Comparing Canadian and American Health Care


JOANNE FARYON (Host): Hello everyone,
I’m Joanne Faryon thanks for joining us. We’re pre-empting San Diego Week
this holiday weekend (tonight) and instead will air an Envision
San Diego special. We’ll hear a little bit more about the Obama
administration’s proposed public healthcare plan at the end of the program
from Kathleen Sebelius, Secretary of Health and Human Services. But first, here’s Right to Health. FARYON: Tonight you will meet a woman who
tried to refinance her house to pay for an MRI and a man who went blind because
he couldn’t afford to see a doctor. And we will tell you about a patient whose care
in hospital cost more than a million dollars; he can’t pay, the government won’t
pay, so just who is picking up the tab? You’ll be surprised. These stories replay themselves
in just about any city in America. It’s the fallout from a privatized health care
system that is loaded with administration costs. Would universal health care make us healthier? We asked the Canadian broadcasting
corporation to help us answer that question. Here is the CBC’s Waubgeshig Rice in Winnipeg. The coldest big city in the world,
right in the middle of Canada. WAUBGESHIG RICE (Reporter): Hello Joanne,
Canadians have had universal health care for more than 50 years, we don’t
call it socialized medicine here. Doctors remain in private practice,
only they don’t bill their patients; they bill the government for their services. Here, cost doesn’t keep people away
from the doctor, waiting lists do. Tonight, I will tell you how people
cope with those waiting lists, and you will meet some seniors who say
they will never trade universal health care for American style medicine, but they
would like some changes, here in Canada. Joanne… FARYON: Thanks
Waubgeshig, I’ve lived on both sides of the border there is a great mythology that
surrounds the American health care system in Canada and one that exists here
too, about the Canadian system. There is the belief that America
will leave you to die on the street if you can’t pay your hospital bill. And here in the U.S. many believe in
Canada you may die waiting to get care. So let’s begin there. What happens here in San Diego County when you don’t have health insurance
and you don’t have any money. Meet Leeann Brady. 52-year-old Leeann Brady loved being a waitress,
but she hasn’t worked for more than a year. She has back pain and can’t
lift her arm above her head. LEEANN BRADY (uninsured): I could no longer
carry the plates without severe pain; shaking. FARYON: Brady needs an MRI, but like 46
million other Americans, that’s one in seven, she doesn’t have health insurance. BRADY: If I needed back surgery
right now, forget it. I mean, I will probably wind up crippled. FARYON: A few years ago, Brady even tried
to refinance her house to pay for the test but couldn’t, her credit wasn’t good enough. DR. JEOFFRY GORDON (family doctor): I actually think her shoulder would get
much better if she could have surgery. FARYON: Doctor Jeoffry Gordon is Brady’s doctor. He sees her regularly for about $15 a visit, about one tenth of what a doctor
could bill for an office visit. DR. GORDON: What I would only call Shocking Gap
FARYON: Dr. Gordon lectures to other doctors on what’s wrong with America’s
health care system. DR. GORDON: It’s set up to make money for
insurance companies and pharmaceutical companies and surgical instrument companies. FARYON: According to the California medical
association private health insurance companies made more than 4 billion-dollars
in profit last year and spent another 6 billion
on administrative costs. In this country if you have the money or
good insurance you will virtually never wait for something like an MRI, if you’re broke
you will never even make it on a list. DR. GORDON: Don’t get sick in
America, that’s the way it is. FARYON: If you do get sick in America and you don’t have insurance you will
probably end up here, in the emergency room. At federal law requires all emergency rooms to treat patients regardless
of their ability to pay. As a result, emergency room doctors
are seeing patients for illnesses that should have been diagnosed and
treated by primary care doctors. DR. KIRK RAEBER (ER doctor): Such as renal
disease, heart disease, diabetes, hypertension, they could have probably prevented them
from coming in from this acute problem and a huge bill and hospitalization. FARYON: We met Betty Ann Bayliss in
the emergency room, she has insurance but it only pays for her breathing
medication ten months out of the year. BETTY ANN BAYLISS (ER patient):
And I can’t afford it too much. So, I have to skip you know
maybe one day, two days, three, four days at the most on my medicine. FARYON: Making the problem worse is the
increasing cost of health insurance, premiums have nearly doubled in the past 8
years, and that’s affecting the middle class. Employers are dropping from health
care plans or the premiums are so expensive they are dropping out on their own. Doctor Gordon supports a publicly funded
health system like Canada, he tells the story of his Canadian friend’s son who hurt his
