America’s Canadian road trip starts today

By Sally Pipes
September 23, 2010


By Sally Pipes
The opinions expressed are her own.

Today, several of the more popular provisions of the president’s health reform law go into effect. Adult “children” will now be able to stay on their parents’ policies until they turn 26, and insurers can no longer impose lifetime limits on the amount of coverage they provide.

Nevertheless, congressional Democrats are running away from Obamacare as fast as they can.

Late last week, Rep. Gene Taylor (D-Miss.) became the first Democrat to sign a “discharge petition” circulated by congressional Republicans as the first step toward repealing Obamacare. At least five Democrats are running ads touting their votes against health reform. And Democratic candidates have spent three times more on ads criticizing the health overhaul than on ads supporting it.

Their apprehension over Obamacare is warranted. The new health reform law will not deliver the savings the president promises, will cost more than advertised, and will not achieve universal coverage. Instead, the president has placed America on the path toward a single-payer, government-run healthcare system.

Speaking as a Canadian who has experienced socialized medicine firsthand, I urge America not to go down that road.

To see why, consider the story of Claude Castonguay, the “father of Quebec medicare.” In the 1960s, Castonguay led a health reform commission that recommended that Quebec implement a publicly funded health insurance system. The rest of the country quickly followed Quebec’s lead.

In 2007, Castonguay was asked to review Quebec’s healthcare system, 40 years after the province adopted his reforms. He concluded that Canadian health care was in crisis. “We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” he said.

His remedy? “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

Just as Canada’s leaders are working to extricate government from their failing healthcare system, Obamacare is injecting an unprecedented level of government into the American system.

How will the U.S. government provide health care to millions more even as new mandates force costs higher?

For starters, Obamacare imposes some $569 billion in new taxes on everything from rental properties to tanning beds.

In addition, the new law raids Medicare for funding — to the tune of $575 billion in cuts over ten years.

Obamacare also creates an Independent Payment Advisory Board (IPAB), which, starting in 2014, will advise the federal government on how to reduce Medicare spending. Although the unelected, unaccountable board is nominally barred from recommending that Medicare change benefits or ration care, its proposals will almost certainly lead to such outcomes.

For example, if IPAB’s recommendations were used to cut payments to doctors and hospitals, Medicare patients would end up waiting longer to receive care — effectively rationing it.

In Canada, officials have had to employ widespread rationing in order to pay for universal coverage. Canadian patients are routinely denied access to the latest care and treatments.

Regrettably, this is something I’ve witnessed firsthand. In 2003, my uncle was diagnosed with non-Hodgkin’s lymphoma. My cousin, a doctor in British Columbia, inquired about the availability of Rituxan, a wonder drug that treats this disease. But the head of the provincial health service’s cancer department had never even heard of the drug.

Rituxan wasn’t available in British Columbia because it was deemed too expensive. So my uncle was told to go to the United States for treatment. But by then, he was too weak to make the trip. He died soon after.

If you think rationing like this won’t happen here, think again. It’s already happening. The Food and Drug Administration is currently considering revoking approval for Avastin as a treatment for breast cancer — despite the fact that it’s extended the lives of thousands of breast-cancer victims.

The Centers for Medicare and Medicaid Services (CMS) may soon opt not to cover Provenge, an effective anti-prostate-cancer vaccine, because it’s not “reasonable and necessary.” That’s bureaucrat-speak for “too expensive.” As the Ovarian Cancer National Alliance observes, “For the first time, an FDA approved anti-cancer therapy may not be covered by Medicare.”

Such gut-wrenching denials of treatment will only grow more likely as the federal government strains to pay for Obamacare down the road.

But the American system need not follow the Canadian example. Poll after poll shows that most Americans disapprove of Obamacare. Consequently, political support for the new law is rapidly eroding.

With Democrats now wavering on the bill, it is time for Americans to make their voices heard and demand that Congress repeal Obamacare. If they don’t, they may soon see their government run out of money — and their sick relatives run out of options.

Sally Pipes is president and CEO of the Pacific Research Institute. Her latest book, “The Truth About Obamacare,” was just published.

Photo: Commission council Doug Hunt makes the Sars Commission’s final report (in foreground) public during a news conference in Toronto, January 9, 2007. The report concluded that there were widespread failures in Ontario’s healthcare system and more could have been done to protect healthcare workers during the SARS outbreak in Toronto in 2003. REUTERS/J.P. Moczulski (CANADA)


We welcome comments that advance the story through relevant opinion, anecdotes, links and data. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters. For more information on our comment policy, see

Ah, the wonders of political bashing. Take one or two extreme examples (spread over a 40yr timeframe no less), mix in a couple of skewed stats (and we all know what stats with background are worth) and make a claim with the results.

