Getting the Treatment

A straw man is a weak argument set up for the sole purpose of refuting it. A weak argument against a health-care system might be called a straw patient. Monday in Bangor a group called Treatment Access Alliance arranged for a straw patient to ride along with a dozen people from New Brunswick as they sought prescription drugs and treatment in the United States, outside the single-payer, government-run Canadian system.

The straw patient implied is this: Advocates of single-payer health-care believe such systems are perfect – everybody in them gets immediate, low-cost care and all the latest drugs and procedures all the time. As a straw companion, they throw in the belief that the world has only one single-payer system worth talking about – Canada’s.

Having set up these weak arguments, the group can then easily knock them down by having Canadians show up in Maine and talk about their health-systems’ flaws. The fact that many also defended their system overall and certainly acted as if they preferred it to the system here was but a small diversion from the pre-arranged conclusion: Single-payer advocates are wrong and the current U.S. system is better than the alternatives.

Now Mainers know how little these lobbyists regard this state’s understanding of health care. The legislative panel currently looking at single-payer for Maine has never said the single-payer system in Canada and in the many other countries that have successful variations of it were without flaws. And which advocates for single-payer have said they would adopt only the Canadian system, without amendment? None.

When the anti-reform lobbyists against the Clinton health plan wanted to kill it, they brought out the fictitious Harry and Louise, a television couple that spread fear about a government takeover of doctors’ offices. The people who arrived from Canada on Monday, certainly, were real and seemed like nice neighbors. But the suggestion that they represent an exodus of Canadians trying to escape their system repeatedly was shown to be false. Each, including the doctor who helped arrange the trip, said they liked or were proud of the Canadian system. Jane Schimpf summed up the group’s feelings, saying she hopes her country sticks with universal care: “Rich, poor or in-between, you get the same health care as everybody else does.” Troy Warnock came to obtain new diabetes medication still being reviewed by the Canadian government but now available here. He said, “Down in the states you have to pay for everything. I like the idea that I don’t have to.”

Of course Canadians have to pay for their care, but the point is they pay less and have access to levels of care millions of Americans who lack insurance do not. And that explains the conclusions of a recent study in Health Affairs that found along border communities Canadians represented a mere .3 percent of inpatient stays and .2 percent of outpatient stays. The study, called Phantoms in the Snow, suggest Canadians are not finding any significant need to turn to the United States for care.

It is terrific that U.S. and Canadian hospitals can cooperate, making efficient use of resources in the way the certificate-of-need process in Maine is designed to encourage, and it is useful to have a reminder of some of the important benefits the current U.S. system offers. But these do not remove the need for serious reform.