Canadian Healthcare and Electric Cars

By Bill Moore

Posted: 30 Sep 2009

I couldn't come to Canada, where I delivered the opening keynote speech at PHEV '09 here in Montreal, without getting into a conversation about Canada's healthcare system.

Given the debate -- as well as the exaggerations, distortions and outright lies -- about what healthcare reform might mean to its southern neighbor, Canadians must have a bemused incredulity about how some Americans view the system they have enjoyed now for the last several decades.

I sat down for pasta and pizza with Ed Innes with Manitoba Hydro, whom I'd met some years ago in Vancouver. We talked about the panel presentation he'd given that afternoon -- more on that in a future Current -- about electric vehicle initiatives in his province -- they have 12 plug-in Priuses in and around Winnipeg -- and his views on his country's healthcare system.

He gave me a brief history of how the Canadian system began to transform itself starting in the depths of the Dust Bowl era, which was taking a tragic toll on the farm families of Saskatchewan. According to Innes, an energetic church pastor named Tommy Douglas saw how the province's private health insurance system, similar to that in the United States, was failing. Impoverished rural families hurt by the years' long drought, were unable to afford their premiums. Their insurance lapsed and the resulting medical bills were devastating them financially.

Douglas began a long campaign for reform, one that would eventually see him elected as the province's Premier -- the equivalent to a Governor in the States. The Saskatchewan he inherited in the early 1950's was the poorest province in Canada, Innes told me. Without the industry of Ontario or the rich oil and gas resources of Alberta, its neighbors to the east and west, respectively, its government debts were piling up, its budget impossible to balance.

Fighting entrenched interests both in Canada and the United States, including the American Medical Association and lobbyists for the insurance industry, as well as the province's own physicians' association, Douglas pressed his campaign for reform that guaranteed all the citizens in the province access to quality healthcare.

Innes explained that Douglas was a eloquent master of explaining in simple, clear terms how healthcare reform would work, adding that there still is archived film footage of his speeches from the 1950's where he is pressing home his message, despite powerful opposition.

The reform passed and within something like three years, the province had balanced its budget.

"How's that?" I asked Innes, who was chewing on his pizza while I twirled my seafood linguini.

"Through the cost savings," he replied. Instead of the patient's premiums being laundered through an insurance company, it went directly to the doctor, whose fees were set by the province. The sheer reduction in administrative paperwork, along with a healthier, more productive citizenry who weren't being forced into bankruptcy and poverty, enabled the province to eventually balance its debt-riddled budget within three years of passing the program.

Douglas's healthcare initiatives were so effective that other provinces began to implement their own reforms. Today, Canada's healthcare system provides full medical -- but not dental coverage -- for all its residents. Oh yes, Canadian doctors are well-paid, especially specialists.

Innes, also admitted the system has it warts. It's not perfect, he said, but when Canadians voted on who they considered the "Greatest Canadian," they picked Tommy Douglas.

Innes went on to tell me how his 80-year-old mother fell a couple years ago, breaking her leg. Due to complications, she had to be hospitalized three times. The only question that was asked, was she able to successfully undergo and recover from the surgery? Despite her advanced age, the system made sure she had full access to all of its services and today, she is a spry octagenarian.

How much did three hospitalizations and follow-up medical care cost Mrs. Innes? Two bills, each for $100 Canadian, for two trips by ambulance to the hospital.

Okay, you say, but Canadians pay more in taxes. Granted, but the average American with healthcare insurance pays something close to $15,000 a year in premiums and deductibles. I am guessing that probably includes employer contributions, so add that to the taxes you pay and factor in the ever-constant worry that if you lose your job, you may not be able find comparable coverage -- or any coverage -- especially if you have a "pre-existing condition," which can include pregnancy, for crying out loud.

Now what does any of this have to do with electric cars, you're asking yourself? A lot, I respond.

When Toyota considered building a new manufacturing plant in North America, it chose to locate it in Canada; and the reason most often cited was Canada's national healthcare system. This was a cost Toyota wouldn't have to bear, allowing it to be even more competitive. Clearly, if America wants to lead in green car technology, it needs to be as competitive as possible, but that doesn't mean abandoning American workers to fend for themselves when it comes to healthcare. We are the only developed nation that still relies on an antiquated, profit-driven system that makes money by excluding people from coverage, and we're reaping the consequences.

Additionally, because having access to healthcare regardless of your previous medical history or whether or not your employer offers an adequate plan, Canadians don't have to fear financial ruin brought on by catastrophic medical bills. That may be why they seem to be a much more laid back, friendly and prosperous people.

I am writing this from the Chili's II restaurant in the G Terminal at Chicago's O'Hare International Airport, and I briefly got into a conversation with another traveler who had just attended an international city managers' conference in Montreal the week before. He expressed his amazement at how clean, neat and prosperous looking are the farms in Ontario and Quebec. He explained that when he briefly crossed back into upstate New York, it was like the difference between night and day. The New York farms were run down and weedy; the entire region clearly economically depressed, reminding me of my conversation with the Haitan cab driver who took me to the airport this morning. From Google Earth you can clearly see the border between Haiti and the Dominican Republic. The Haitian side is barren and eroded, the hills denuded of trees and vegetation; the Dominican side verdant and lush with forests. The difference between Ontario and New York might not be that pronounced from a satellite, but from the ground, it is quite discernible, at least in the view of the city manager from Midwest City, Oklahoma.

Whatever they're doing in Canada, they seem to be doing it right and I think a case could be made, based on Saskatchewan's experience, that the reformation of their healthcare system is a contributing factor.

ADDENDUM: I have found several YouTube videos featuring Tommy Douglas, who happens to be the grandfather of actor Keifer Sutherland. Below is one of those videos featuring his defense of funding the Canadian Medicare system he fathered.

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