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ONCE UPON A HEALTHCARE PLAN

By Laurie Simons

 

Once upon a time there were two neighbouring countries that shared the longest international border in the world.  (5,525 miles including Alaska)

They were very much the same in many ways.  But there was one way in which they were very, very different.

One of the countries was spending over $7000 per person on health care costs, and 5o million people had none.  Every year thousands and thousands of people died of sicknesses that could have been helped by a doctor, but they didn’t go to see the doctor because they couldn’t afford to pay for doctor and hospital bills.

The other country was spending less than $4000 per person.  Every single one of its citizens could go to a doctor or hospital any time they needed to, and it didn’t cost them any money.  No one died because they couldn’t afford the doctor.

This is the story of what happened.

In both countries, doctors were trying to help people pay for the expensive care they needed if they had to go to the hospital or see a doctor for an injury or sickness.

They had an idea:  a doctor run plan where all the people paid a monthly amount to the doctors.   The doctors looked after them when they were sick and were paid from the money that was collected.

But some people didn’t have enough money to pay the monthly fee.

The government wanted to help.  They were already collecting tax money from everyone who was working.  People who made a lot of money paid a lot of taxes.  People who made just a little money paid a smaller amount of taxes.  The government put all the money together to help pay for things that all the people needed like roads and parks and schools and firefighters and police officers and libraries.

Maybe the government could also pay the hospital and doctor bills for the people who didn’t have enough money to pay every month to be in the doctor’s health plan.

Some people thought this was a good idea.  The government could pay for the poor people, and all the others could pay for the doctor’s plan.

But in one of the two countries, Canada, the people who worked in the government said, “I don’t think so”.

They said, “What if the price of the doctor’s health plan keeps going up and up and up so the doctors could get more and more money?  What if a lot of the people can’t afford to pay the higher prices each month?  Then more and more people would need the government to pay for their plan, and the prices would be so high the government would run out of money for all the other things it needed to provide, like roads and parks and schools and firefighters and police officers and libraries.“

So, in Canada, the government and the people thought that instead of a doctor’s plan, there would just be a government plan.  They thought that this plan should pay the doctor bills for everyone, not just the poor people.  The money for the plan would come from the taxes that everyone paid to the government.  All the people would have to pay a bit more in taxes than they did before.  People who made a lot of money would pay a lot in taxes.  People who made just a little money would pay a smaller amount in taxes.  But no one would have to pay for the doctors’ plans any more.

The government and the people thought this would be a fair way to make sure everyone paid something for the government health plan, and that everyone would be able to see a doctor or go to the hospital when they needed to, without having to pay anything more at all.

At first, some of the people who made a lot of money didn’t like the idea that their money was going to be used to pay for doctors and hospitals for others who made just a little or maybe even no money.

Some of the doctors were upset because they could not collect as much money from the government if they had to be paid from the bank of money that was also needed for roads and parks and schools and firefighters and police officers and libraries.

On Sunday, July 1, 1962, the day had come in Saskatchewan, a province of Canada, when the new government plan was supposed to start.  Almost every single doctor stopped working that day.  The people were very frightened.  What if someone was sick or injured and there was no doctor to help?  Newspaper and television reporters came from all over Canada and the United States, and even Britain and Australia to see what was going to happen.

The next day, the doctors still did not come to work.  And the next, and the next.  And pretty soon 23 days had gone by.    Finally, the doctors agreed to come back to work after the government agreed to let the doctors help set the prices for their work.

In the meantime, in the other country to the South, the United States of America, the people were still paying every month for the doctor plans.  If people went to work at a big company, their boss would pay the monthly fee for them.   People who had jobs really liked this arrangement.

Some businessmen and women started to notice that the health plans were very popular.  They thought that they could make a lot of money by selling health insurance plans themselves.  But they had to make sure that they sold the plans to healthy people, because these business men and women didn’t want to have to pay a lot of doctor and hospital bills for sick people.  Being very clever, they decided to sell their insurance plans to companies that had lots of workers who were probably quite healthy.  They sold their plans for a lower price than the other doctor plans, and lots of bosses of companies decided to switch from the doctors plans and pay for the less expensive insurance plans instead.

Pretty soon the insurance companies were making lots of money selling their plans to lots of bosses.  People were afraid that if they wanted to leave their job or if they got really sick and couldn’t work, then they would no longer have a plan that would pay for doctor and hospital bills.  Everyone in the country got worried, except people who had a good job and didn’t think about leaving it.

Meanwhile, the prices of the doctor plans and the insurance plans kept going up and up and up.  More and more people did not have a doctor plan or health insurance plan.   If they got sick, or injured, pretty soon all their money was used up paying for doctor or hospital bills.

A lot of people in the United States of America did not want the government to be in charge of the money for doctors and hospitals.  They looked at the country across the border, Canada, and they called the Canadian government health care plan a bad name.  They called it “socialized medicine”, and made people think that only bad doctors and hospitals would work for a plan like that, and that people would have to pay taxes to the government that were way too high, and that the government would start telling people how to live their lives and the people wouldn’t feel free any more.

In Saskatchewan, Canada, a couple of years after the Doctors Strike, everyone was very surprised at how well the new government plan was working.  The doctors were still making more money than anyone else in their community, although not as much as the doctors in the other country to the south whose prices were going up and up and up.  The plan was working so well in the Province of Saskatchewan that pretty soon every Province in the whole country decided they wanted the same kind of plan.

The people in Canada really liked the idea that every single person in the whole country could get help from the doctor or go to the hospital and not have to pay anything at all when they went.  Even the rich people liked knowing that everyone was being looked after if they were sick or needed to see a doctor.    The doctors decided what care their patients needed.  (The government just collected the money and paid the doctors’ bills.)  The government was proud of what they were able to do for their people.  And the doctors got used to the plan and began to like it a lot, especially when they saw what was happening in the country to the South.

And, oh yes, the people didn’t mind paying higher taxes* because it felt so good not to worry about getting sick.  The doctors and hospitals helped everyone, not just poor people or rich people, so everyone made sure that the doctors and hospitals were doing a really good job.  If they didn’t like the job doctors and hospitals were doing, they complained and talked about it until it got fixed.  And all the people were free to work anywhere they wanted.  They could even to start a small business of their own without having to think about doctor and hospital bills.

 

*Actually, the people in the country to the North who paid taxes to cover health care were paying less than people in the country to the South, who had to pay taxes plus insurance bills plus extra money every time they saw the doctor plus extra money when the insurance plans wouldn’t pay all of the costs of going to the hospital.