Socialized Medicine Essay, Research Paper

Canada s healthcare system has been the envy of many western industrialized countries for years. England s Prime Minister Winston Churchill inspired it in 1948 when he said:

The discoveries of healing science must be the inheritance of all [ ] Disease must be attacked whether it occurs in the poorest or the richest man or woman, simply on the ground that it is the enemy [ ] Our policy is to create a national health service in order to secure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available (Wollstein 23).

Completed in 1970, this socialized health plan provides free public healthcare. Every Canadian receives free doctors visits, free hospital care, free surgery, and free medicine while in the hospital. So well known and regarded, Canada s healthcare system has long been looked to as a shining example of what socialized medicine could be and even won an international award for excellence in 1993.

Even though Canada s Healthcare plan has had such a positive history it is now plagued with problems. Some of these problems include lack of doctors, lack of beds and supplies, and very long waiting periods for medical attention. Because of these problems arising in Canada s healthcare there has been quite a debate going on in Canada over socialized medicine. Many people argue that these problems are due to the fallacies of socialized medicine claiming,

Socialized medicine, like all other forms of socialism, is a world-wide failure. As people throughout the world from the Soviet Union to South America are learning, socialism cannot work. Socialized medicine results in skyrocketing demand for nominally free health care, doctors being over-burdened, medical services steadily deteriorating, and endless waiting periods for health services (Wollstein 24).

Others, who are for socialized medicine in Canada feel the problem is not with the system but with the people themselves. They argue that people are exploiting the system and, not taking enough responsibility for themselves (Pierson 26). In any case both sides agree that the main cause of these problems is lack of money, but instead of arguing how they intend to secure more money for healthcare, they argue whether socialized medicine is good or not. This question of good and bad is a philosophical issue best discussed over time. Instead both of these sides should be joining together to fight for funds. Funds that their government owes them.

In 1970 at the dawn of Canada s healthcare the federal government promised to provide 50% of all healthcare costs in Canada. The other 50% was supposed to be provided by local provinces. Since then the government has yet to pay 50% of healthcare costs and, to add insult to injury, has steadily decreased the amount of funding they once promised. From 1970 to 1983 the Canadian government paid only 37% of all health care costs leaving the local provinces to pay the other 63%. At this rate local provinces could fit the bill but in 1984, when the Canadian government amended the National Health Care Act, they cut their funding of health care costs down to a mere 29%. Then in 1990 after another budget cut the Canadian government paid only 25%. Since then there has been so many cuts in healthcare funding that ever since 1990 the Canadian government, with a population of 21 million, has spent less on healthcare than Washington D.C. who has a population of only 4 million (Frampton).

With ever increasing demand and cost for healthcare, local provinces, which now must pay over 75% of all healthcare services for their citizens, are forced to make cuts. Since service is one major cost for medical care many local provinces choose to cap doctors salaries. These caps range from each province but the average ceiling for doctors is 150,000(CD) for general practitioners and 175,000(CD) for specialists. These caps, besides making most doctors unhappy, has had some negative effects. The first and most noticeable effect is Canadian doctors leaving Canada for the United States. Dr. Warren Molberg, an emergency ward physician at Edmonton s Royal Alexandra Hospital, says he and his colleagues regularly receive letters from United States healthcare companies. These companies apparently promise them guaranteed salaries that are much higher than what they receive in Canada and the benefits, incentives and tax rates are also very attractive, as is the chance to work in sophisticated healthcare facilities equipped with the latest medical technologies (Sillars 59). These packages are appealing to doctors whose work places are deteriorating and many are willing to go says Dr. Eldon Smith, dean of the University of Calgary medical school, A lot of people are unhappy and a lot are talking about [moving to the U.S.] Many people do not find this a problem and feel that there are too many doctors in Canada already but Dr. Smith believes that there is a risk of losing highly specialized physicians and teachers and says, if we lose those, that s a very serious issue.

The second negative effect of these salary caps has to do with physicians distribution. Because of the cap on doctors salaries most doctors are choosing to work in major cities. In fact, over 85% off all doctors in Canada practice in the city. This has left a serious shortage of doctors in rural areas. The reason for this is rural doctors have much more work to do then city doctors do.

In the countryside there are at most two doctors for an entire area. These doctors must see everyone and are usually on call 24 hours a day. This was not a problem for most rural doctors because due to the increase in work they had a direct increase in pay. In fact, until the salary caps, most rural doctors were averaging 10% higher incomes than city doctors were. After the salary caps these rural doctors still had the same amount of work but could no longer make higher incomes. In the city physicians now made just as much money and with much less work. This created doctor shortages in rural areas and has had some very negative effects such as this story taken out of a local newspaper:

Dennis Goodswimmer was driving eastward on highway 34 as fast as he dared to the Valleyview General Hospital. Beside him in the van s passenger seat lay his son Joey, unconscious and bleeding after being hit by a car. Fortunately the hospital was no more than a 10 minute trip. But as the desperate dad neared town, paramedics in an ambulance intercepted him. Their news was grim indeed: due to an unexpected shortage of doctors, the Valleyview hospital was closed for the weekend Aug 21-22.

