Dr. Danielle Martin, a family physician from Toronto, compared health care in her country to the more expensive but less effective system in the United States. She was questioned at a Senate hearing on Tuesday by Sen. Bernie Sanders, the health subcommittee chairman, and Sen. Richard Burr, the ranking Republican.
With a hint of sarcasm, Sanders asked the doctor to explain how come the conservative Canadian premier hasn’t gotten rid of the country’s health care system. In another exchange, as the Los Angeles Times put it, Dr. Martin “bats down the myths and misunderstandings about the Canadian system that Burr throws at her.” Burr, for example, asked why former Newfoundland Premier Danny Williams had a heart valve operation in Miami, where he owns a condo, instead of in Canada.
* * *
Read portion of the transcript provided by the L.A. Times:
BURR: Why are doctors exiting the public system in Canada?
MARTIN: Thank you for your question, Senator. If I didn’t express myself in a way to make myself understood, I apologize. There are no doctors exiting the public system in Canada, and in fact we see a net influx of physicians from the United States into the Canadian system over the last number of years.
What I did say was that the solution to the wait time challenge that we have in Canada — we do have a difficult time with waits for elective medical procedures — does not lie in moving away from our single-payer system toward a multipayer system. And that’s borne out by the experience of Australia. So Australia used to have a single-tier system and did in the 1990s move toward a multiple-payer system where private insurance was permitted. And a very well-known study by Duckett, et al., tracked what took place in terms of wait times in Australia as the multipayer system was put in place.
And what they found was in those areas of Australia where private insurance was being taken up and utilized, waits in the public system became longer.
BURR: What do you say to an elected official who goes to Florida and not the Canadian system to have a heart valve replacement?
MARTIN: It’s actually interesting, because in fact the people who are the pioneers of that particular surgery, which Premier Williams had, and have the best health outcomes in the world for that surgery, are in Toronto, at the Peter Munk Cardiac Center, just down the street from where I work.
So what I say is that sometimes people have a perception, and I believe that actually this is fueled in part by media discourse, that going to where you pay more for something, that that necessarily makes it better, but it’s not actually borne out by the evidence on outcomes from that cardiac surgery or any other.
(The ultimate zinger came at the end of the exchange, when Burr thought he had Martin down for the count about wait times in Canada, and she neatly put the difference between the Canadian and U.S. systems in perspective.)
BURR: On average, how many Canadian patients on a waiting list die each year? Do you know?
MARTIN: I don’t, sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all.
