WASHINGTON (CN) – In a hearing that sparked fiery debate, members of Congress on Wednesday considered the merits of French and Canadian health-care systems as Congress struggles to change the American “nonsystem” run by profit-seeking insurance companies. “Health care is directed towards maximizing income,” a Harvard professor testified, “not maximizing health.”
The debate before the Subcommittee on Health, Employment, Labor, and Pensions, quickly turned into a contest of Canada versus the United States in the health care arena.
In his criticism of the employer-based American system, California Democratic Representative George Miller noted, “Your medical condition doesn’t know if you’re employed or unemployed.”
“We really don’t have a system. It’s a nonsystem” said Dr. Marcia Angell, a senior lecturer in social medicine at Harvard Medical School. She testified that insurance companies profit by refusing care.
“Healthcare is directed towards maximizing income,” she told the legislators, “not maximizing health.”
The United States remains the only industrialized nation without some version of a single payer healthcare system, and pays more than twice the average per-person cost of other western nations.
A single-payer system typically pays all medical bills from one government fund. Benefits of a single-payer fund are lower administration costs because of the simplicity of one system, and strong leverage in negotiating prescription prices and doctor fees.
Witnesses both pro and con used Canada, which has a single payer system, to make their points.
Dr. David Gratzer, a senior fellow at the conservative think tank, Manhattan Institute of Public Research, testified that a single payer system would be “a terrible mistake” and called it “socialism.”
Gratzer was born in Canada.
In the packed hearing, Georgia Republican Representative Tom Price also attacked the single payer system, and said the one in Canada is inefficient. The right to health care in Canada, he said, is “a right to get in line.”
In a sharp rhetort, Illinois Democratic Representative Phil Hare said, “Here we don’t have lines. We just get rejected.”
Hare was referring to the fact that nearly 50 million Americans are going about their lives without health insurance. He added that 97 percent of Canadians polled said they would not trade their health care system for one like the Americans have.
The beleaguered Gratzer — who was the sole witness to testify against single-payer systems — responded to his attackers by listing the shortfalls of Canadian healthcare. Three of four people who need urgent cancer surgery don’t get it in a timely manner, he said, and cancer survivorship is better in the United States than in Canada. He added that Canada has a rate of MRI’s per person that is one third that of the United States.
But Angell from Harvard contended that if other countries were to spend as much money on healthcare as the United States, there would be much better care and no waiting lines: “For them, the problem is not the system, it’s the money. For us, the problem is not the money, it’s the system.”
Gratzer sur-replied that Canadians flood into the United States for care. “When Canadians need quadruple bypass, they cross the border.”
“I’m from Illinois, I know about floods from the river,” Hare joked. He said he was unaware that Canadians are flooding in for health care.
Angell also disagreed. The 50 million Americans without healthcare “would love to go to Canada,” she argued. “That would be droves.”
She added that the high cancer survivorship in the United States is evidence that government health care works, rebutting Gratzer’s argument that it demonstrates the benefits of the system the United States has now.
“Cancer is a disease of the older people,” she said. Medicare insures almost everyone over the age of 65. It proves the entitlement program’s success, she reasoned.
Angell highlighted the fact that insurance companies gobble up 20 percent of healthcare costs while Medicare, a single payer program, uses a relatively tiny three percent for administrative costs.
Ohio Democratic Representative Dennis Kucinich began his questions by highlighting the fact that one in six Americans is “starving for healthcare.” He treated the hearing like a deposition, directing fiery questions at Gratzer.
He asked how many uninsured there are in Canada. Gratzer replied that there are none or very few.
“How many medical-related bankruptcies?” he asked. Gratzer replied again that there were either none or very few.
Gratzer was then asked how many uninsured Americans go without care. This time, Gratzer didn’t respond. When he was prodded, he said, “I don’t want to be led down a garden path.”
“I’m glad that we have other witnesses here,” barked Kucinich.
Dr. Walter Tsou, an advisor the Physicians for a National Health Program, said people should not be scared of a radical change in the health care towards a single payer system. “I come from Philadelphia where revolutionary ideas are celebrated, not dismissed,” said Tsou. “Our most famous radical document begins with the words ‘We the People,’ not ‘We the insurers.'”
Michigan Democratic Representative John Conyers also referenced the American Revolution, but to make the point that big movements, such as the adoption of a single payer system, don’t have to be supported by all Americans.
When the United States was founded, he said, “a third of the people wanted to be free, a third wanted to stay with England, and a third of them didn’t give a damn.”
Representative Robert Andrews, a New Jersey Democrat who is the subcommittee’s chair, reminded the audience that universal health care has a long history of being debated, but not of being adopted. Harry Truman advocated for it. Nixon proposed a plan for it, and attempts were again made in 1994. But, he said, “This time there is going to be a law.”