Linda Silas, president of the Canadian Federation of Nurses Unions, is a strong believer in a robust public health care system, and she's got some advice for Americans who oppose 'socialized medicine.'
"If you really want to save money from your pocketbook and your government purse, you need a publicly funded and delivered health care system," asserts Silas, who heads the largest organization of nurses in Canada. Silas, a registered nurse who has worked in intensive care units and emergency rooms, is a staunch supporter of her country's provincially-based, publicly-funded health system, which by almost any indicator delivers better outcomes at a much lower cost than the for-profit US model.
This Digital Journalist recently interviewed Silas as part of a series on global health leaders' reactions to America's rejection of public health care. We discussed the history of Canada's vaunted universal health care program, known as Medicare, and what it means to Canadians, as well as why so many Americans remain so afraid of 'socialized medicine,' even as unpaid medical bills remain the leading cause of US bankruptcies, the country ranks 51st in global life expectancy, its health care is ranked 37th by the World Health Organization, and one in six Americans-- 47 million people-- lack health coverage.
Digital Journal: Is health care a human right?
Linda Silas: It is. It is a basic human right. Health care and education are basic human rights. It's the same when we talk about the environment, the air we breathe, those are basic human rights. Just like living without violence. But health care is part of those human rights we have to defend.
DJ: Why did Canada implement universal health care?
Silas: Medicare started... to really take care of each other as a community, to take care of our neighbors. We didn't want our community doctor to leave the community because he or she was only getting paid in chickens and fruit baskets coming from the farm, and going to the big cities where he or she could get paid. So that whole community sense, that sense of equal treatment across the country, was really picking up 50 years ago and has continued.
DJ: Tommy Douglas, the former Saskatchewan premier known as the 'Father of Medicare' for introducing publicly-funded, universal health care in Canada, was named the "Greatest Canadian" of all time in a CBC survey. Fully 85 percent of Canadians surveyed in a 2007 McGill University poll said that eliminating Medicare would "result in a fundamental change to the nature of Canada." Canadian Medical Association President Dr. Louis Hugo Francescutti told me that Medicare is "ingrained in Canadians like maple syrup or hockey." Why do you Canadians love your system so much?
Silas: We're so lucky with what we have... It is part of our core of being Canadian. We don't want to lose it. It's a no-questions-asked system. When you need help, it's there. We're covered from birth through any intensive care, trauma or anything you would ever need. That's including long-term care, which is the most topical issue right now, in regard to our aging population.
DJ: You have written that Canada is the only OECD nation with universal health care that does not also have a plan to cover pharmacy needs. Is this a big problem?
Silas: The cost of drugs has doubled in the past 15 years. It's costing more to the system, and it's costing more to the individual. So we need to deal with the cost and availability of drugs. If you don't get the right drugs, you won't get better. So you end up back in the public health care system. You go back to the hospital, where it costs us all. And that's why we need a national drug program.
DJ: What about long waiting times? We always hear health care horror stories about Canadians having to wait ridiculously long periods of time for certain procedures. Is this true?
Silas: Some people will say you have to wait longer than a rich American who can go to the Mayo Clinic. But you'll only wait longer if it's a non-emergency.
DJ: Why do you think so many Americans are so afraid of the idea of publicly-funded health care, or 'socialized medicine,' as we derisively call it-- even people who rely upon government health care programs such as Medicare?
Silas: You have to look at who is afraid of it. If you're rich, if you're a multimillionaire, you don't want a public health care system because it doesn't really matter if you're rich when you go in to a public system. You will be treated by the medical evidence, so if you need your surgery immediately, you will receive it. If you need a private room, due to infection, for example, you'll get a private room. It doesn't depend on how much money you make. So you just have to really examine who's making the most noise against socialized medicine in the United States, and it's almost 100 percent those who are better off in society.
And when you look at any study done on social determinants, any international study, and the WHO did a study two years ago on social determinants, it was those who live in poverty or in very impoverished areas, those who have mental health issues, those who live in rural areas, those who have less education-- these are the people who need health care the most. You don't hear their voices, because they're not as well organized as the well-educated and more affluent.