[Congressional Record Volume 146, Number 6 (Tuesday, February 1, 2000)]
[House]
[Pages H93-H95]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               CANADIAN HEALTH CARE IS A COLOSSAL FAILURE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 19, 1999, the gentleman from Florida (Mr. Stearns) is 
recognized during morning hour debates for 5 minutes.
  Mr. STEARNS. Mr. Speaker, back in the 1970s when Canada unveiled its 
national health care program, it promised its citizens universal and 
free health care. In fact, in 1984 the Canadian Government promised 
that it would make available to all its citizens health that would be, 
``universal, portable, comprehensive and accessible.''
  Now, we can learn a lesson from Canada because the promises that were 
made have not been kept. Far from it. Before I elaborate on why I 
believe it is a mistake for this country to go down the same road, I 
wish to point out that we have several candidates who are running for 
president on a national health care program much like Canada's. Of 
course, they talk about it differently, but basically they want to have 
the same health care plan that Canada has, even though the Canadians 
are swarming across the border because the waiting lines are so long in 
their country.
  National health care often results in the rationing of health care 
itself. In his State of the Union address, the President outlined 
several new health care spending initiatives that would cost the 
taxpayers at least $150 billion. What troubles me about this is that 
the President's health care plan looks a lot like the plan they 
proposed several years ago. That plan would have put the Federal 
Government in charge of our entire health care delivery system.

                              {time}  0945

  And, as we remember, this was soundly defeated by the electorate.
  By rejecting the Clinton administration's Health Security Act, the 
American people sent us a message. That message was that they did not 
want government-run health care. Countries such as Great Britain and 
Sweden are now moving toward privatizing their health care system 
because it has resulted in rationing of health care benefits.
  Let us review the promises that were made and the reality of Canada's 
health care system. The Canadian government promised they would provide 
universal coverage. However, two provinces, British Columbia and 
Alberta, require that premiums are paid. And, if they are not, then the 
individual is not covered. In other provinces residents must register 
to be eligible for coverage. Studies show that in 1997

[[Page H94]]

through 1998 approximately 170,000 people in British Columbia alone, 
that represents 4.2 percent of the population, were not covered.
  In touting its national health care plan, the Canadian government 
also promised portability. If I might interject here, we enacted 
legislation to address the portability issue in 1996 here in Congress. 
Now, suppose a resident of Quebec became ill in another province. They 
must pay out of pocket for their health care services. Quebec will 
reimburse for those services, but will only reimburse them for what 
that service will cost in Quebec. Does that sound like something we 
have heard before or something that we would like to have?
  The next promise was that it would be a comprehensive program. Let us 
take a closer look. Each province defines the services that are 
medically necessary and then only pays for those services. An 
interesting twist on this is that pharmaceutical and many surgical 
procedures are, for the most part, not covered for individuals under 
the age of 65, and only provide partial coverage for those above 65. 
Still not convinced?
  The last promise made was that national health care would be 
accessible. Since the government has had difficulty in funding this 
program, it has resulted in rationing of services. I would like to 
share with my colleagues some excerpts from an article that appeared in 
The New York Times on January 16 of this year. It was aptly titled 
``Full Hospitals Make Canadians Wait and Look South.'' The article led 
by reciting an incident involving a Ms. Boucher at a hospital in 
Montreal. She ate breakfast on a stretcher in a hall under a note on 
the wall that marked her patient spot. Sixty-six other patients without 
rooms also waited in that corridor.
  Mr. Speaker, I do not think this is what the American people want. 
Another very telling example is in Ontario, Canada, Canada's wealthiest 
province. The waiting list for a magnetic resonance imaging test is so 
long that one man recently reserved a test for himself at a private 
animal hospital that had this type of machine. He registered under the 
name of Fido. This is not a joke, and it certainly is not meant to be 
funny. It just illustrates how bad the Canadian health care system is 
now that it is being run by the government.
  There are countless examples given in this feature story, and I ask 
my colleagues to review it. Mr. Speaker, I will ask the article to be 
made part of the Record.

                [From the New York Times, Jan. 16, 2000]

           Full Hospitals Make Canadians Wait and Look South

                           (By James Brooke)