Canada’s system is not perfect, but it is far better than America’s. At least in Canada EVERYONE gets a very good level of treatment covered by our blanket ‘insurance’, and if that’s not good enough other options are available on a pay-as-you-go basis. In America all you get is pay-as-you-go. And many companies in Canada offer supplemental insurance to cover even the pay-as-you-go items… in America those plans are falling increasingly by the wayside as corps ‘streamline’ their bottomlines. There are not enough doctors in Canada, but that is more a factor of America paying more than double and luring our doctors there… unfortunately I don’t see that changing anytime soon as the Obama healthcare bill doesn’t fully address doctor pay and poaching foreign doctors.

So much more to say, but I’ve got to take my son to daycare. Ms. Pipes should apply for a position at the Fraser Institute – she’d fit right in.

Posted by CDN_finance | Report as abusive

I am a Canadian ex-pat who has been living in the US for fifteen years. I am fortunate to have access to an HMO (Kaiser Permanente) that approximates the medical coverage which is universally available in Canada. It is indeed sad that

As to the current state of the Canadian system – I’m sure that there are other stories like Sally Pipe’s uncle, but whenever I check in on my family and friends in Canada, it seems like everyone is getting the care they need and promptly, at that. This includes a number of elderly aunts and uncles who certainly are not in the best of health.

Posted by JFranz | Report as abusive

Hm, sounds to me as if Sally has never faced life without health insurance. Would like to see her not have health insurance for a few years and see if she maintains her positions on the health care reform law. I’ll take some rationing if need be and HAVE health insurance versus no health coverage at all.

Posted by Centerline | Report as abusive

Being the one of 12 children, all others in Canada, and making frequent visits back to my native Canada and finding all brothers and sisters are quite happy, even proud of the Canadian medical system, I simply disagree entirely with Ms. Pipes. It’s not as if we were born yesterday, rather up to 68 years ago. The group cuts across the spectrum from wealthy to working-to-make-ends-meet. Substantial medical difficulties have occurred. But, no substantial complaints about the system.

In the Canadian vernacular: Ms. Pipes is evidently full of it.

Posted by xcanada2 | Report as abusive

If Canadian system was in crises; chaos was written all over the US system. The apostles of private enterprise, without any governmental control will go to any length to demagogue any government attempt to leaverage its power. For as long as Ms. Pipes could not challenge the ability of a sick and poor Canadian from getting healtcare, US will do fantastic if she stays at that end of the continent.

Posted by 0okm9ijn | Report as abusive

This article loses a lot of legitimacy when you make it seem like Quebec was the first to implement a universal health care coverage, “The rest of the country quickly followed Quebec’s lead.” When in fact it was Saskatchewan, then the rest of the country followed Saskatchewan’s lead. If you can’t get such a simple fact correct what credibility do you have?

Posted by carvythew | Report as abusive

To our American friends, please do not believe the rants of Ms. Pipes, who is the president of the Pacific Research Institute, an extreme right-wing organization. The Canadian system has its flaws and there is always room for improvement. However, the vast majority of Canadians prefer our system over the American model, even after the needed reforms promoted by President Obama. If anything, most Canadians think that President Obama did not go far enough and compromised too much. There is little political appetite in Canada to move away from the single payer model. On most basic measures of health care such as infant mortality, life expectancy, etc., Canada does as well as the USA, and not infrequently exceeds American standards. And we do it for far less in cost. In fact, so much more efficient is the Canadian system in economic terms that the lower health care cost in Canada is a frequent reason why American companies locate their operations here rather than in the USA. Our health care system is probably our biggest competitive advantage over the USA.

Posted by DanToronto | Report as abusive

Your arguments are flawed and unsubstantiated. Taking 2 seconds to do actual research (ah wikipedia… I love you), Canada’s health care system was ranked higher than the American health care system by the World Health Organization… and Canada also pays less per capita for that coverage.

The only question then, is if you could pay less money for better coverage, would you?

Posted by gmmw | Report as abusive

Before the person who is knocking Ms. Pipes I think he or she should come down to my area in South Florida. My building has about 30% of owners who are Canadian snowbirds. They come usually just after Thanksgiving (there’s not ours) & stay for the winter season. Yes, these are people who could afford health care in the homeland, if any was available. Every year it is the same, They get off the plane, they unpack, & by then their cars are delivered by car-carriers. What do you think is the very next thing they do? They come to me & other neighbors from the United States & get the names of Medical groups or doctors who can do the tests that can’t be gotten up north. Bone scans, gastro exams, & regrettfully cancer specialists who they can’t get there either. Imagine this perfect life, living in Canada during the nice weather,moving to the south for the winter & unable to get treatment in there own country. I wonder where we will have to go for health care? Maybe we can sneak across the Rio-Grand & get service there.

