From screaming babies to frail seniors, Canadian-born or recent immigrants, the patients flow continuously through the waiting room of Dr. Kamini Kambli's clinic. Most have made their appointments that day. None will receive a bill.
The receptionist swipes their ID to verify their eligibility as Ontario residents for coverage under Canada's universal health care system. Kambli's family medical practice will be reimbursed by the government.
Canada's system is called Medicare, and is much like Medicare in the U.S. for over-65-year-olds, except that this one treats virtually the entire Canadian population of 33million.
“It's one of the best systems in the world. Everyone is guaranteed health care and it does not matter if you're rich or poor or what your medical condition is – you will be seen and provided health care. How can you argue with that?” says Kambli, who used to practice medicine in her native India.
To be sure, Canadians have their complaints about their health care system – about long waits for elective care, including appointments with specialists and selected surgical procedures; shortages of doctors and nurses, particularly in rural areas; and the growing costs of covering an aging population.
The Canadian Medical Association wants to mix private insurance into the government monopoly. There have been lawsuits demanding the right to buy private health insurance. David Sebald, a Toronto-based health care consultant who has lived in the U.S., calls for a co-payment system to “eliminate the hypochondriacs.”
But right now, Canadians are setting aside their criticisms of Medicare and rallying to its defense. The reason: Their system has been dragged into the debate over President Obama's health care overhaul proposals by opponents who say Canada proves Obama is wrong – that Canadians endure long waits for critical procedures, medical rationing, scant resources and heavy-handed government interference.
A TV ad sponsored by the conservative Americans For Prosperity Foundation spotlighted a Canadian woman, Shona Holmes, who has challenged the system in court.
Holmes spoke of suffering from a brain tumor and declared she would “be dead” had she relied on her government. She said she had to mortgage her home to pay more than $97,000 to get timely treatment at the Mayo Clinic in Arizona.
In Canada, groups quickly sprouted up on Facebook accusing Holmes of betraying her country and exaggerating her illness.
In a report on its Web site, the Mayo Clinic said Holmes was suffering from a Rathke's cleft cyst near her pituitary gland. The Web sites of several reputable medical groups list the cyst as non-cancerous.
“We've heard talk in the U.S. that you may die here because of long wait times, you can't choose the doctors or the care you want and that the government makes your health decisions for you, but none of that is really true,” said Dr. Michael Rachlis, a leading Canadian health policy analyst who has written three books about Canada's system. “I think there's a lot that the U.S. could learn from Canada.”
Rachlis believes the most significant lesson is the Canadian system's egalitarianism: health care regardless of income, age and health status. No one is left without critical care and consequently, Canadians live three years longer on average than Americans, according to the World Health Organization.
“The flaw in the American system,” Ontario Health Minister David Caplan said recently, “is that first they check the size of your wallet, not the size of your need.”