Fact-Checking Trump: Are Canadians Swarming the Border to Get Better Healthcare?
Many Canadians were irked by the comment.
Image: Gage Skidmore/Flickr
Among all of the things the candidates said during last night's presidential debate, there was one comment that caught the attention of our neighbors north of the border.
"[Hillary Clinton] wants to go to a single-payer plan, which would be a disaster, somewhat similar to Canada," Republican nominee Donald Trump said in response to a question about healthcare plans. "If you ever notice, the Canadians when they need a big operation, when something happens, they come into the United States in many cases, because their system is so slow it's catastrophic in certain ways."
First of all, it's worth noting that the premise of this critique is not true: Clinton has proposed expanding Obamacare and introducing a "public option," but wouldn't swap out the current system for a single-payer one wholesale.
Even so, many Canadians on social media took umbrage with this remark, pointing out that the country's single-payer healthcare system, which provides "free" (it's paid through taxes) universal health care to all, is a point of pride for many Canadians. But did the Donald have a point? We've all heard about Canada's notoriously long wait times, so even if it is free, it pales in comparison to America's healthcare, right?
The debate over different structures for funding health care largely philosophical, but the difference in quality of care between our two countries is something we can, at least partly, measure. So here's what the data says.
In some comparisons, the countries are pretty similar. The Commonwealth Fund, a private healthcare think tank based in the US, compares health systems of developed countries around the world in a report published each January. This year's report showed that 41 percent of Canadians reported being able to see their doctor on the same or next day when sick, compared to 48 percent of Americans. When it comes to getting care after hours, the two countries were also similar: 38 percent of Canadians said it was "very or somewhat easy" to get after hours care, compared to 39 percent of Americans.
Of course, these are averages and within a country, access to care can vary greatly. In Quebec, a third of patients in the emergency room wait five or more hours before seeing someone. In the US, some areas such as Boston see patients waiting as long as 45 days to get an appointment with their doctor.
Canada's wait times are much worse than the US when you start looking beyond regular doctor visits. According to the Commonwealth Fund report, 29 percent of Canadians wait two or more months for a specialist appointment, compared to just 6 percent of Americans, while 18 percent of Canucks waited four months or longer for elective surgery, compared to 7 percent in the US.
However, these lengthy wait times don't actually translate to a mass migration of patients popping across the border for surgery or specialist appointments. Though some of Canada's wealthiest patients may choose to do this rather than wait, they represent fewer than half a percent, according to a study published in Health Affairs in 2002 (there hasn't been a scientific look at this in recent years). Meanwhile, the Centers for Disease Control estimates 750,000 Americans travel outside the country for medical treatments each year.
And longer wait times don't necessarily translate to poor quality of health. Other measurements put Canada's system ahead of the US. The life expectancy in Canada is 83 for women and 79 for men, compared to 76 for American men and 81 for American women. Canada's maternal mortality ratio is half the US's rate, the country's infant mortality rate is lower, and so is the obesity rate. Canada has fewer barriers to access, too: that Commonwealth Fund study found 37 percent of Americans faced a cost barrier to health care in the last year, compared to 13 percent of Canadians.
Canadians are also just happier with the system than Americans: 40 percent of Canadians said the system works well and needs just minor changes, compared to 25 percent of Americans who said the same thing about the US system.
All these stats boil down to a less dramatic reality: when it comes to quality of care, our systems aren't all that different, which is why the debate is really a philosophical one. Should access to healthcare be a human right, and if so, how do we protect that right? It's a question you should answer for yourself, especially before heading to the polls.