is this contradiction to Medicare’s (sorry, the Canada Health Act’s)  founding philosophy that makes discussions of reform so difficult to do. Despite economists from both sides of the political spectrum presenting financial models that our system as it currently is constructed is unsustainable, few pols want to discuss the inevitable correlation between service levels and how we will pay for what we want. We all want excellent care but don’t want to pay more or higher taxes.

It is as if by suggesting we merely look at other options or discuss any alternative models that we are choosing to abandon universal care. Why can’t reform elements such as treating patients as assets rather than cost centres be part of the discussion? As it is now hospitals are given a set budget and as more patients come through the door, each essentially gets progressively less of the pie. Why can’t we discuss intelligent ways to pay hospitals for each person they treat and incentivize care quality? After all this is our money and our healthcare at stake. Why can’t we strive for universal healthcare that is both cost effective and high quality?

With this in mind, the vitriolic criticism about government sponsored health care one can hear in the current American media is a little bewildering. Almost every other modern country in the world has moved to a federally managed healthcare system and not one country who has initiated a single-payer government-run health system has moved back to privatization. According to a report from the Fraser Institute both the Canadian and U.S. governments spend about 7 percent of their GDPs on health-care costs. But when you include U.S. private healthcare expenditures that number balloons to about 16 percent. Put another way The United States spends more in total dollars, percentage of GDP, and per capita than every other country in the world on health care all while being the single largest reason for American bankruptcy and leaving some 40 to 50 million or so Americans (depends on whose figures you prefer) without coverage. As well despite reports to the contrary Canadians are covered for all medical care, plus some prescription drug costs and have complete freedom to choose their physicians. Canadians live on average more than two years longer than Americans, and have similar or better rates of survival after cancer diagnoses.

So while Canadians have better healthcare than many Americans we shouldn’t use that as an excuse not to strive for better and to demand Ottawa keep a dialog about reform going.