Posted by free4me | Report as abusive

I love how some extreme cases somehow offer enough evidence that someone can then draw conclusions on the entire system. I think that issues exist but to somehow say that the Canadian system is so flawed that we are wanting to move more towards the US system is extreme at best and possibly ludicrous at worst (versus suggesting that alternatives to the current method that then do not deny all a level of coverage is what is really being sought in this instance). There are issues in our system but the ability to ensure the coverage of all people has to be seen as a step in the right direction versus a system that offers no coverage for so many.

Posted by CDN-Calgary | Report as abusive

All this about Canada’s medicare system may or may not, in general, be true. I have had my own experiences with medicare here in the True North:

My late mother flatlined during surgery to fix a previously botched biopsy; fortunately she survived but my late father was never informed. My late brother was given an erroneous cancer diagnosis after a misdiagnosis of diabetes. He was suffering from depression at the time and this sort of news was hardly welcome. In my own case, after seeing all this firsthand, I now work out regularly, eat carefully and avoid drugs of any type so I can avoid any need, other than an annual examination, to have any contact with the Canadian hospital system.

The cost thing is interesting. Canadian hospitals are constantly trying to raise funds for needed capital work and investments because governments never seem to have enough for these requirements, having spent most of the funds available on wages and salaries for hospital workers. The unions representing these workers are very militant and quite conscious of their monopoly position.

But to return to the cost angle – medicare consumes a vast amount of government’s budgets here in Canada and, given the rather tattered appearance of many hospitals and the unavailability of much modern technology, it could be argued that Canadian taxpayers are paying for a Mercedes but getting a Cadillac. A Cadillac is a nice car but, if I’m paying for a Mercedes, I want a Mercedes. JMHO

Posted by Gotthardbahn | Report as abusive


The situation you talk about is completely true… and in fact, it is probably very widespread in areas where snowbirds vacation. However you are missing a very, VERY large component of the reality of the situation. Canadian Snowbirds do not MOVE to the United States. In fact, I would suggest that most, if not all limit their stay to under 6 months. Why 6 months specifically? Because any more and they would lose their coverage under Canadian medicare. Even the wealthy individuals who are able to pay more for health care are NOT willing to lose the coverage they get in Canada. If the people most able to afford the best coverage in the American system CHOOSE not to be stuck with it, then who does the American system work for?

Can the Canadian system be better? ABSOLUTELY. So can every health care system in the world. But Americans pay MORE than any other country, and rejecting any inquiry into how AMERICANS can get better coverage for less money is irrational. Your healthcare is not the best in the world… and even if it was, it could still get better.

Posted by gmmw | Report as abusive

This is getting silly. The US is a democracy and as such they will get the health care system that the people want. Whatever that turns out to be, I’m not too concerned about. If Americans want to keep getting ripped off by private insurance companies then so be it, I wish them luck.

As a Canadian I’m perfectly happy with our health care system, it has served me, my elderly parents and my family very well. I get prompt, professional health care and I don’t have to worry about “preexisting conditions” or any of the other scams that American insurance companies pull. I lived in the States for two years and was very glad to get back home where I can receive excellent health care without going into debt.

I wish my American friends all the best in their quest for decent health care.

Posted by GeorgeBrown | Report as abusive

The way to solve the US healthcare problem is to start by revoking agricultural subsidies, the bulk of which fund our obesity and diabetes epidemics. Next, health insurance should be abolished altogether with the exception of privately-purchased catastrophic and long-term care plans.

The current system of private insurance is idiotic in the extreme. A third party (one’s insurer) stands between doctor and patient in every transaction, sucking value out of each encounter. Consumers cannot possibly make good choices about the cost and benefit of any treatment option, and doctors cannot price services at a level that serves patients and their own businesses.

The whole system should be chucked in favor of a purely cash-basis approach. Costs would decline dramatically, and people would become smarter, healthier consumers because it would be in their financial interest to do so.

Posted by JackMack | Report as abusive

Sally said, “If you think rationing like this won’t happen here, think again. It’s already happening. The Food and Drug Administration is currently considering revoking approval for Avastin as a treatment for breast cancer — despite the fact that it’s extended the lives of thousands of breast-cancer victims.”

How is revoking approval for a specific treatment rationing? She probably heard this her buddy Rush Limbaugh who falsely claimed that the FDA was going to pull the drug altogether. The FDA is concerned that Avastin may cause you to develop a hole in the wall of your stomach or intestine, and also might not be as effective as claimed by Lilly.

