Canada, we are constantly being told by single-payer advocates, is a model social democracy with a medical delivery system that we should envy. Oddly, the people who make such claims never want to answer a question that Bill Steigerwald reiterates in a recent column

If Canada’s national health care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?

And it’s not only pregnant women, like the one who recently had to drive to Montana to have her baby, who cross into the U.S. on a daily basis seeking health care. Thus, Steigerwald inquires further:

Why is the hip replacement center of Canada in Ohio–at the Cleveland Clinic, where 10% of its international patients are Canadians … Why is Brain and Spine Center in Buffalo serving about 10 border-crossing Canadians a week?

By way of answering his own questions, Steigerwald provides the following datum:

Number of Canadians on waiting lists for referrals to specialists or for medical services–875,000.

It would appear that Canadians with sufficient financial means are seeking medical treatment in a country where such waiting lists exist only in the the fond dreams of single-payer advocates.

And what about the Canadians who don’t have the money to come here for care? I guess they just pray that their illnesses don’t kill them before the vaunted Canadian system can fit them in.

Comments 30

  1. Marc Brown wrote:

    How many Americans wait for treatment, and how many are going abroad for affordable healthcare?

    Posted 04 Sep 2007 at 3:24 am
  2. DrRich wrote:

    Canadians, and other peoples more civilized than we are, can afford to be smug about their “rational” healthcare systems to at least some extent because the “irrational” American healthcare system exists. Their richer citizens can come here for care, thus decompressing what otherwise might be a powerful voice for change. Non-American companies can invent healthcare products, knowing that a market exists for selling those products at a profit – it exists here. Most importantly, American ingenuity percolates to other nations over time (often at famously discounted prices), so there is indeed continued medical progress in countries like Canada. It’s just that this progress is subsidized by the American taxpayer.

    If the great American engine of healthcare progress should finally fail (by, say, adopting a Canadian-like system), healthcare will change radically not only here, but all over the world.


    Posted 04 Sep 2007 at 7:30 am
  3. Marc Brown wrote:

    ‘Non-American companies can invent healthcare products, knowing that a market exists for selling those products at a profit – it exists here. ‘

    Er, a market to sell healthcare products exists everywhere. The US is of course one of the biggest markets, but overconsumes many things.

    Posted 04 Sep 2007 at 9:54 am
  4. Jayson Martineau wrote:

    Just talked about this in my graduate class. I agree Canada has issues about health care but I know that we don’t get turned away because we don’t have coverage or can’t afford the procedure. We also don’t abandon the dieing like the USA. We fully treat all patients even when cases are deemed to be terminal. A classic example in the USA is the woman from Seatle that is trying to marry a Canadian so she can get treatment for her cancer because her insurance won’t cover it. You must also acknowledge that your place on a waiting list is determined by your level of need.

    Posted 22 Oct 2007 at 5:51 pm
  5. Frustrated Canuck wrote:

    Canadians are denied treatment. My mother was denied treatment for a severe infection. I believe treatment was denied based on her age, she was 70. Her infection got into her blood stream and even showed up on a blood scan, although, she actually saw various doctors with the exception of one none of the others treated her. One started her on antibiotics. Another took her off antibiotics. She was sick for six months and afterwards was never the same. What good is a healthcare system that is not there when people need it the most? Canada is not the perfect system, people die waiting for care, people are denied care, we often wait months and even years to see a doctor if we live long enough, and so-called elective surgeries which may be more serious than “true? elective cases can take weeks, months and in some cases years to obtain. Some people have died on waiting lists for cardiac surgery. The Canadian system stinks.

    Posted 30 Jan 2008 at 8:36 pm
  6. Ed wrote:

    I get a kick out of what Martineau wrote. “We also don’t abandon the dieing like the USA. We fully treat all patients even when cases are deemed to be terminal.”

    That’s downright funny. Denying patient’s care is exactly (down to the last detail) what Canada’s health care does on a daily basis. Martineau needs to change his statement claiming that Canada has a government that SAYS it wants to help the needy and dying. In truth, it is one of the least compassionate systems in the world. It doesn’t matter how much money you have, you’re still probably going to die waiting for the treatment you don’t have to pay for.

    And then Canadians are going to tell me this is “compassionate”

    Go figure.

