Anyone who dares criticize the overly rigid Canada Health Act meets a standard reaction: “So you’d rather live with the American system, where 40 million people are deprived of health insurance?” This is an irrational reaction, as if there were only one alternative to medicare. (Let’s hope America’s health-care system will soon undergo the much-needed reforms envisioned by President Barack Obama.)
The head of the Canadian Medical Association, Robert Ouellet, should be credited for breaking with this obsession with the United States and broadening the issue by using the European experience to promote changes. He recently met health experts in France, Denmark, Belgium and the Netherlands and uses the European model to call for a blend of public and private medicine in Canada.
The European model is successful, indeed. According to the last World Health Organization ranking, in 2000, the top 20 countries with the best overall health performance were all in Western Europe, except for Singapore, Oman and Japan. France was No. 1; Canada placed 30th and the U.S. 37th.
What’s interesting is that most Western European states have lived under socialist governments for long periods, while the Scandinavian countries have pioneered social democracy. Left-wing European leaders have never sought to outlaw private medicine, a fact that contradicts the prevalent view in Canada that allowing private clinics to co-exist with public institutions is a right-wing ploy.
Dr. Ouellet told a reporter that the European experts he met were shocked by the Canadian waiting lists. “They don’t get it,” he said. That’s absolutely true. In Canada, people keep exchanging horror tales about how long they had to wait in emergency wards or for an operation or even for a doctor’s appointment. It’s a common topic of conversation. In France, a country I know well, waiting times is a subject no one talks about, for the simple reason that people are cared for without delay.
Occasionally, though, my French friends do complain about their health-care system. They say it has deteriorated. One friend, for instance, recently told me that “we no longer can call doctors at their home on the weekend, and house calls are difficult to get.” To a Canadian ear, this sounds like a description of paradise.
Call any GP in Paris or in the smallest French village. Even if you’re not a regular patient, you will be offered an appointment the following day. Sometimes, you’ll even be offered a choice: “Do you want to come today at 3:30 or at 6?”
One of the reasons for the sterling performance of the French system is its large network of family doctors – which means that everything is done to closely monitor the patient’s condition and prevent disease. There’s a glitch, though. There are so many physicians that their earnings are not as high as Canadian GPs. Most of them have no secretary, and they answer the phone, set up appointments and fill out insurance forms themselves.
I vividly remember the time we rushed to a hospital in the town of Béziers because my husband had badly cut his thumb. It was a Sunday at lunch time — the most sacred period of the week, when families regroup for long, leisurely déjeuners. We brought along several books and a pile of magazines because we were sure we would have to wait for hours. (After all, a cut is a minor emergency.) The nurse who greeted us (yes, she did greet us, with a sweet smile) took off my husband’s blood-soaked home-made compress, applied a temporary bandage and told him: “Unfortunately, there will be a little wait.” That wait was 20 minutes.
Later, on our way back to Paris, we stopped at a clinic in Montluçon to have a doctor look at his thumb, as the physician in Béziers had suggested. We had no appointment. We were directed to a sitting room and waited for 10 minutes. Then a surgeon came in, still in his operating gear and told us: “I apologize for the delay.” We almost fell off our chairs.