American friends, in particular those choosing a Democratic candidate for President, something’s been bugging me about the debates I’ve been watching. It’s the rhetoric attacking Medicare for All.
In particular, it’s the concept that if you don’t make government-funded healthcare just one option among many private options, you will be unfairly taking something away from people. While the impetus for politicians to make such arguments clearly lies in the fear of losing donor money, those who believe their logic most likely do so out of a real fear of losing something they actually need or like.
I suspect it’s due to a fundamental conceptual misunderstanding of how Medicare for All works. With that in mind, I’d like to explain, or Canadian-splain if you will, how Universal Healthcare works here in Canada.
It’s in the Cards
All Canadians are entitled to a Medicare Card. They are issued by the government of the province you live in.
These cards need to be renewed at a minimal cost. The specifics vary from province to province, but they’re all in the same range.
In Quebec, where I live, renewal is every four to eight years and costs $25. If you move to a different province, you have to prove residency to get a new card.
Having lost my card once at the same time I moved, I know all too well that you really have to prove who you are and where you live. Given that your health card also serves as a photo ID for things like voting, it’s good to know that this is a secure system.
It’s Really Quite Simple
With the card, you can walk into any hospital you want and get the treatment you need. There’s no such thing as “out of network” or a “deductible” here.
When it comes to family doctors, you choose the one you want. They still have to accept you as a patient, but your bank balance won’t be a factor.
When you arrive at the hospital or the doctor’s office, they swipe your card, treat you and send the bill to the appropriate provincial government. The provinces administer and directly pay for the healthcare system with the help of transfer payments from the Federal Government, as universal coverage is mandated by the Canada Health Act.
It’s important to note that the cost of procedures the government pays for is standardized here. Given the fact that hospitals in the US can currently charge whatever they want, I get why the prospect of universal coverage may erroneously seem too pricey to many.
What’s Covered and What’s Not
In Canada, Medicare covers everything from AIDS and Cancer treatment and gunshot wounds to non life-threatening stuff like sprained ankles. While medicine you get when in a hospital is covered, prescription drugs you take after aren’t (except for in some cases like people on welfare), but they are considerably less expensive than in the US.
We also don’t cover dental care or surgery considered cosmetic. It’s interesting to note that the Medicare for All plan Bernie Sanders is proposing does cover dental as well as home healthcare and, from the looks of it, a better plan than Canada currently has.
In our recent election, one party, the NDP, was pushing for Universal Dentalcare and prescription drug coverage, but they lost to (everyone outside of Canada’s favourite Liberal) Justin Trudeau. While he’s not for expanding the Canada Health Act, he wouldn’t dare suggest scrapping it, and neither would our most right-wing politicians.
Currently, for stuff like dental, we still have private and workplace insurance. I seriously doubt that if our government started funding dental or pharmacare, people would fear losing their private insurance.
A Different Mindset
That’s because you don’t have to give up any treatment with Medicare for All. If your system turns out anything like ours, the only thing people will lose is the cost.
If people “like their insurance” what they really like is the healthcare they get. And they’ll still get the same healthcare.
Yes, treatment will be prioritized for those who need it most and then for those who arrived first. It’s possible a millionaire will have to wait in line behind a minimum wage worker and someone on welfare if all three require the same care at the same urgency, but that’s how it should be.
When you stop seeing healthcare as a commodity and instead see it as an essential public service, like the fire department or the roads, you’ll realize that you aren’t giving up anything with Medicare for All.
Featured image of a Medicare for All Rally in Los Angeles 2017 by Molly Adams via Flickr Creative Commons