The Truth About Canada (50 page)

Gerard F. Anderson, professor at the Johns Hopkins Bloomberg School of Public Health, complaining about the failure of the United States to switch to a single-payer health-care system, says, “The story never changes. The United States is twice as expensive with about the same outcome. As a consumer, I don’t mind paying more if I’m getting more, but that’s just not the case in the U.S.”

In 2005, the Lewis Group, a U.S. health-care consulting firm, said that universal health coverage in California would have saved $8-billion in 2006, and from 2006 to 2015 estimated savings would be $343-billion.
³

In 2005, the prestigious
American Journal of Medicine
reported that the quality of care for patients is better when care is provided through not-for-profit health-care plans than through for-profit plans. Another report from the Harvard School of Public Health “reinforced the concern that the financial incentives of for-profit plans lead to less aggressive efforts to manage the quality of care.”
⁴

By the end of 2006, the number of Americans without health insurance had grown for the sixth year in a row, increasing to 47 million, some 14 million greater than the entire population of Canada. The number of people in the United States with employer-provided health insurance fell by more than three million in 2005, to only 56 percent of employees. Some 8.3 million children, about 11.2 percent, had no health insurance.

In 2003, over 43 percent of the non-elderly population in Texas had no health insurance. In California it was over 37 percent, and in Florida 35 percent. Associated Press reported that in 2004 “nearly 82 million people — one third of the U.S. population younger than 65 — lacked health care insurance at some point over the past two years.”
⁵
Of the 47 million Americans with no health insurance, 82 percent live in households where the head of the family had a job. More than one-third of the uninsured have family incomes of $40,000 or more. According to a
New York Times
editorial (August 26, 2007), “Families with incomes of $70,000 or more can be hard pressed to pay for private insurance in high cost areas.”

The percentage of children not covered by employer-provided health insurance has increased for six years in a row and has now risen to 40 percent.

In 2004, a shocking 40 percent of American adults surveyed said that they have had to go without needed health care due to costs. For those with below-average incomes, the percentage increases to 57 percent.
⁶

In the words of Paul Krugman, writing in the
New York Times
, employer health insurance in the United States is unravelling with a “crazy quilt of private insurers” in an “extremely inefficient health care system” that now costs the average employer $10,000 for a family of four, and private health insurance for a family of four now costs an average of some $12,000 a year. According to Krugman, “the U.S. is now spending more on health care, but the results are worse.”
⁷

Some 19,000 American men and women die every year directly because they had no health insurance. Where in 1993 some 60 percent of American employers had company health-care plans, by 2005 that number was down to 45 percent and rapidly decreasing.

By 2005, the percentage of Americans who could afford private health-care insurance was at its lowest level in 19 years. While over 86 percent of Americans in the highest income quintile had insurance, fewer than 22 percent in the lowest quintile were insured.

In the first five years of the George W. Bush presidency, the cost of health insurance premiums rose 73 percent. One projection is that by 2008 the average annual premium for employer-sponsored family coverage would be over $14,500, more than double the cost in 2001. Many employer health insurance plans have deductibles ranging from $1,000 to $5,000, and a choice of a doctor or hospital is not often possible.

By 2013, predictions are that 56 million Americans will have no health-care insurance.

In 2005, over 700,000 households declared bankruptcy in the United States because they were unable to pay health-care bills. Over two million Americans were directly affected in this way. Yet almost 70 percent of these people had some form of health insurance.

Paul Krugman writes, “The health-care crisis in the U.S. is back, both because medical costs are rising rapidly and because we’re living in an increasingly Wal-Martized economy, in which even big, highly profitable employers offer minimal benefits.”
⁸

In March 2007, the
New York Times
reported that a majority of Americans said that the federal government should guarantee health insurance to every American, especially children, and that they are willing to pay higher taxes for this.

In October 2007, government audits showed that tens of thousands of U.S. Medicare recipients had claims improperly denied by private insurers, including people with HIV and AIDS. Many of the private insurers were accused of not answering phone calls from patients, doctors, and drugstores.

SOME SAMPLE AMERICAN SURGICAL COSTS IN U.S. DOLLARS

APPENDIX TWO: POVERTY

MEASURING POVERTY

Statistics Canada has never had an official poverty line. It does, however, measure the number of Canadian who they define as living on “low incomes.” In 2004, some 3.5 million Canadians were living on low incomes. In recent years, the number peaked in 1996 at about 4.6 million.
¹
However, some other measurements place the number as high as 5.7 million.
²

Some of our extreme right-wing, anti-poor fanatics object to the idea that the Statistics Canada low-income cut-off is a reliable definition of a proper poverty line. Witness, for example, the regular attacks on the annual reports of Campaign 2000 by the
National Post
,
³
Montreal economist William Watson, the far-right Fraser Institute, and Chris Sarlo, among others.

But as Laurel Rothman, national coordinator of Campaign 2000, has pointed out in answer to the critics of low-income cut-off measurements that have been used in Canada for over two decades, the newer market basket measure commissioned by the federal, provincial, and territorial governments as “a consensus definition of basic needs/poverty levels” after years of study produces results similar to the low-income measurements, but with an even higher child poverty rate of 16.9 percent compared to 16.6 percent. (Remember that in 1989, when the House of Commons promised to abolish child poverty by the year 2000, the rate was 15.1 percent.)

