COLUMN

A tragic tale of unnecessary death

Canadians don’t want to be like Americans, unless they become like us. But they want changes that will make them more like us.

DIANE FRANCIS December 30 1991
COLUMN

A tragic tale of unnecessary death

Canadians don’t want to be like Americans, unless they become like us. But they want changes that will make them more like us.

DIANE FRANCIS December 30 1991

A tragic tale of unnecessary death

COLUMN

DIANE FRANCIS

Canadians don’t want to be like Americans, unless they become like us. But they want changes that will make them more like us.

I’ve been a longtime critic of Canada’s health care system for a number of reasons, but I agree with its basic principle that society should provide everyone with an opportunity to get medical care. Likewise, I have complained about some aspects of Canada’s educational system but cannot fault the fundamental concept of equalization of the education dollar, which means that the provinces spend more or less equally on children (if not always wisely) regardless of color, creed, race or wallet size. By contrast, America’s medical and educational systems are a disgrace and should be, and hopefully will be, “Canadianized” this decade.

Fortunately, more Americans than ever are beginning to realize this. The recent Senate election in Pennsylvania sent a message to Washington that taxpayers want a decent medical system. There’s also plenty of talk, sometimes misguided, about education reform. Some states are looking at equalization payments to level the playing field and others are looking at making schools more accountable through greater parental participation. Such proposals have been slow to become law, but the signs are that the proverbial penny drops and then, hopefully by the middle of this decade, Americans will have a social safety net as broad as Canada’s.

I say that because such reforms cannot come fast enough. The sooner the Americans adopt our health and education systems the better off economically we will be in Canada. Right now, much of the cost of our medical and educational entitlements is borne by business in the form of higher taxes and operating costs, compared with American competitors. This gives many U.S. companies a competitive edge. Hopefully, the playing field will become level through a combination of cost-cutting measures in Canada and proper coverage in the United States.

Besides the issue of competitiveness, it’s also instructive to remind ourselves what Canada represents as a society compared with the United States, as we enter another hand-

wringing round of constitutional talks and collective self-doubt. We Canadians are not like Americans and don’t want to be, unless they become like us. Americans, on the other hand, are increasingly demanding that their society change, which will, whether they know it or not, make them more like us.

This is long overdue. As I’ve written here before, the United States is a great country to live in, unless you are poor, sick, old or black. Put another way, it is the richest country in the world, which contains a Third World country of 50 million blacks, Hispanics and others who are disenfranchised educationally and economically. Harsh words, but the United States is a have versus a have-not society while Canada at least tries to look after its underclass properly. What brought these issues home once again was the death last month of one of my American uncles at the age of only 60.

He died years before he should have because he was one of the 34 million Americans without medical insurance. When he was diagnosed with cancer a year ago, he told friends and relatives that he didn’t want to go through the chemotherapy, radiation or surgery which could have extended his life. The real truth was, he couldn’t. He didn’t have the option

because he was not insured and did not have the money to pay the cost. He was not insured because between jobs a few years back he was injured in an accident which resulted in chronic medical problems and provided an actuarial reason that made him uninsurable. My uncle paid his taxes and obeyed the law, but was the victim of a ruthless system.

Ironically, the Americans are partway towards a medical scheme like ours already, but U.S. coverage is only for the highest-risk persons in their society: senior citizens and welfare recipients. Because medical costs are highest to cover these groups, critics such as doctors and insurers claim that the United States cannot expand coverage to other citizens. But I would argue that the United States can’t afford not to change because lawyers, along with doctors and insurers, are sinking its medical system, along with the companies that buy insurance for their employees. Huge court settlements contribute mightily to soaring medical costs.

Only a government-backstopped medical system can end America’s vicious medical cycle: it begins when private-sector insurance companies must charge doctors huge malpractice premiums because of huge court awards; higher premiums mean higher fees charged by doctors; higher fees mean higher court awards; and higher awards mean higher premiums. In Canada, there are still lawsuits, but no one needs millions of dollars to cover future medical costs.

Like overdue medical reform, education reform south of the border would also solve other seemingly unrelated problems. In a recent discussion on U.S. public television, New Jersey’s reformist governor, James Florio, said that tax-supported schools in the state’s wealthiest area spent $14,000 per child per year on education while only $4,000 per year was spent on black students in the state’s poorest neighborhood. Why such a discrepancy? Because the U.S. education dollar is largely drawn from local taxes, unlike Canada, where tax dollars are distributed evenly, or according to need.

The fact that a poor black has so little spent on education makes it difficult for him or her to ever break out of the poverty cycle. Money spent on education cannot do it all, but it helps. Besides giving poor people an opportunity to prosper, education reform would arrest the destruction of American cities abandoned by well-off whites, who for two generations have fled to suburbs where schools are dramatically better. They leave behind decaying cities with shrinking tax bases populated by an underclass which is saddled with the tax burden of maintaining the cities’ underutilized transportation systems and other infrastructures.

Neither Canadians nor Americans really appreciate how profound the effects of Canada’s social programs have been in shaping two very different societies on the same continent. Canada’s social programs have helped create cities that work and resulted in a less hostile, more law-abiding underclass. The United States deserves no less, but must first realize that Canada has done it right.