       Montreal, Jan, 15.--Dressed in her orchid pink bathrobe and 
     blue velour slippers, Edouardine Boucher perched on her bed 
     at Notre Dame Hospital here on Friday and recounted the story 
     of her night: electric doors constantly opening and closing 
     by her feet, cold drafts blowing across her head each time an 
     ambulance arrived in the subzero weather, and a drug addict 
     who started shouting at 2:30 a.m., ``Untie me, untie me.''
       But as nurses hurried by on Friday morning, no one though 
     it remarkable that Ms. Boucher, a 58-year-old grandmother 
     awaiting open heart surgery, had spent a rough night on a 
     gurney in an emergency room hallway. After all, other 
     hallways of this 3-year-old hospital were lined with 66 other 
     patients lying quietly on temporary beds.
       To explain overflowing hospitals here and across the 
     nation, Canadian health officials are blaming the annual 
     winter flu epidemic.
       But, at the mention of flu, Daniel Brochu, the veteran head 
     nurse here, gave a smirk and ran his pen down the patient 
     list today: ``Heart problem, infection problem, hypertension, 
     dialysis, brain tumor, two cerebral hemorrhages.'' On 
     Thursday, he said, crowding was so bad that he was able to 
     admit one patient only after the ambulance crew agreed to 
     leave its stretcher.
       When Canada's state-run health system was in its first 
     bloom, in the 1970's, 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 system as a model for export.
       Improving health care should be the federal government's 
     top priority, said 93 percent of 3,000 Canadians interviewed 
     last month by Ekos Research Associates. In another poll last 
     month, conducted by Pollara, 74 percent of respondents 
     supported the idea of user fees, which have been outlawed 
     since 1984.
       ``There is not a day when the newspapers do not talk of the 
     health crisis,'' said Pierre Gauthier, president of the 
     Federation of Specialist Doctors of Quebec. ``It has become 
     the No. 1 problem for Quebecois and for Canadians.''
       In Toronto, Canada's largest city, overcrowding prompted 
     emergency rooms in 23 of the city's 25 hospitals to turn away 
     ambulances one day last week. Two weeks ago, in what one 
     newspaper later called an ``ominous foreshadowing,'' police 
     officers shot to death a distraught father who had taken a 
     doctor hostage in a Toronto emergency room in an attempt to 
     speed treatment for his sick baby.
       Further west, in Winnipeg, ``hallway medicine'' has become 
     so routine that hallway stretcher locations have permanent 
     numbers. Patients recuperate more slowly in the drafty, noisy 
     hallways, doctors report.
       On the Pacific Coast, ambulances filled with ill patients 
     have repeatedly stacked up this winter in the parking lot of 
     Vancouver General Hospital. Maureen Whyte, a hospital vice 
     president, estimates that 20 percent of heart attack patients 
     who should have treatment within 15 minutes now wait an hour 
     or more.
       The shortage is a case of supply not keeping up with 
     demand. During the 1990's, after government deficits 
     ballooned, partly because of rising health costs, the 
     government in Ottawa cut revenue-sharing payments to 
     provinces--by half, by some accounts. Today, the federal 
     budget is balanced, but 7 hospitals in Montreal have been 
     closed, and 44 hospitals in Ontario have been closed or 
     merged.
       Ottawa also largely closed the door to the immigration of 
     foreign doctors and cut the number of spaces in Canadian 
     medical schools by 20 percent. Today, Canada has one medical 
     school slot for every 20,000 people, compared with one for 
     13,000 in the United States and Britain.
       With a buyout program, Quebec induced 3,600 nurses and 
     1,200 doctors to take early retirement. And across the 
     nation, 6,000 nurses and at least 1,000 doctors have moved to 
     the United States in recent years.
       At the same time, demands on Canada's health system grow 
     every year. Within 30 years, the population over 65 is 
     expected to double, to 25 percent.
       Unable to meet the demand, hospitals now have operation 
     waiting lists stretching for months or longer--five years in 
     the case of Ms. Boucher.
       As a result, Canada has moved informally to a two-tier, 
     public-private system. Although private practice is limited 
     to dentists and veterinarians, 90 percent of Canadians live 
     within 100 miles of the United States, and many people are 
     crossing the border for private care.
       Last summer, as waiting lists for chemotherapy treatments 
     for breast and prostate cancer stretched to four months, 
     Montreal doctors started to send patients 45 minutes down the 
     highway to Champlain Valley Physicians' Hospital in 
     Plattsburgh, NY. There, scores have undergone radiation 
     treatment, some being treated by bilingual doctors who left 
     Montreal.
       Business has been so good that the Plattsburgh hospital, 
     which was on the verge of closing its cancer unit, has 
     invested half a million dollars in new equipment. And on the 
     Quebec side, the program has allowed health authorities to 
     boast that they have cut the list of cancer patients who have 
     to wait two months or more, to 368 today from 516 last 
     summer.
       In Toronto, waiting lists have become so long at the 
     Princess Margaret Hospital, the nation's largest and most 
     prestigious cancer hospital, that hospital lawyers drew up a 
     waiver last week for patients to sign, showing that they 
     fully understood the danger of delaying radiation treatment.
       With the chemotherapy waiting list in British Columbia at 
     670 people, hospitals in Washington have started marketing 
     their services to Canadians in Vancouver, a 45-minute drive.
       A two-tier system is also being used for other kinds of 
     operations.
       ``I would like to buy mother a plastic hip for Christmas, 
     so she doesn't have to limp through the year 2000 in 
     excruciating pain,'' Margaret Wente, a newspaper columnist 
     for The Globe and Mail in Toronto, wrote last month. ``I 
     could just drive her to Cleveland, which is fast becoming the 
     de facto hip-replacement capital of Southern Ontario.''
       Allan Rock, Canada's health minister, disapproves of such 
     attitudes. In an essay in the same newspaper, he wrote 
     sarcastically: ``Forget about equal access. Let people buy 
     their way to the front of the line.''
       In defense of Canada's state health system, he wrote, ``Its 
     social equity reflects our Canadian values.'' Mr. Rock, who 
     hopes to become prime minister one day, said that health 
     delivery could be improved through better, computerized 
     planning. He attacked a proposal in Alberta to allow private 
     hospitals, warning readers, ``The precedent may be set for 
     American for-profit health-care providers looking to set up 
     shop in Canada.''
       But the idea that there may be room in Canada's future for 
     private medicine is gaining ground.
       ``We have no significant crises in care for our teeth or 
     our animals, largely because dentists and veterinarians 
     operate in the private sector,'' Michael Bliss, a medical 
     historian, wrote on Wednesday in The National Post, a 
     conservative newspaper. ``So we have the absurdity in Canada 
     that you can get faster care for your gum disease than your 
     cancer, and probably more attentive care for your dog than 
     your grandmother.''
       In Ontario, Canada's wealthiest province, the waiting list 
     for magnetic resonance imaging tests is so long that one man 
     recently reserved a session for himself at a private animal 
     hospital that had a machine. He registered under the name 
     Fido.

[[Page H95]]

       To Ms. Boucher, who jealously guarded her 15 square feet of 
     corridor space today, such cocktail circuit anecdotes were 
     not amusing. Glumly eating her cold breakfast toast, she 
     said, ``It scares us to get sick.''

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