knee in California and didn’t have insurance. The doctor’s advice, fly home to Canada. I bet you people in Canada are saying I
wonder how long he waited to have surgery. DR. GORDON: Waiting is much better than going
without or going broke or going bankrupt or having to take money from your
mortgage or from your home equity or your kids college fund to
pay for your medical care. RICE: It’s sophisticated medical technology
that can pinpoint problems in the body from your brain to your heart to your limbs,
Magnetic Resonance Imaging, or MRI uses magnets and radio waves to take a
closer look at soft tissue. Health officials say getting an MRI
in Manitoba has never been better. DR. BLAKE MCCLARTY (Manitoba health):
I think we have improved things. And the volume of Diagnostic imaging procedures
has gone up an awful lot over the years. RICE: Compared to the United States
Canada has fewer MRI machines per capita but does more scans per machine and
patients the get the scan free of charge. But there is a catch, if it’s not
an emergency you’ll have to wait. TERESA CLIFTON (Canadian waiting for an
MRI): Extremely painful, it’s hard to walk. RICE: Teresa Clifton broke her foot last spring, but months after she got the
cast off she was still in pain. After CT scans and x-rays
doctors couldn’t figure out why. CLIFTON: They finally said, okay, we are going
to send you for an MRI, we think it’s muscle or tissue damage but now I’m on
a four month waiting list for it. RICE: She knows others need the scans more
than she does, still that wait is too long, and if the price was right,
she would pay for one. CLIFTON: I would really like to get this
fixed, find out what is wrong with it. Because the last thing I want to do is
take medication for the rest of my life. RICE: For non-urgent MRIs the wait
is typically five to eight weeks but the prevention government health department,
recently, changed how doctors order them, and that’s bumped wait times
up to fourteen weeks. Health say officials are working
on getting that back down. A unit like this scans 29 patient as day. This clinic also recently
expanded its operations to 7 days a week to see even more patients. The regional health authority also
has plans to add another MRI unit to another Winnipeg facility
hoping it will reduce wait times. DOCTOR MCCLARTY: Historically we’ve done
well on almost all of the wait list issues. RICE: Still health officials acknowledge that’s
little comfort for the people who are in pain, and if their health issues escalate
they will be bumped up for an MRI. So Doctors are asking people
on waiting lists to be patient. DOCTOR MCCLARTY: I’m not overly concerned that
there is a major health risk in any of that but it’s more should they have the right
to buy that if they can buy a steak at the grocery store, can they buy an MRI. That, I think, is the controversy. I’m comfortable with the quality of and the
availability of imaging services in Manitoba. CLIFTON: I definitely prefer our Canadian
medical system over the states, but when you — if you do get an opportunity to
pay a couple extra bucks to get down to the problem, I kind
of like that as well. FARYON: More than half of all bankruptcies filed in the United States are
triggered by medical bills. Evidence, the system takes its toll financially. But are we healthier in the U.S. than Canada,
we took a look at a very common diseased caused by an even more common condition,
diabetes and obesity. The statistics tell us we are the fattest nation
in the word and it’s making us sick, even blind. JEANNE TEAGUE (Volunteer, Center for the Blind):
For a diabetic, bacon does not count as a meat. FARYON: Every Monday at this support
group at the center for the blind, Armando Carrillo learns about what she
shouldn’t eat to control his type-two diabetes. Its information he should have had years ago,
information that could have saved his sight. MARIA CARRILLO (Diabetic): It was a slow thing. FARYON: Carrillo was working in a California
restaurant, back in the early 90’s, when he got stick, he was feeling weak
and constantly going to the bathroom. He didn’t see a doctor because
he didn’t have insurance. He was finally diagnosed with
type-two diabetes when he went to the emergency room because he hurt his knee. Soon after, Carrillo went blind. TEAGUE: At least Armando has his life still. So many of the people that have come
through this center, this was fatal to them. This lack of insurance. FARYON: Type-two diabetes is preventable. In the U.S. 1 in 13 people are affected by
the disease, among the Latino population that rate is even higher, one in ten. The reason, obesity, one of the
main causes of type-two diabetes. The U.S. is the fattest country in the world. In just one generation, obesity rates
have doubled tripled among children. DOCTOR JERRY PHELPS (UCSD Wellness Center):
What we are seeing now is cardiovascular disease in teens, and that is very scary. FARYON: Fast food and TV contribute to our
waistlines so does all the sitting in traffic. And as the economy struggles, it’s becoming more
difficult for Americans to buy healthy food. DOCTOR PHELPS: But for example a