Campaign 2000’s November 2007 report about poverty in Canada shows that despite our growing economy, in 2005, using after-tax measures, the rate of child poverty was 11.7 percent, exactly what it was sixteen years earlier in 1989. Using the before-tax measure commonly employed until recently, child poverty increased from 15.1 percent to 16.8 percent.

In its 2007 report, Campaign 2000 uses both before-tax and after-tax figures. For obvious reasons, government and war-against-the-poor commentators much prefer the after-tax numbers which are much lower, since they include both taxes and government transfers.

Michael Goldberg of Vancouver, a member of the Campaign 2000 National Steering Committee explains further:

Most of the public reports by Statistics Canada now use the after-tax figures. It seemed to us that arguinig over what measures should be used took us away from the task at hand, namely getting governments to commit to a poverty reduction plan that would eliminate poverty in Canada.

If you prefer the lower after-tax figure, that still leaves a disgraceful 788,000 Canadian children living in poverty, roughly one in eight.

In fact, all three commonly accepted measurements of poverty in Canada have produced similar results, yet the federal government has refused to recognize any of them officially despite the fact that the statistics are comprehensive and reliable. So, year after year goes by without any official recognition of Canada’s disgraceful poverty figures.

Could it be that both Liberal and Conservative governments have been too embarrassed by the shameful annual survey results, especially when they are compared with those of so many other developed countries?

SOME NOTES ABOUT POVERTY IN THE UNITED STATES

As indicated earlier, the United States has by far the highest rates of poverty in the industrialized world, with some 22 percent of all children living in poverty. And as I have pointed out often in the past, the official
U.S. method of measuring poverty, essentially unchanged since 1963, is regarded almost everywhere as a sad joke. In 2005, the U.S. rate was said to be 12.7 percent, but according to much more reliable international estimates, the real rate is far above that figure. The renowned Luxembourg Income Study puts the American child poverty rate at about 22 percent, compared to the Canadian rate of 16.6 percent.

As low as the
official
American poverty figures are compared to reality, even the official rates are horrendous in some parts of the country: almost 34 percent in Detroit, just under 25 percent in Philadelphia, almost 29 percent in Miami, and over 20 percent in New York City. This despite the fact that over 40 years ago, President Lyndon Johnson declared a “war on poverty” in his 1964 State of the Union address.

Incredibly, an American family with two children and a total income of $19,850 ($1,650 a month) is not considered poor even if they live in a city where average rent in a working class neighbourhood is well over $1,000 a month.

Unicef explains: “The official U.S. poverty line dates back to concepts and judgements made in the 1960s.… In August 2000, 40 prominent scholars sent an open letter to senior government officials stating that unless ‘we correct the critical flaws in the existing measure, the nation will continue to rely on a defective yardstick.’ ”
⁴

And why has the official measurement of poverty in the United States been left at such a ludicrously unrealistic level? The
New York Times
explains: “During the last four decades, no president of either party has wanted to draw attention to a statistic that the nation has come to take for granted, especially if updating it might cause the number of people regarded as living in poverty to increase.”
⁵

And what do most Americans think about the millions of poor men, women, and children? A Pew Research Center poll in 2005 showed that between 40 and 50 percent of Americans say that “poor people have it easy.”

And of course this attitude is reflected in public policy. In the mid-1990s, some 4.4 million poor American families received welfare payments. In 2006, that number was down to only 1.9 million families.

In 2006, almost six million people were living in poverty in California, where an average family in the lowest 10 percent of incomes had an income of some $15,600, a decline of 12 percent since 1969. A very modest two-bedroom apartment in San Francisco rents for $21,300 a year.

It’s interesting to compare the disposable incomes of the poor in the United States and Canada. In Canada, the poorest 10 percent have almost 60 percent more disposable income than the poorest 10 percent of Americans. The next 10 percent have almost 20 percent more disposable income.

The Pew Research Center says two in five low-income Americans at times go hungry, the highest such proportion in the industrialized world, compared to one in four low-income Canadians and Britons according to the well-respected research centre.

In 1974/1975, 13 percent of Americans said they periodically couldn’t afford to see a doctor. By 2002, the percentage had grown to 26 percent. As many as 55 percent of low-income Americans occasionally could not afford to pay for care, while only 17 percent of low-income Germans and 8 percent of low-income Japanese faced the same problem.

A February 2007 report said that

the percentage of poor Americans who are living in severe poverty has reached a 32-year high, millions of working Americans are falling closer to the poverty line, and the gulf between the nation’s “haves” and “have-nots” continues to widen.

Sixteen million Americans are living in deep or severe poverty as wages are dwarfed by profits.

Household income for working age families, adjusted for inflation, has fallen for five straight years.

Forty-three percent of the nation’s poor are living in deep poverty, the highest rate since at least 1975.
⁶

NOTES

PART ONE

CHAPTER ONE

1.
Human Development Report
, 2006. United Nations, for period 1990 to 2004.

2.
E-mail to the author, March 21, 2006.

3.
Vancouver Sun
, July 29, 2006.

4.
OECD Health Data
, 2007.

5.
Dr. Richard Levin, dean of medicine, McGill University,
Globe and Mail
, April 18, 2007.

6.
Health at a Glance
, 2005, OECD.

7.
Globe and Mail
, July 31, 2007.

8.
Globe and Mail
, August 1, 2007.