    Posted 19 Feb 2008 at 3:28 pm
  7. Jeff Gannon wrote:

    I find it sickening that Americans have the gall to point fingers at the Canadian healthcare system. Not only is it superior in almost everyway – it works. Sure, of course it is not infallable – what system is? Of course people die waiting for treatment – but that isn’t because the system failed them – other factors are present. Everyone can’t use the same equipment at the same time – that is only logical – regardless of where you live – there are always going to be more patients than doctors/hospitals/available equipment. This is not a Canadian healthcare issue – it would be the same in ANY country regardless of the system in place. So to say that Canadians are dying waiting for treatment is a stretch of the truth without including the necessary facts to understand why. The system is not to blame – it works fine – not perfect, but again – which system is? The fact is – there are alot of sick and injured people out there and the Canadian system itself does not turn anyone away. Like waiting in line at McDonalds for your Big Mac – you will get served – but to think that you HAVE to be first in line – and get treatment immediately over the other people that are ahead of you is a ludicrous argument – wait your turn – you WILL get served. Unfortunately, if you die while waiting – your death will only add to the growing number of American HMO’s argument of – “See! The Canadian healthcare system failed another one”
    The fact is these large conglomerate drug companies and HMO don’t want to see a Canadian system adopted – because they know that it is a cashcow for them. Their system of greed and unethical performance would come under scrutiny and indeed be in question under the Canadian model.
    One must keep in mind that in America Insurance companies are fighting over themselves to get your business. They all offer the best service “since sliced bread”, and promise to be there for you when you need them. As we know, that isn’t always the case. Often people are denied on technicalities ranging from denial of treatment due to any number of reasons ranging from experimental, to cosmetic. Often patients are denied the proper insurance to cover many of their ailments because the HMO’s don’t want to make a payout unless they absolutely have no other choice. This is a daily fact of life for many people with health insurance living in America.
    Now one must ask, why would the HMO’s and drug companies stop at nothing – including unfair propaganda touting the ills of the Canadian healthcare model? Well, the answer is really quite simple. Under the Canadian healthcare system – private healthcare from Insurance companies is illegal. It is illegal for a Canadian citizen to seek out an Insurance company and pay for their service.
    Under the Canadian model – all of these private and/or state run insurance companies would go out of business. Considering that their way of life is at stake – it is no wonder that these companies would do and say anything to make the Canadian Healthcare system look flawed and imperfect. They are fighting for survival.
    Understanding this is key to understanding how their mindset works.
    Now you know why they insist that the Canadian system is flawed.

    Posted 05 May 2008 at 6:42 am
  8. America wrote:

    I’m sorry Mr. Gannon, but you are wrong. You wrote that shortages would exist in any country regardless of the system that is in place. The basics of a capitalist system is that it encourages competition which is what brings any market into equilibrium (supply=demand). There is not a shortage of doctors or equipment in the US. You rarely hear that people in the United States can’t find a doctor, instead you hear that they can’t afford a doctor. In Canada, even those who can afford a doctor can’t find one and that is because there is no competition in the marketplace because it is all government run. What do you think the government is going to do? Establish a costly system that meets the needs of all citizens, or, establish the cheapest system that covers only the basic needs of citizens. Canadian specialized care is a joke and that is why your system will not last. I know that if my wife were to have complications with her pregnancy she would receive the care she needs right away because our insurance covers all specialized care surrounding a pregnancy. Do you?

    Posted 01 Aug 2008 at 2:24 pm
  9. Geir Magnusson wrote:

    Has anyone done an unbiased,honest comparison between the two systems?
    We pay between 7 and 8 thousand dollars per person a year in the US and yet we have a large population uninsured.How do the two populations come out in basic measurements, such a infant mortality, longevity,and other fields? These numbers must be available and they tell a truer story than anecdotes.

    Posted 10 Jan 2009 at 5:37 pm
  10. Paul wrote:

    Magnusson, longevity and infant mortality are poor measures of health care because other factors like environment, education, heredity, lifestyle, and income have a much greater effect on them. Also, different nations have surprisingly different criteria for what constitutes infant mortality. A better measure would be mortality rates for diseases that rarely go away on their own and can’t be treated without modern medicine.

    Posted 11 Jan 2009 at 11:59 am
  11. Dan Maachini wrote:

    Longevity and infant mortality are poor measures of health care? Listen to yourself!!!

    Posted 06 Mar 2009 at 11:34 am
  12. Taylor wrote:

    You hear a lot about how many people die waiting for treatment, what about people dying because they are uninsured?

