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A Letter For All Americans

July 24, 2009

Barack H. Obama, President of the United States
Kathleen Sebelius, Secretary of Health and Human Services
All members of the U.S. House of Representatives
All members of the U.S. Senate

Dear Friends,

I am writing to you on behalf of the 340,000 members of the National Union of Public and General Employees (Canada) about the scurrilous misrepresentations of Canada and our single-payer health system in the debate over the future of health care in the United States.

We applaud you for reopening the national discussion of health care reform in the U.S. There are various policy proposals on the table and you’ll have important decisions to make in the months ahead. As legislators, it’s critical that you use the best available evidence to inform your decisions.

Unfortunately, rather than a true debate about its merits, Canada’s single-payer system, and by extension Canada’s reputation, has been the victim of a multi-million dollar tidal wave of special-interest propaganda and scare tactics. You need to know that an objective examination of the evidence reveals that Canada’s single-payer health system is the triumph of values and economics.

Our system speaks volumes about the character of our nation. It provides all Canadians with equal access to care on the basis of need, not wealth or privilege or status. Previous generations understood that sickness doesn’t discriminate and they made the collective moral decision that
health care shouldn’t discriminate either. It was a courageous initiative by visionary men and women that changed us as a nation and cemented our role as one of the world’s compassionate societies. We will always defend the proud legacy we have inherited from previous generations of Canadians.

Indeed, Canadians today still strongly support the core values on which our system is premised - equality, compassion and solidarity. In fact, our Medicare system is now tied to our understanding of citizenship. More than just a social program, Medicare to us represents a birthright and an identifying mark of “Canadian-ness”. It is, we believe, the clearest reflection of who we are and what we value.

But more than that, our single-payer system is, quite simply, a good and sensible idea that serves Canadians extremely well. The overheated rhetoric and outright falsehoods that you’ve heard about the quality and viability of Canada’s system simply do not stand up to scrutiny.

When it comes to health outcomes, on almost every critical measure, whether it is life expectancy rates, infant mortality rates, or potential years of lost life, Canada rates much better than the U.S. and we’re among the best in the world. Notwithstanding the “real life” stories you’ve heard in TV ads launched by the group Patients United Now, a very strong majority of Canadians who use the system are highly satisfied with the quality and standard of care they receive.

In terms of controlling costs, health spending in Canada is on par with most countries in the Western world and it’s substantially lower than in the U.S. And yet we devote a smaller portion of Gross Domestic Product to health care today than we did over a decade ago. It’s totally unthinkable to Canadians to experience bankruptcy due to medical bills, as do over one million Americans every year. Unlike in the U.S., not a single Canadian who is unemployed has lost the ability to access health care during the current economic recession.

In addition, our single-payer system provides both small and large businesses in Canada with a clear competitive advantage. Employers don’t have to provide basic health care for their workers, our single-payer system does that. Our businesses also enjoy the benefits of a healthier
and more productive workforce thanks to our universal system. Unlike in the U.S. where basic health care is a major source of labour relations strife, it’s hardly an issue at the bargaining table in Canada. We also enjoy greater labour mobility because workers who don’t have to worry
about losing health benefits are more willing and able to switch jobs and move to where the work is.

Finally, what you’re being told about government-run health care with patients suffering and dying on wait lists is nothing but lies. No need for emergency or urgent care is ever neglected in Canada. If your doctor says you need the care urgently, you get it, period. Moreover, Statistics
Canada reports that the median wait time for elective surgery is four weeks and the median wait time for diagnostic imaging like MRIs is three weeks. And contrary to popular myth, we’re free to choose whatever doctor we want. And all decisions about care and treatment are left to patients and their doctors, there’s no interference by the government or private insurance companies.

An objective review of the evidence shows that Canada’s single-payer system has consistently delivered affordable, timely, accessible, comprehensive and high-quality care to the overwhelming majority of Canadians on the basis of need, not wealth. It has also contributed to our international competitiveness and the productivity of our workforce.

Times of great need, we are told, are the times when true leaders emerge and display the ability to separate fact from fiction and the courage to set aside political agendas for the sake of the common good. The challenge facing health care reform in the U.S. demands that kind of ability and courage from each of you.

I would be pleased to speak or meet with you at anytime, or if you’re interested we could arrange a “study mission” to Canada, to ensure you have an accurate picture of the benefits and popularity of Canada’s most cherished social program. Please do not hesitate to contact my office.


James Clancy
National President

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