hamburger costs less than a veggie burger. FARYON: On average, people living in low income
neighborhoods have five fast food outletsand convenient stores near their home. Twice the number than their
more affluent neighbors. Obesity rates are higher in America
than in Canada, especially among women. And despite the year around good
weather, and access to all this, more Californians are overweight than in a
place like Manitoba, Canada where cold weather and snow keep people indoors six months a year. Experts say it may come down to health
care and a simple visit to a family doctor, but government programs like Medicare don’t kick
in until people with diabetes are on dialysis. Carrillo lists all his family
members who also have diabetes, he is learning now why the disease has affected
his family, and now that Carrillo is blind and had a kidney transplant, he has two
government funded health care plans. The irony of the American health care system
is not lost on a man who worked all his life but couldn’t afford to see a doctor
to prevent a disease that, in the end, cost him his vision and a kidney. And now costs the government tens of
thousands of dollars in care and disability. RICE: For John Paintin, it’s simple, the
more he runs the longer he will live. Just three years ago he weighed
twice as much as he does today. JOHN PAINTIN (Canadian): I took a look
in the mirror and thought wow look at me, I’m 400 pounds; massively overweight. I had to do something with myself otherwise
I was going to be at risk of heart attack, diabetes, whole range of
different health problems. RICE: Paintin managed to skate off
diabetes as many Canadians have. In Canada only one in 17 has the disease,
a far healthier percentage than south of the border where it’s one in 13. And for anyone who is at risk in
Canada, getting good health advice is as easy as a free trip to the doctor. But for Canadians like Wendell
Oigg, free healthcare wasn’t enough to prevent his kidneys from
failing five years ago. He says he never took the
warning signs seriously. WENDELL OIGG (type-two diabetic): I’m sick. It comes back to haunt you. Why did I not listen to that? I should have listened, but I was stubborn. RICE: Wendell was first diagnosed with type
two in 1990 when he was 23 and 300 pounds. He never took his doctor’s advice to
lose weight and eat healthier food. Just a year after the kidneys
failed he slowly went blind. OIGG: If I would have listened and
ate everything I was supposed to eat. RICE: Wendell is an Ojibway,
one of the groups making up Canada’s 1.1 million aboriginal people. And while diabetes was virtually unknown
in aboriginal communities 50 years ago, today it’s reached epidemic proportions. Experts estimate one in four have the disease. DINA BRUYERE (Canadian Aboriginal
Diabetes Association): Today we live a sedentary lifestyle. And the food that we were able to access
now is not very good for our systems. RICE: A half century of change to traditional
lifestyles has meant less physical activity and less access to a healthy, natural diet and
a greater reliance on cheaper processed foods. BRUYERE: That’s very concerning. It should be a priority health
issue on Canada’s health agenda. RICE: So while Bruyere feels
the government has to act, she also thinks individuals can
improve their own situations too. Winston Thompson has seen the disease tear through the family a few years ago his brother
died from complications of the disease. WINSTON THOMPSON (type-two diabetic): Not
even less than two years after he passed away, that I was diagnosed with diabetes. And so I thought okay, that doesn’t sound
like – it’s not a good situation to be in. RICE: So he decided to get in
shape, now he watches what he eats and monitors his blood sugar regularly. BRUYERE: I think people are starting
to become aware of it now because a lot of people are experiencing complications. RICE: Complications that people like
Wendell can’t get fixed, only treated. He is grateful he is able to access
free treatment like dialysis. But that is little solace when he has himself to
blame for suffering through this new epidemic. OIGG: Take a look at what happened to me. I didn’t listen. Do you want what I’m going through? FARYON: The U.S. spends more money
than any other country on health care. But it’s not buying us longevity, Canadian
men and women live at least two years longer than Americans, we wanted to speak with
Canadian ex-patriots living in San Diego about which health care system they preferred
and where do you find a Canadian in California? At the hockey rink, of course. This isn’t hockey night in Canada; this
is hockey night in Escondido, California. “Who is from Canada?” Almost all of the players are
Canadian, a handful from Winnipeg. When they’re asked which
country has better health care, Canada versus the U.S., there’s no clear winner. Rob Kerr moved here years ago from Alberta,
his 22-year-old daughter can’t get insurance because she once had a benign cyst on her ovary. ROB KERR (Canadian living in San
Diego): Now, it’s called a precondition so she can’t get healthcare, anywhere. GEOFF LEIBL (Canadian living in San Diego): Well Rob that’s the difference we were
