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ACTION ALERT:
U.S. Media Favor Radical Health Reform-- for Canada

February 17, 2000

When mainstream media report on widespread dissatisfaction with the
HMO-driven U.S. health-care system, reporters seldom mention proposals for
fundamental health reform; debate is usually limited to modest, incremental
plans, like the "patients' bill of rights."

But as Canada has struggled this year with a funding shortage for its
much-admired public health system, ABC News and the New York Times have
pounced on the story as an opportunity to declare the failure of that
country's system of universal healthcare.

On February 3, ABC aired a report by correspondent Deborah Amos in Toronto,
depicting a country "struggling with universal healthcare." Most of Amos'
report was taken up by grim descriptions of crowded hospitals: "The
emergency rooms in Toronto hospitals are so clogged this winter, patients
wait hours for critical treatment," Amos reported. "They sleep on stretchers
in drafty hallways. And wait days for a hospital bed."

Introducing Amos' report, anchor Peter Jennings made it clear that the
problems described in the segment were meant to be viewed as the pitfalls of
universal health insurance: "For many years, politicians, the press, and the
medical community have looked to Canada for the pros and cons of universal
health care. There are pros and cons...And [in Canada] it's a very serious
situation."

But Amos' attempt to explain why Canada's health service has suffered in
recent years did not even make a pretense of journalistic balance. She
reported that while health authorities blame shortages on this year's flu
epidemic, "many Canadians believe it is the healthcare system itself that is
truly sick":

"The problem goes back a decade to when the Canadian government, in the
middle of a recession, recognized that universal care was inefficient and
expensive. So Canada closed hospital wards, eliminated 11,000 hospital beds,
reduced nursing staffs, cut the number of places in state medical schools."

Not only does Amos' diagnosis blatantly take sides in an obviously
controversial debate, but it contradicts a large body of evidence about the
Canadian health system. The notion that universal health care is "expensive"
in Canada is hard to reconcile with the fact that per capita health spending
in the U.S. is more than twice as high: $4,000 last year, compared with
$1,800 in Canada.

And while Amos calls Canada's system "inefficient," administrative costs in
the U.S. system are far higher, due to a sprawling private-sector
bureaucracy: A landmark 1991 New England Journal of Medicine study found
that 24 percent of U.S. health spending went to administration, compared
with 11 percent in Canada.

In fact, as Amos herself seems to recognize, the immediate causes of
Canada's current health-care delivery problems are the austerity measures
implemented by a series of recent budget-cutting governments. While real per
capita health spending in the U.S. has risen by 27 percent since 1990, in
Canada it has risen by only 7 percent--leading to predictable shortfalls in
services, given the healthcare industry's higher rate of inflation.

Likewise, a January 16 New York Times article, headlined "Full Hospitals
Make Canadians Wait and Look South," also made dubious claims about Canada's
health program. Illustrated with a photograph of an overcrowded Montreal
hospital, reporter James Brooke's article depicted a country rejecting its
model of universal care in favor of more American-style solutions:

"When Canada's state-run health system was in its first bloom, in the 1970s,
Americans regularly trooped up here on inspection tours, attracted by
Canada's promise of universal 'free' health care. Today, however, few
Canadians would recommend their model for export."

Yet the closest evidence Brooke could find to support this  thesis was a
January poll by the Pollara firm that found 74 percent of Canadians
"supported the idea of user fees," which have been outlawed in Canada since
1984. But Pollara surveys have also found that Canadians would only be
willing to support very small fees, averaging about $18 per health visit--a
sum that is unlikely to add more than 1 percent to the annual health budget
(Montreal Gazette, 1/13/00).

Moreover, the poll presented user fees as the only alternative to higher
taxes or less spending on other government programs. (Respondents rejected
both higher taxes and lower social spending, but 64 percent favored cutting
military spending to pay for health.)

Yet Canada has a large and growing federal budget surplus that can be used
to dramatically increase healthcare spending--an option endorsed by the
leaders of Canada's 12 provinces at their February 3 meeting, but not given
as an option in the poll (Montreal Gazette, 1/13/00; Globe and Mail,
2/3/00).

The last time the Gallup polling firm asked Canadians whether they preferred
the American health-care system, in 1993, only 2 percent said they did; 96
percent prefered their own system (UPI, 9/13/93). By contrast, a 1998 survey
by Zogby, the Republican polling firm, found that 51 percent of Americans
would favor a "government-run health care plan that covers everyone in the
same way, like the system used in Canada. It would be paid for through taxes
and cover all necessary medical costs." Despite the abundance of negative
buzzwords ("government-run," "covers everyone in the same way," "taxes"),
only 38 percent were opposed.

ACTION: Ask ABC News and the New York Times to take another look at the
issue of Canada's health system. Urge them to cover the full range of debate
in Canada on how best to improve the system--not just the views of those who
favor privatization.

CONTACT:
Peter Jennings
ABC World News Tonight
mailto:netaudr@abc.com

James Brooke
New York Times
mailto:brooke@nytimes.com

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