    Wonder which is higher, per capita?

    Posted 11 May 2009 at 4:21 pm
  13. Catron wrote:

    The number is pretty close to zero.

    Posted 11 May 2009 at 7:48 pm
  14. Robert Parker wrote:

    It appears that the major problem with the Canadian system is a lack of sufficient infrastructure and numbers of providers to support the demand for health services. Canadians acknowledge these shortcomings, but efforts to increase funding to improve the infrastructure and attract sufficient numbers of providers are opposed routinely because they must be funded through tax increases of some sort. In the USA there is already a considerably better infrastructure. Would that not translate into shorter waiting lists than Canadians experience? My point is why demonize the Canadian system on the grounds of long waiting lists if the same system in the USA would work, given our superior infrastructure? I believe that we can offer decent healthcare to everyone without creating Canada’d waiting lists.

    Posted 14 Jun 2009 at 1:07 pm
  15. Gerard Freisinger wrote:

    Writing from the perspective of 40 years as a physician in practice and someone who has been a patient.
    Please read “Phantoms In The Snow” written by Katz and Evans, et al in HEALTH AFFAIRS in 2002. It is a study of the number of Canadians coming to the US for health care. Very few. Not anecdotes but an actual study. We all have anecdotes. I can use them to show how US patients go to India for bypass surgery or Canada for lasik surgery.

    We seem to think a government system with 3% overhead is more expensive than an HMO system with an average of 27% overhead. We seem to think a system which is based on stock holder profit vs patient welfare is ethically superior in the name of capitalism.

    The handwriting has already been written on the downside of so called free enterprise. The banking system and the US auto industry have collapsed and require federal bailout. Pity the poor car dealer who, I believe, was held in the lowest esteem of all professions. Greed was the basis of failure in both the banking and auto industry. Private health insurance is next on the block. Check on the salary and benefits of top wall street CEOs, top auto industry CEOs and top HMO CEOs.

    The nay sayers -Republicans – have little to offer other than sniping. Their philosophy is… “I have mine, #$@^ you”.

    How about social responsibility as number one and greed as number two?

    Posted 24 Jun 2009 at 7:46 am
  16. TR wrote:

    The unbiased truth is Canada has 10% the population the US has. This means what ever Canada spends on health care the US would have to spend ten times more.

    Biased opinion:
    The US HAS a Government health care system in place, in fact it has 3. Social Security pays for Debilitating conditions, Medicare, Medicaid, and one thing you hear about all those systems is they don’t work. Why? The Government tells doctors “You must charg this much for seeing a patient on our health care system.” why? the Government does not like to spend money. This is why 40% of US doctors will NOT see a patient on a US health care system. You honestly think that is going to change because O’Bama says “Make it so?” O’Bama wants US troops to use Private medical insurance to pay for war injuries. It might be because O’Bama gives money to people that lie to his face (car companies and AIG saying they will reform, then flip him the finger and give out bonuses with Gov bail out money)

    Canada has a system, this system is used in other places in the world as well. This system helps minor and long term curable needs. Quick and Long Term Terminal needs are not as well looked after.

    This is shown as Canada has a HIGHER mortality rate for heart related cases then the US. Canada also has a LOWER survival rate for Cancer then the US has. Sure, overall people live longer, but how many Terminal patients live past the limit on their life the Doctors give them.

    Also Canada has a HIGHER income tax then the US… nearly twice as much first first $36,848 = 21.05%

    up to 33,950 in the US gets you a 15% tax rate

    Posted 12 Jul 2009 at 2:50 pm
  17. Ed Mounr wrote:

    It’s sad that so many USA citizens buy the BS. At tops we are maybe 12th in the world. LOL Checks the stats people, we are not as good as your illusions.

    Posted 17 Jul 2009 at 1:18 pm
  18. Truth seeker wrote:

    Only twenty (.1%) of 18,000 respondents to the 1996 Canadian NPHS survey indicated that they had gone to the United States in the previous 12 months expressly for the purpose of getting health care. No wonder Canadians are not scrapping their system for ours. No wonder the politician who instituted their health care plan was voted “Most Outstanding Canadian.”

    Conversely how many U.S. citizens go to Canada for their drugs?

