Bernie Sanders’ Playbook is Straight Out of Canada

by Diane Francis

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I wrote a book two years ago about merging the U.S. and Canada and it’s interesting to note that two “Canadians” are seeking the U.S. Presidency for the first time in history.

Republican Ted Cruz was born in Canada and is Canadian whether he likes to admit it or not. He shed that citizenship and became an American and is a tough right wing candidate. The other “Canadian” is Bernie Sanders. He was born in Brooklyn, has been a politician in Vermont but his playbook, hardly surprising given that Vermont is a border state, is right out of Canada’s.

Namely, Sanders proposes a health care system like Canada’s, where health care for everyone is just as good at half the price because the middleman, Big Insurance, has been cut out of the picture. Even Donald Trump has said the Canadian health care system is good but that it may be too late to do in the U.S.

But not Bernie Sanders. He also believes that Americans should, like Canadians, enjoy low university tuition, should bridle its Big Banks, hike minimum wages and embrace a more nuanced foreign policy. Like Canada, Sanders voted down the Iraqi invasion in 2003, and both turned out to be correct.

Sander’s is correct about health care. Canada’s system was instituted in the late and phased in over a couple of years. The first step was that we paid our doctor then submitted a form to the government for a partial reimbursement. Shortly after that, we didn’t pay our doctor, but he or she submitted a form to the government for payment based on a fee schedule negotiated with their physician bargaining units.

This system, while not perfect, has helped Canada’s middle class catch up and overtake America’s by 2010. The Luxembourg Income Study compiled these figures.

Other factors have been Canada’s lower tuitions and higher minimum wages but the reduced health care burden is significant. For example, Canadian families don’t have to mortgage their homes for cancer treatments because costs are spread across the entire population. Canadian employers don’t have to fork out huge insurance benefits for their workforces.

Take the example of the 147 million American workers whose employment benefits include healthcare coverage. In 2015, premiums for these health care family schemes cost employers, on average, $12,591 a year and their employees $4,955.

By contrast, Canadians just pay taxes and the government delivers the benefits. The comparison of the two countries illustrates why governments can provide better and more cost effective health care than can the for-profit sector.

Sanders points out that America’s three biggest pharma giants made profits of $45 billion in 2015 — that is equivalent to 30 percent of the entire health care tab paid by Canada’s governments for its 34 million residents.

By eliminating the unneeded insurance middleman, administrative costs and profiteering disappear. Sizeable volume discounts from Big Pharma as well as from medical equipment suppliers are negotiated. Hospital costs are kept in line.

A Canadian health care system also eliminates costly, burdensome litigation over medical costs.
That, in turn, results in dramatically lower costs to obtain professional insurance coverage for doctors and hospitals. Insurance for a Canadian physician is one-tenth the amount charged an American one in a comparable specialty.

This all translates into an enormous savings for individuals and the nation itself. The most recent figures, in 2014, provide a comparison: Healthcare in Canada cost $4,351 per person and healthcare in America cost $8,317 per person.

The same differentials exist between the United States and France or Britain or Germany. These countries, like Canada, realize that the insurance middleman is unnecessary. Obamacare represents the first step in fixing America’s healthcare train wreck, but it’s still costly and complex because Big Insurance is still along for the ride.

Frankly, American taxpayers should demand a single-payer health care system. So should all the country’s fiscally responsible politicians. Here’s why: In 2013, the United States spent an estimated $2.8 trillion on health care but a single payer system would cost $1.46 trillion, based on Canadian per person figures.

A savings of $1.4 trillion is equivalent to the amount collected for Social Security annually or forked out for defense.

To use a Silicon Valley term, America’s health care system has to be “disrupted” because it represents an enormous inefficiency and competitive disadvantage. That means taking on powerful, profitable vested interests. That’s the bad news but the good news is that one need only look northward to see a template that works. Sanders has done this and so should voters.

First published in Huffington Post Feb. 1, 2016

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