I’m a family physician who moved to Canada from California 14 years ago, largely because of Canadian Medicare, the country's national ...
I’m a family physician who moved to Canada from California 14 years ago, largely because of Canadian Medicare, the country's national health insurance program. I’ve been much happier practicing medicine where my patients have universal coverage. It frees up doctors like me to focus on patient care and frees patients to focus on their health, instead of worrying about how to pay for it.
But I have never felt more grateful to work in a universal health care system than during the COVID-19 pandemic. My heart aches for the millions of Americans who have fallen ill and then have had to worry about how they will pay for tests and treatment, who have gone to work while sick for fear of losing their health coverage or who have lost not only their jobs but their insurance, leaving them at risk for financial ruin.
While no country is immune from COVID-19, Canada has been able to mount a much more effective response. Canada’s infection rate is a tiny fraction of that of the United States, and trending downwards. Its health system has two big advantages when fighting the pandemic: universal health coverage and an administratively simpler system.
Canadian Medicare is good for patients
Canada’s publicly financed single-payer system covers everybody, regardless of age, health or job status. No one loses coverage due to COVID-19. Canadian Medicare covers services like hospital and emergency care, doctor appointments and lab tests—without copays, deductibles or medical bills. Everyone is in a single “network,” so there are no artificial limits on which hospital or health provider a patient can see. As a result, Canadians are much less likely to delay testing or treatment for COVID-19, or for the chronic medical conditions that increase the risk of severe illness and death from the virus.
Canada’s universal system also has made it easier for medical and public health professionals to respond quickly — and together — without the administrative headache of multiple insurance companies.
In my province of British Columbia, our ongoing history of collaboration between physicians and the provincial health system made it easier to coordinate responses from hospitals, primary care clinics and long-term care facilities. From the start, emergency response committees held daily meetings to address challenges of hospital capacity, distribution of supplies and protective equipment, testing procedures, staffing policies, telemedicine, COVID-19 protocols and the safety of health care workers. The British Columbia public health officer gives regular updates and guidance as we move through pandemic phases.
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Instead of primary care practices shutting down and forcing patients to go without care, as reported in many parts of the United States, we have been able to work together through our province’s longstanding “Divisions of Family Practice.” Most of us work in private practice, but we get help to coordinate with other family doctors to make sure that on-call shifts are covered, our practices are safe and our patients get the care they need during the pandemic. I have not had to care for a patient with COVID directly yet, but I have been part of the extensive planning process.
America should follow
As health care shifted from in-person to virtual practically overnight, Canadian health authorities put systems in place for more provincial phone triage, patient self-assessment protocols, virtual care software and better internet access to remote areas. The province made investments to support the needs of vulnerable populations, such as aboriginal communities, and those who are homeless, live in rural areas, travel for agricultural work or struggle with mental illness or addiction — groups that have suffered disproportionately from COVID-19 in the United States.
Many of my American colleagues tell me that they’re burned out from administrative demands and anguished from seeing patients not get the care they need because of cost. Now it is worse, as the number of uninsured has soared with the pandemic. My message for them is this: I know we can do better, because I see it every day. It is worth fighting for a system that puts public health ahead of profits: Medicare for All.
Dr. Khati L. Hendry is working in private practice in British Columbia and has served on Ministry of Health-physician collaborative committees and the local hospital staff. She worked as a family physician and medical director associated with community health centers in Oakland, California until 2004.
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