For most Canadians, the current debate in the United States over Medicare for all seems like a no-brainer. Medicare for all, or what we term Universal Health Care, has been in place across Canada since 1972 and even earlier in some provinces. (The administration of health care remains a provincial or territorial responsibility, although the federal government sets nationwide standards and provides approximately 50 percent of the cost through transfer payments to the provinces.)
Basic health care in Canada is free and universal, as it is totally funded through tax dollars. It covers approximately 70 percent of Canadians’ health-care needs, including all essential medical needs, doctors’ visits and hospital costs. The remaining 30 percent, which relates to services not covered through Medicare, such as prescription drugs, dentistry and optometry, is paid for through the private sector. However, approximately 65 to 75 percent of Canadians have some form of supplementary health insurance like Blue Cross.
The move towards publicly funded health insurance began soon after World War II. In 1947, the province of Saskatchewan established Canada’s first publicly funded hospital insurance plan. Other provinces, including British Columbia, Albert, and Ontario, introduced their own insurance plans, with varying degrees of coverage, and varying degrees of success.
In 1962 Saskatchewan introduced a universal Medicare system which included doctors’ fees. This was followed up by the federal government’s Medical Care Act, which was passed in 1966 by a vote of 177 to 2 in the House of Commons and established the transfer payment formula for approved expenditures like hospital and physician services. Within six years all provinces had established Medicare systems that fell under the framework of the Medical Care Act. This was modified in 1984 with the unanimous passage of the Canada Health Act.
Universal access to publicly funded health services is often considered by Canadians as a “fundamental value that ensures national health care insurance for everyone wherever they live in the country.” It has strong public support. A 2009 poll by Nanos Research found 86.2 percent of Canadians surveyed supported or strongly supported “public solutions to make our public health care stronger.” A Strategic Counsel survey found 91 percent of Canadians prefer their health-care system to a U.S.-style system.
By contrast, more than 50 percent of Americans think that government-run health care will impact their freedom of choice. Nearly 25 percent believe that their freedom of choice will remain the same as it currently is. Another 54 percent feel that health care would become less personal as a universal health system, and 39 percent of citizens believe that government-run insurance will result in a lower quality of health care.
Much of this is due to a common perception of publicly funded Medicare as “socialized medicine.” While publicly funded Medicare was initially proposed by democratic socialist and social democratic parties in a number of countries where it now exists, once in place it was readily accepted by centrist and conservative governments around the world. (The difference between democratic socialists and social democrats is that, while democratic socialists still believe in replacing the free market system with a state-run economy, social democrats support a mixed economy where some key industries may be nationalized, but the bulk should remain in the hands of private owners. Their approach to promoting social equality is through taxation.)
Looking at the global picture, the United States is the only developed democracy that does not have a free and universal health-care system. Europe, Canada and just about all of Latin America do. Some countries may have systems that are universal, but not free, while others are free, but not universal. Aside from the United States, the only countries that are without free or universal health care, are mostly in Africa, a few in the Middle East (Syria, Iraq, Jordan and Lebanon), Central Asia (Afghanistan, Tajikistan, Turkmenistan) or Southeast Asia (Cambodia, Indonesia). What’s more, when it comes to per-capita spending on health care, the United States is by far the highest.
Whether or not the United States establishes a publicly funded Medicare system, or continues to be one of the few countries in the world that does not provide one, is up to American voters themselves. But if you want the opinion of someone who benefits from such a system in his own country – take it from me. Like most Canadians, I am happy with our system and proud of it.
Marco Levytsky may be contacted at [email protected].