    Posted 23 Jul 2009 at 10:18 am
  19. David wrote:

    I just want to add in some comments about my healthcare in the USA. I have always carried insurance, either group or individual insurance. In 1992 I had an individual policy with Blue Cross. I had developed symptoms that caused me promlems with my heart. I had to have surgerie to remove the linning from my heart. I had to wait 3 and half months before having the operation. Then my insurance would not pay all the bills and I had to send letters and make calls to get my bills paid. Oh and while I was in the hospital the billing department called my room. They could not even wait for me to leave the hospital. Anyway now I have a pre-exsisting conditon that rates me up so high that paying for medical insurance is like making a house payment. Some insurance companies will not even write a policy for me at all. I would welcome a national healthcare like Canada. Oh and when I lived in Florida I went to see a doctor and had an appointment in advance. I waited over 2 hours in the waiting room just to get five minutes of his time and he billed my insurance over $100.00 for that visit.

    Posted 23 Jul 2009 at 9:49 pm
  20. Gerard Freisinger wrote:

    Read “Phantoms In The Snow” by Katz and Evans in “Health Affairs” May/June 2002.

    A lot of people from all over this country -especially health care providers go to Mayo and Cleveland because they are major magnet hospitals.

    Posted 04 Sep 2009 at 5:00 am
  21. Hank wrote:

    The Canadians crossing for treatment to the US nevertheless have their costs subsidized by their governments. They are sent by their government to the US for treatment because they could not be accommodated in their system as they pleased. No queue in the US? Just look at County Hospitals and the ERs in other private hospitals. Also, look at the lines in charity medical fairs and the like.

    Posted 11 Sep 2009 at 9:48 pm
  22. Kate wrote:

    Um, Jeff Gannon is incorrect to have said that private health care is illegal in Canada. Canada has at least Blue Cross health care that you can pay for in addition to the provincial. Blue Cross would cover things like ambulance rides, dental care, physio-therapy and seeing a chiropractor (last two disciplines have the first 15 visits covered by provincial plan, then after that you’re on your own—pay yourself or get extra coverage). The provincial health care plans cover medical doctor’s visits, optician and ophthalmologist visits and hospital visits. It does not completely cover physiotherapy. It does not cover the filling of any prescriptions. It does not cover dental work. It does not cover counselling. If you want any subsidising of these things, you must pay for extra health insurance outside of the provincial coverage.

    I’d like to see the US develop a health care system that looks at what’s around the world and try to adopt the best of everything—including what might already work in their own country (a country to which I have emmigrated as a Permanent Resident and the lack of BASIC national coverage is terrifying to me). Yes, it’s probably pie-in-the-sky dreaming, but they could at least try . . . you guys could at least let them try.

    Posted 05 Oct 2009 at 6:54 pm
  23. Carole Eberhardt wrote:

    The Canadian single payer systems does pay for Canadians to receive medical services in the USA.Also many seeking care live closer to a hospital in the US than one in Canada. Many border cities are that way. A great many Canadians live in the US part of the year and thus receive medical where they are living.
    Yes you can get privat health care in Canada if what you want is private nursing, rooms and gormet food service.

    Posted 03 Mar 2010 at 3:56 pm
  24. Trevor Howard wrote:

    Gerard Freisinger,

    It was not the CEO’s that gave permission to receive federal bailouts for themselves. (Though, who knows, the line between capitalism and politics is ever increasingly blurred due to special interests.)

    Government stepped in under the name of ‘social responsibility’ to keep inefficient and irresponsible businesses afloat.

    This is not how capitalism is supposed to work.

    Point being, be careful requesting for social responsibility. Just look at what the government throws money at in futility under the very same premise.

    Nothing changes when crying loud enough brings the milk every time. At least someone else will pay for it, right?

    Posted 22 Jun 2010 at 3:18 am
  25. Gerard wrote:

    Trevor Howard,
    Your point being, I think, is that the “Market” will sort it all out. What makes the market are firms that build factories and hire workers in other countries. Thus leaving the US empty in all but consumerism. Eventually, there will be noone employed to consume anything.
    A start would be to have firm overhead cut by not requiring an employment based health benefit model but to have salaried providers funded by an income and sales tax with elimination of all private and government third parties.
    The sales tax would pay for the free health care for the unemployed, retired and illegals.
    All of them buy stuff.

