In the September issue of The Atlantic magazine, business executive David Goldhill writes about "how American health care killed [his] father" and shares his conclusions, after a year of research and thought, about what's wrong with the U.S. system. After reading the piece, one of my smug colleagues sent around an email saying, if I may paraphrase slightly, "Look how awful their system is. This makes me grateful to be living in Canada."
It's true that Goldhill makes a convincing case for U.S. health care needing a massive overhaul -- and quick. But all I could think, as I read the article, was: Their problems sound a lot like ours.
The common terribleness of important aspects of our health systems is not something Americans and Canadians tend to dwell on. We are usually too busy pointing out the differences: Americans have HMOs; Canadians don't. (Good on Canadians.) Americans have a plethora of MRI machines; Canadians don't. (Good on Americans.) While in the throes of a catastrophic illness, a lower-middle-class American will spend more time worrying about going bankrupt than about getting better. While in the throes of a catastrophic illness, a lower middle-class Canadian will spend more time worrying about whether he'd be getting better care in Buffalo, Boston or Seattle than about getting better. You get the idea.
Yet consider this: Goldhill, who says he's a Democrat, thinks that no matter what reforms Obama and his fellow politicians come up with -- whether or not there's a public option, or some kind of insurance mandate -- they won't do any good unless Americans learn to "rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices and sensible trade-offs between health-care spending and spending on all the other good things money can buy."
In other words, the problem lies not with who's insured or what's covered, but with placing all the power in the hands of one or a few bureaucratic entities (insurance companies and/or government) instead of consumers. The theory applies equally to Canada, where we have the same his father, and they're certainly a distressing expression of a troubled system. While I am fortunate enough not to have any first-hand experience with anything as dire, I can attest to having witnessed in both Canada and the U.S.: lengthy emergency room waits with no pain killers for the broken-limbed, delayed lab results and botched lab results, week-long stays in the ER because of no beds in real rooms available, nurse call buttons unanswered, nurse call buttons answered by surly nurses, misdiagnoses, lost records, broken diagnostic equipment, months-long waits for tests and specialists. And I'm a healthy person under 40.
We put up with the poor treatment because we have no choice.
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