talking about, who falls through the cracks. FARYON: That’s Winnipegger Geoff
Leibl, he is an immigration lawyer. He moved to San Diego 15 years ago and has a successful law practice helping
thousands more Canadians immigrate to the U.S. LEIBL: The Canadians
biggest fear of moving to the states without a doubt is the health care system. FARYON: But it’s a misconception that is usually
cleared up when they visit an American doctor or see the inside of an American hospital. Leibl’s first experience with the
health care system happened just months after he arrived in the states. He had pain in his leg for weeks, when he finally saw a doctor,
he learned he had a blood clot. Leibl says if he’d been living in Canada
he probably would not have seen a doctor. He assumed he would have to
wait weeks or even months for an appointment and that
could have been fatal. LEIBL: As a Canadian growing up, I feel that
everybody should have access to health care. And the last thing you want to be worried about,
when you’re sick, is how am I going to pay for it, or what am I going to do? Am I going to get $100,000 in bills? But you also should have access to good
health care and immediate health care, there’s no point having free health care
if you are going to die waiting for it. FARYON: Canada spends about 10%
of its gross domestic product on health care, the U.S. spends more, about 16%. But still here in America, one out of
seven people has no health coverage. JAN SPENCLEY (former hospital administrator):
A lot of people will not agree with me on this but I’m going tell you that health care
should be a right for every American. FARYON: But not the way they do
it in Canada, Jan Spencley says. She is a former hospital
administrator turned advocate. SPENCLEY: I don’t want to wait a year for an
MRI like Canada does and I don’t want my father who needed hip surgery to
wait for more than a year for hip surgery because it was debilitating. So I think that we have to not — I
don’t use Canada as the only model. I think we need to be looking at the
world and picking and choosing the best and what fits our culture and our world. DOUG FROST (Canadian living in
San Diego): I think it all comes down to is it a privilege or is it a right? I think in Canada they see it as a
right here we see it as a privilege. FARYON; Leibl believes health care is a
right but like a lot of Canadians accustomed to waiting he feels privileged he has
immediate access to care here in San Diego, something he wishes for his
parents back in Canada. LEIBL: Sometimes I get the urge to say
get on a plane and come on down here and we can get the treatment down here quick and take the results home
and have them deal with it. They haven’t done it yet,
but I could see it happening. WAUBGESHIG RICE (Reporter):
Ron Leibl is Jeff’s dad. He knows staying active plays a huge role
in staying healthy, so he meets twice a week with his buddies at this Winnipeg Curling club. For Ron Curling has become as Canadian as
universal health care, he and his wife, Anne, have lived on the prairies their
whole lives and they see access to healthcare as one of the big advantages. RON LEIBL (Canadian): Everyone gets it. That’s the big picture. ANNE LEIBL (Canadian): What makes me happy
about it is that everybody is covered. RICE: Outside of a few minor procedures,
the Leibl’s haven’t had to rely too much on the health care system in recent years but as they get older they
know they’re covered regardless of their pensions or other insurance plans. RON: We wouldn’t dare go to the
states without having coverage over and above what we have here. RICE: But that’s exactly what their son, Geoff,
did when he moved to San Diego 15 years ago. RON: He went down with not
that much money at the time, and so we didn’t know how he
would be able to afford it. Yes, there was a concern, obviously. RICE: Jeff eventually got a good
job and health care along with it. His parents believe he is in good hands
if he or his family gets hurt or sick. RON: It’s wonderful that they get
terrific coverage, they use the system to their advantage and it
works out well for them. RICE: So well in fact that, even
though the Leibl’s are big supporters of Canadian health care, they wouldn’t rule out
someday going south for specific treatments. And it’s all because of where
they see Canada falling short – long wait times for different services. RON: I think it should be
enhanced quite frankly. I think there should be other schemes too
that should be outside the universal system. RICE: In Manitoba, you could
wait up to 7 weeks for a CT scan if you need a hip replacement you will wait 14
weeks, and for cataract surgery up to 10 weeks. ANNE: If somebody wants to pay,
they should be able to pay. RICE: There is an on-going debate
in the Canada, stick with a system where everyone has equal
access to healthcare or allow for some private services
which would relieve wait times. But that would mean people who
could afford it would jump ahead of the line.The Leibl’s seek marrying a
system that allows some private services, but for now they are happy to be at home
