News | Blame Canada?

McGill expert speaks on the United States’ portrayal of our universal health care

As the fervent debate over health care reform has unfolded across the United States, Canada’s publicly funded universal health care has become a potent symbol for both sides. Proponents of public health care cite Canada’s system as a model for reform, while those in opposition have brought up long waiting times and unavailable treatments to criticize the very concept of public health care.

The U.S. debate has been characterized by a confusing multitude of assumptions about Canadian health care, which has often been portrayed as a failing system. Professor Antonia Maioni, Director of the McGill Institute for the Study of Canada, spoke with The Daily about how Canada has been portrayed in the health care debate. She argued that while the Canadian system may have its flaws, interest groups opposed to reform have perpetuated inaccuracies in order to misinform the American public about Canadian health care.

McGill Daily: Why has the health care debate been so explosive? What are the interests at stake?
Antonia Maioni: In the U.S. health care reform is the great, unfinished business of the Democratic Party— an issue divided on deep partisan lines. The debate about health care has a larger meaning about the role of government in people’s lives, government regulation in the economy and in society, and also a larger political meaning, in that President Obama has staked a lot of his political reputation on the health care issue.

MD: How has Canadian universal health care been used in the debate?
AM: It’s not the first time that Canada has become a player in the health-care debate. Since the seventies, there has been a push to provide all Americans with the kind of coverage they need. Under Bill Clinton, Canada was used as a model by those who wanted to see more government involvement, and also used by interest groups against government regulation. Canada became a whipping boy for these interests—most typically the insurance industry. We are seeing a revival of this in 2009— of seeing Canada used as a political instrument. Also we see how deeply conservative Republicans and their allies in federal interest groups are characterizing the Canadian system as something that is not attractive and something even Canadians don’t want.

MD: Is Obama’s reform intended to bring about a system similar to the Canadian model?
AM: Not really. What most Democrats would like to see is reform that intends for more access for more of the public. Every American should have access. Today most are insured through their employers. But what Democrats want to develop is a public plan that could be an option alongside employer insurance and private insurance, so people can choose how they would like to continue. It would still be a health care system in which there are different systems, not just single-payer like we have in Canada, but what is being proposed is a public option.

MD: Why has Canadian health care been distorted in American media coverage?
AM: I don’t watch Fox News so I can’t tell you the extent of it. However, the misinformation does not appear out of nowhere but is being promoted by interests who do not want to see reform. It’s not The New York Times talking about it—the facts, and the people that respect the facts, know what the Canadian health care system looks like. The misinformation is strategic. I don’t think Americans are purposefully bashing Canada. The United Kingdom and European countries have also been targets of misinformed scrutiny. Why have such wildly inaccurate statements been directed at health care systems abroad?
There is something in American political culture about the belief in American political exceptionalism — a belief that the U.S. is so different from other places that there is little that can be learned from abroad. Many Americans are insular in that way, and because the U.S. has many institutions that are believed to be unique, it would be impossible to have institutions that are similar to those found abroad.

Since the beginning of the twentieth century, every time the debate has come up there has been a backlash against a foreign model. In the early parts of the twentieth century, social reformers in California based reform on a model in place in Germany. The opponents of this reform used the anti-German war sentiments a way of really destroying that effort. In the forties, the debate became more about the communist threat. Anything seen as government regulation was seen as a slippery slope towards communism. So, the vilifying of Canada is nothing new from the American perspective.

MD: How have Canadians reacted to the portrayal of their health care system?
AM: We complain so much, but as soon as someone attacks it, most Canadians are ready to be up in arms. One of the things which is interesting and happened in the nineties as well, is when you keep on seeing something vilified in that way, many people begin to wonder, “Am I missing something? Is that really the way things are?” It plants a seed of doubt that can undermine confidence within as well. Attacks on some of the problems on our health care have given a lot of fuel to people that want to see more private health care in Canada. People who want more private health care are using the criticisms we are hearing on the American side as ammunition.

—Compiled by Humera Jabir

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