    Posted 15 Sep 2010 at 8:19 am
  26. Frank Halstead wrote:

    What’s BS is having a debate based upon anecdotal stories. For example the womam going to Montana to have a baby likely happened because that was where the closest emergency facility was located. Having grown up in Montana things like this are not even unusual. But what is more ridiculous is this oft repeated made up argument of how Canadians are flooding the US because their system is so horrible. This can all be traced back in fact to an ‘editorial’ comment made on the Fair and Balanced Network years back without any substantiation just ‘stories’ and even those were stories without circumstances or facts. Ironically the situation has been studied empiraclly but ‘data’ isn’t as sexy as, “Oh, did you hear about the one that …” If there is any genuine objectivity about this discussion on the part of the originator (which I doubt since it’s a statement disquised as a debate) then take the 10 or 15 minutes to read an actual study of the problem or rather perceived problem

    Oh and at present an estimated 1.5 million Americans leave this country each year to seek care abroad and in some cases their insurance providers are paying for trips to Malaysia and India get surgeries performed ‘cheaper’ than here so in a manner of speaking US Healthcare is already being rationed to a lower quality standard and paying to have it done. BTW people coming here posting as ‘doctors’ should know better, unless all they are is what they likely are, internet posers. Finally, the number of respondent doctors turning away Medicare patients is 13% NOT 40% more apocryphal BS.

    Posted 21 Oct 2010 at 7:08 am
  27. Wodahs wrote:

    It is not BS to state that US doctors turn away Medicare and Medicaid patients. I have experienced this with both my elderly mother and my disabled brother. The classic statement is “We aren’t taking any more Medicare patients”. They can’t afford to. I did find a doctor for my brother by offering cash. For the last four years that’s the only way my brother can see his specialist. Without the treatment provided by this doctor, my brother would most likely be dead by now.

    Posted 29 Nov 2010 at 11:15 pm
  28. Se wrote:

    I would like to say both systems are wrong. One for making people to die at no cost and the other that is making people die because of extremely high unaffordable service prices. I think many European countries would be ideal to look at where one can use their government offered health care service but also has an option to go to see a Dr. in private and pay the high price for that. This way everyone has an option to fit their circumstances.

    Posted 04 Dec 2010 at 12:45 am
  29. Marc Brown wrote:

    ‘I think many European countries would be ideal to look at where one can use their government offered health care service but also has an option to go to see a Dr. in private and pay the high price for that. This way everyone has an option to fit their circumstances.’

    That’s exactly how the United Kingdom works, although if you pay to see a physician privately the chances are that you could also see the exact same doctor for free under the state system. What you or your insurer pays for is the plush private clinic outside of a teaching hospital, so none of those awful med students around either.

    Posted 04 Dec 2010 at 4:14 pm
  30. Josh wrote:

    With the exception of Gerard Freisinger and a few others, I am amazed at the amount of willful ignorance and unmittigated stupidity expressed in this blog.
    I was born in Canada, but I moved to America for the love of an American girl. Believe me, I did NOT come to America for the healthcare. As a mater of fact, I have NEVER known a single Canadian who would come to America for healthcare. But I DO know many Americans who have come to Vancouver for Lasik (where the process was invented, thank you very much). I also know many Americans who come to Canada to buy prescription drugs. Also, my home province of British Columbia is having a severe problem with uninsured Americans coming to our cities to try and receive free healthcare because they can’t get treatment in America. Uninsured Americans are starting to become as much a problem for us Canadians as illegal immigrants from Mexico are for you Americans! My wife is an American and she is a Nurse Practitioner/Midwife. I am a sonographer. We both see first-hand the problems with the American healthcare system. An American hospital will charge $11.00 for ONE Advil. ONE ADVIL!!! That pill cost 0.0003 cents to produce. When you and I buy in bulk at Costo, our toilet paper and aspirin are CHEAPER. Well, nobody buys Advil in greater bulk than a hospital. So, why are they charging $11.00 for one pill? I’ll tell you why…greed. And this one example is applicable across the board for all pharmaceuticals and medical procedures. The American-Medical-Industrial-Complex has the citizens of America by the shorthairs and they have managed to convince poor, conservative Americans that they like it. I may live in this country, but if I ever fall seriously ill, I’m going back home where I won’t be financially raped and left to the wolves. America is a great country and it DOES have a lot going for it. But your leaders are liars, your system is failing, and your people are to prideful to take a good long look at your own messy messy house. And that is too bad for you, frankly. As much as I admire Americans, I also feel sorry for them. You are all getting f*&@ed in the backside but you’ve been convinced that you like it. I’ll never understand it.

    Posted 05 Jan 2011 at 6:32 pm

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