The hospital rebuilt just two years ago, cost $15 million. Virtually on its doorstep, Joey and his father waited for an air ambulance. The boy was flown from Valleyview to Grand Prairie and then to Edmonton, delaying his medical care for nearly an hour. The next morning, doctors at the University of Alberta Hospital declared the lad dead of head injuries (C.S. 11).

Joey had the misfortune of living in a rural area. The hospital was closed due to one doctor being on vacation and the other doctor resting from exhaustion. Valleyview General hospital had tried to find a replacement physician but could not. With these caps rural areas cannot find enough doctors and because of this these people are not receiving medical services. This is definitely tragic especially when we look to poor little Joey as an example.

Doctors are not the only ones affected by the Canadian government s budget cuts. The patients themselves are suffering. Due to lack of money for services and lack of doctors, patients are placed on long waiting lists. These waiting lists are so severe that women, on average, wait 6 months just for a pap smear and depending on the seriousness of your case you can be seen as early as 3.5 weeks for chemotherapy or up to 33 weeks for orthopedic surgery. Either way both of these waits are exceedingly long. In fact, a 1993 study found that Canadian cancer patients were waiting an average of three times longer than patients in the Untied States for treatment and one third longer than what their doctors thought was clinically reasonable. Even the wait that Canadian doctors deemed clinically reasonable was 33% to 50% longer than what United States doctors thought reasonable (Walker 45). Here is a list of average, actual wait periods in weeks versus clinically reasonable waits:

Week s Actual Wait Week s Reasonable Wait

Internal Medicine 3.1 1.9

General Surgery 3.8 3.3

Urology 4.3 3.3

Radiation Oncology 4.4 2.0

Gynecology 6.5 4.5

Neurosurgery 6.6 3.6

Otolaryngology 7.8 5.5

Plastic Surgery 9.8 6.7

Opthamology 11.3 6.3

Orthopedic Surgery 13.0 7.2

Apparently the Canadian government feels that an extreme waiting list will not kill you. This is not so when headlines like Lack of beds and long lines killed my hubby, wife claims appear in their newspapers. But even if the wait does not kill you, data published by Statistics Canada indicate that 45% of all patients waiting for healthcare say they are in pain. Some of these waits can be up to 6 months and according to Mr. Walker of the Fraser Institute, The physical and psychological pain can be devastating.

These lists have become so bad that many Canadians are now crossing the border into the United States to receive medical treatment. This phenomenon of border crossing became prevalent in 1987 and has grown larger year by year. In fact by 1994 over 30% of Canadians have crossed the United States border for medical treatment of one type or another. Border hopping to avoid lines has now become a common practice for anyone who can afford to pay for medical services in American hospitals. Unless the Canadian government owns up to its responsibilities this problem is going to continue to grow. In fact people on waiting lists grow each year by 20%.

This is completely unacceptable and unfair to Canadian citizens and this is also why they have had so many debates in this last decade discussing their healthcare. Unfortunately they have looked past the real cause of the problem and instead argued over whether socialized medicine can work or not. Both sides agree there is not enough money for their hospitals but fail to see the true reason why. One side argues that government controlled healthcare becomes too expensive and claims,

The monopoly of basic health insurance has led to a single, homogenous public system of healthcare delivery. In such a public monopoly, bureaucratic uniformity and lack of entrepreneurship add to the costs. The system is slow to adjust to changing demands and new technologies. It is no longer efficient and costs more money (Lemieux 36).

Because of this reason they believe that socialized medicine should be discarded. But this will never happen in a country where 86% of the citizens still want free healthcare and this argument does not hold true in a country that pays much less for healthcare than the United States does. The other side has even less of an argument. They believe that people themselves are ruining the system. They feel that people abuse the system and expect too many services. But how can someone abuse that which is free?

Both sides recognize the shortages, the long wait periods, and the gaping lack of funds but they do not attribute this to the real culprit, the Canadian government. The Canadian government promised to pay a certain amount of the bill and with increased costs they are now trying to back out. They even passed laws making it impossible to receive private healthcare, which now forces everyone to wait in line for medical care. With their decreasing support Canada s local provinces cannot bare the burden and healthcare, inevitably, is going down the tubes. Those who would argue whether socialized medicine is good or not should instead focus on making their government own up to its responsibilities.