While Canada has, for the most part, stayed out of the American election, the country’s health-care system has been brought into the fray – by Donald Trump in the debates, and now his running mate, Mike Pence.
So what is Trump’s campaign saying about Canadian health care?
They’ve dubbed it “socialized” health care as well as “slow” and “catastrophic.” And on Tuesday, Pence falsely said Clinton is proposing a similar “single-payer” system. Americans, he said, don’t want it.
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“Hillary Clinton’s plan is actually to introduce what is called single payer into the system. More government-run health-care insurance. She actually went to Canada and gave a speech that came out not too long ago,” Pence told a crowd of supporters.
“She told Canadians and business groups that she wanted to get, and I’m quoting, ‘universal health-care coverage like you have here in Canada.’ Well, we don’t want the socialized health care they have in Canada. We want American solutions.”
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Trump too has repeatedly and wrongly said Clinton is calling for a “single-payer” system. She is actually calling for the expansion of the Affordable Care Act, also known as Obamacare, while adding a “public option,” or government-run insurance plan, to the existing options.
READ MORE: Trump calls Canadian health care ‘slow’ and ‘catastrophic’
Tuesday’s statements have not been the first time Trump’s campaign has gone after Canadian health care.
During the second presidential debate earlier in October, Trump also said Canadians are heading to the States for major operations. A recent report by the Fraser Institute, a right-leaning think tank in B.C., found that 45,619 Canadians in 2015 received non-emergency medical treatment outside of the country, roughly 0.126 per cent of Canada’s population.
So for our American audience, here are some things to keep in mind when looking at the Great White North.
We don’t have one health-care system, we have 15
Under the Canada Health Act, which outlines universal access to hospitals and doctors, the details of how health services are administered fall to the provinces and territories.
“We have 13 provincial and territorial health-care systems,” said Danielle Martin, a family physician and vice-president at Women’s College Hospital in Toronto. “The federal government does set out standards for what each province and territory has to cover.”
The federal government is also required to look after aboriginal and veterans health care as well.
Does Canada truly have a ‘single payer’ system?
While Canada has a single-payer system for hospital and physician services, most vision and dental care is paid for out-of-pocket. And as many Canadians know, prescription medications are not entirely paid for by the government.
“Our single-payer system is focused on physicians and hospitals and we have a multi-payer system when it comes to many other aspects of health care, including prescription, medication, dental and optometry.”
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While our health care is sometimes referred to as “socialized” medicine, it is a mix of publicly funded services and private insurance.
In 2015, health-care spending in Canada was estimated at $219.1 billion, or roughly $6,105 per person, according to the Canadian Institute for Health Information. Overall, it represents almost 11 per cent of our gross domestic product
We don’t have to worry about who is paying
Martin says that even with Obamacare, one in 10 Americans still have no health insurance.
“I’m not talking about insurance for prescription medication or glasses, I’m talking about insurance if you get hit by a car and you end up in the ICU,” she said. “There are very serious problems in the American health-care system with respect to affordability and access to coverage.”
Under the Canada Health Act, every province and territory is required to have a public insurance plan that covers all “medically necessary” doctor and hospital care.
“My colleagues in the U.S. can’t believe how lucky I am that I never have to worry about that. It’s the universal coverage for those medically necessary physician and hospital services that is an incredible privilege … But there is still lots of work to do.”
Canada’s health care is not perfect
Martin says that some of the biggest challenges facing health care across the country is prescription drug coverage and wait times for elective surgeries.
And this a huge worry for doctors.
“We don’t have single-payer coverage, we don’t even have universal coverage when it comes to prescription medicine,” she said.
READ MORE: Wait times for health care services vary across Canada: report
And while the rhetoric is often amped up south of the border, Martin said Canada does struggle with wait times for elective procedures.
“Every Canadian knows that if your health is in serious, urgent trouble you’re going to get your care,” she said. “But where we are talking about more chronic, longer-term issues and problems, surgeries that are planned and not urgent or emergent often Canadians are waiting longer than we would like.”
Two reports released last December, from the Wait Time Alliance and the Fraser Institute, say many wait times are unacceptably high.
“But both of these get mischaracterized when they migrate into the media south of the border,” she said. “It’s not at all catastrophic or patients dying on a wait list.”
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