Posted by Andvari | Report as abusive

The opinions of Sally C. Pipes, an American citizen who has shaken the Canadian dust from her sandals, on Canada’s health care system must necessarily be taken with a grain of salt.

Posted by DrvandenBerg | Report as abusive

“The new health reform law will not deliver the savings the president promises, will cost more than advertised, and will not achieve universal coverage.”

For someone that works at a think tank, you’d think she’d cite her sources, especially when making allegations of this nature. She should at least attempt to explain them in some way later on in the article, instead of asserting them as fact.

She throws around a number with no citation or even a mention of it’s origin and then uses the term ‘raid’ which is a very vague term, and probably intentionally vague.

Posted by Fishes | Report as abusive

Wow, Sally you are plumbing the depths of deceit with this article. You cite a couple of anecdotal instances from a couple worst case scenarios versus millions of actual good experiences for us Canadians. Try some empirical data and facts next time. Our health care in Canada is not perfect, but no one sole in our nation has ever been refused treatment because they did not have insurance. Which HMO is lining your pockets?

Posted by idisagree | Report as abusive

I am 65 years old, living in Victoria, and have never had a single complaint about my health care. Ever. (This in spite of years and years of an unhealthy lifestyle.). Of course, I also try now to keep my weight under control, eat well, ride a bike, and exercise daily. I wonder how many of those snowbirds in Florida could say the same?

Posted by YoungTurkArmy | Report as abusive

Mrs Pipes should apply for a position at the Fraser Institute? She worked there for 11 years before moving to the Pacific Research Institute.

Posted by donald4 | Report as abusive

I’m a retired Canadian who in the past, spent several years living in the USA, paying for a comprehensive healthcare plan. In my experience, it was expensive but delivered top notch coverage. However, it was in no way superior to the single pay system in Canada.

The thing that puzzles me is why the American right seems obligated to distort the facts and demonize Canadian healthcare. Why would Americans care how we run our affairs? Looks like wasted energy to me, with all the economic concerns on America’s plate these days. Over the long haul, Americans will get exactly the healthcare they deserve. Not Canada’s problem.

The substantial majority of Americans pitch infantile fits over paying taxes, but love their unfunded entitlement programmes. They also are delusional in the belief that privatized anything trumps responsibilities of the state. That would include national defence. Halliburton, and Blackrock, and Kellogg Root & Brown skimming hundreds of billions in Iraq come to mind.

By the way, how’s that WMD / War On Terror thing working out, America? Maybe you can hire some of those guys to pull your economy out of the ditch.

Posted by peteypuck | Report as abusive

Sally, Why are you lying ? Is removal of Avastin, actually rationing ? If that is rationing what about AVANDIA. Stop lying, Sally.

Avastin has many side effects and that is the prime reason. May be, you should start taking it – and prove the world that Avastin is safe not words.

Posted by Donotlie | Report as abusive

What the author leaves out is the plain fact that “around the world” whether you live in a capitalist society, communist society, or socialist society you are free to seek the medical care of your own choice, you just have to pay for it. American medical plans exclude all kinds of treatments on a variety of grounds, but mainly because they will cost the insurer too much, which means reduced profits.

Of course a government providing socialized medicine is going to try to keep costs down by rejecting costly treatments. There has to be enough money to go around right? The difference is that an insurer is going to try to make a “profit” not just break even. It is not fair to Americans to sell them “for profit” plans with high premiums and limited care. It is an obvious conflict of interest between the consumer and insurer.

American insurers have been spreading a bunch of baloney about how medical costs have increased so they have to raise our premiums. Do you actually know a doctor or two? Have you talked to them about that issue? Perhaps you should. Or perhaps they are sucking up all the little perks provider to favored doctors by drug companies?

The American doctors I know are not fooled by insurance company rhetoric and are pretty disgusted with the insurance industry. They make decent money and have not seen “their” costs rise. We talk about these very issues. They did not go into medicine to have insurance companies directing patient treatment. If you think that your insurance company has “your” best interest at heart when you have a serious and costly condition, I’ve got a bridge . . .

Get real. A sick person is just a liability in for profit America. Sick and cannot work because you got cancer? Bye, bye employer provided health insurance, you are going to lose your job, and without a job you cannot afford your insurance premiums. Next you will be on disability and then a liability for the rest of us tax payers. And without a job, the government will pay most of your medical because you “will” qualify for state or federal and programs which pay next to nothing to doctors. And you don’t think “that” is socialized medicine?

Healthcare in America is on par with healthcare in Estonia. Seriously. Research the issue. Get a passport. Travel around Western Europe. Actually see and experience the counties you are not familiar with.

Posted by KimoLee | Report as abusive


[...]check below, are some totally unrelated websites to ours, however, they are most trustworthy sources that we use[...]…