in Winnipeg especially during a time of economic hardships straight
across the continent. ANNE: Massive layoffs in the United States. Those people now have no medical coverage. At least that’s my understanding
anyway, they have no medical coverage. Layoffs are happening in Canada,
but those people are still covered. That’s a big plus as far as I’m concerned. FARYON: Now a story about a man who,
after spending a year recovering in a hospital made his way to the top. As president of one of San Diego’s
largest health care providers, Chris Van Gorder is president
and CEO of Scripps health. And just wait until you hear what he
has to say about health care in America. With five hospitals, ten clinics and
12,000 employees, Chris Van Gorder runs one of the largest corporations in the county. Scripps Health is a nonprofit
health care provider. Today Van Gorder is sharing some
good news with his employees. Scripps has made fortune magazine’s
list of top 100 companies to work for. It’s been an unconventional
road to the top for Van Gorder. He started out as a police officer,
but was seriously injured on duty. Van Gorder spent a year as a patient. And eventually left the force
and changed careers, working his way up in the world
of hospital administration. CHRIS VAN GORDER (CEO Scripps
Health): So I had, I guess, a fairly unique perspective on healthcare. FARYON: When Van Gorder sat down to tell us about his perspective on
healthcare, he was direct. The system in place now isn’t
working; it’s full of gaps and has left hospital emergency
rooms holding the bag. VAN GORDER: We really do have a national health
care system, it’s called the emergency room, but it’s a very expensive
way to get health care. FARYON: By law, emergency rooms have to treat
people regardless of their ability to pay. According to a San Diego
study, nearly half the people in emergency rooms could have
seen a family doctor instead. VAN GORDER: We’ve literally had
generations of families that believe that the emergency room is
their doctor’s office. Their parents got care in the emergency
room, so their children now get care in the emergency room because
nobody else will take care of them. FARYON: This kind of treatment is expensive. Scripps absorbed almost $240 million in
medical bills that were never paid last year, other hospitals in the county
report similar costs. Sharp spent more than $257
million on unpaid care. Van Gorder tells a story of
a 63-year-old man who walked into a scripts emergency
room almost three years ago. His diabetes was so out of control,
he needed his leg amputated. He spent a year recovering
in ICU; he had no insurance. VAN GORDER: It cost us over a million
dollars to take care of this gentlemen. That’s at cost, a million dollars. FARYON: The story doesn’t end there, the
man had nowhere to go when he was better but wasn’t well enough to live on his own. So, Scripts paid for the patient to live in
nursing care at a cost of $86,000 a year. VAN GORDER: This is a gentlemen, that because
there is no other program in this country that will take care of him, and he came to our
hospital emergency room, we have now have had to assume responsibility for his life. And we could be paying for his care, unless another system develops,
for the rest of his life. FARYON: Those costs eventually get passed
on to people who do have insurance. It’s one of the reasons hospital
fees are so expensive these days and insurance rates are climbing. Van Gorder believes health care would be cheaper
for everyone if everyone had health care. That is, a more regulated system that allowed
everyone to buy in at affordable rates. VAN GORDER: I can’t imagine looking
at somebody that needs health care and saying I’m sorry you don’t have health
care I’m just going to leave you now. You can’t do that as a healthcare provider,
these are human beings that have a right to health care, because we have the
ability of delivering that healthcare. The issue isn’t the desire for providers to
give care; it’s the economics of healthcare. That’s the problem. We need to fix the economics of health care. FARYON: President Obama has committed to the
creation of a health-care-reform bill this year. His proposal for a public healthcare
plan is being opposed by private insurers and has been slow to gain
support from legislators. Kathleen Sebelius, Secretary of Health and
Human Services was on the NewsHour recently and she spoke about the how the
president’s plan would impact all Americans. KATHLEEN SEBELIUS (Secretary, Health
and Human Services Administration): He’s a pretty strong proponent of a
new marketplace for those Americans who can’t afford the coverage they have, they don’t like the coverage they
have or have no coverage at all. A marketplace that would have
private plans standing side by side with a public option some competition
and some choice for consumers, he thinks is a very good thing and so to I. FARYON: We’ll continue to cover
this issue here on San Diego Week. Join us again next Friday at night at 7. Thanks for watching.

Daniel Yohans

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