An Open Letter To The People Of The United States

Last modified on August 17th, 2009

This is an open letter to the people of the United States, namely those people who think universal (or government run) health care is bad.

In November of 2006 four idiots I had never met threw me through the plate glass window of a 7-11. Apparently, it was a fun thing to do after a few beers. I ended up in the hospital that night with five fractures in my face. Approximately two weeks later I had surgery to repair the damage to my face, and ended up getting a piece of plastic surgically fitted under my left eye. Without it, due to the lack of bone, my left eye would probably hang down into my left sinus. This same surgery in the United States, when not done in emergency conditions, would probably run between $25,000 and $40,000 USD.

Unfortunately, I required a revision to the initial surgery, mainly because the position of my left eye was still slightly out (this was by no means a result of lack of care, simply because of the nature of my injury). After several X-Rays and CT scans, and a pile of doctor’s office visits, I once again entered the operating room for yet another $25,000 – $40,000 USD surgery. Thankfully, the results of that surgery were much better, and for all intents and purposes, fixed the damage.

For all of you in the United States arguing against universal health care, I’d like to point out the final bill I received from the hospital, and ultimately what I ended up paying for my health care:


Because of that low cost, I didn’t lose my home, or my car, or the clothes on my back, or have to borrow money from friends or relatives. I didn’t lose any sleep wondering about how to pay, and never once questioned whether or not I’d ever be healthy again. Sure, our system isn’t perfect, but it sure beats a system that forces a lot of people into bankruptcy whenever they get extremely sick.

20 responses to “An Open Letter To The People Of The United States”

  1. Of all the things I don’t like my taxes paying for, I have never. Not.Even.Once resented my money/monthly insurance of $55 that goes to help pay for our healthcare system. I simply can’t imagine what it would be like always to wonder if I could afford my own healthcare, when the need arises!

  2. Dale says:

    The funniest part is that the proposal is only for a health care plan the goverment will offer that competes with the private plans in the states. And people will still pay for it in premiums.

    It’s nowhere close to the coverage and structure of every other developed nation in the world.

    In the U.S. The goverment spends nearly 17% of its GDP on healthcare that doesn’t cover anyone— twice as much as Britain, which has public universal care for all.

  3. Henry Lee says:

    Thanks, Duane.

  4. Tina says:

    I will forward this to all the idiots in my country fighting against their own best interest.

    thank you

  5. Duncan says:

    Interesting. I’m not an expert but I do believe that if you had decent coverage in the US it would cover the cost of your surgery? As for the Free part, well it’s half right. In Canada with our progressive tax system, the more you earn the more you pay as a percentage of your income. I’m not against this but as your income rises, your paying much more in taxes over a lifetime than our American friends. Granted we can rest easy because we will never have to fight insurance companies for coverage, but from a fiscal standpoint you certainly pay dearly for Canadian Healthcare as a higher income earner. That’s not including our higher sales taxes and the lack of deductions against taxable income that Americans enjoy. The truth is that the US govt is tapped out and simply can’t afford to take on Universal Health Care. Our own physicians just met in Saskatchewan and are speaking out about the abysmal state of our own health care and the sub par access to treatment experienced by many on long waiting lists for “elective” surgery. Neither our system or the US system are working for the majority. We should look to the Netherlands if we really want to see a better system in practice. As my economics 101 teacher used to say “there’s no such thing as a free lunch”. Make no mistake. We pay dearly for our health care in Canada. It’s just not something the average person considers as they dutifully fork over their taxes.

  6. But don’t you guys have death panels deciding when grannie has to go? 😉

    Frankly, I don’t think a “public option” is far enough and I’ve rooted for single payer health care since I canvassed for it in the 1990’s. Unfortunately, we might not even get that.

    Even the co-op plan that some Democrats (who have aligned with the insurance companies) are fighting for essentially leaves me with the same plan I have in Washington State that I pay $1100 a month for. Ugh.

    We’re screwed. Can I move to Vancouver now?


  7. Duane Storey says:

    @Duncan – those are good points, and I believe the proposed system in the US will hurt higher income earners as well. But truthfully from a moral perspective, I don’t see anything wrong with that. I guess in some regards its anti-capitalistic, but often earning money and doing the moral thing are opposing principles in everyday life.

    In a lot of ways, the Canadian system is hurt because of the American one. Doctors in the US earn way more because the system charges Americans far more money per surgery. As a result, health care workers in Canada often migrate to the United States. At least in Vancouver, we don’t really have a lack of surgeons or physicians, what we are lacking are people to staff the operating rooms. I had this conversation with my plastic surgeon last fall while waiting to get an iPhone. He said they’d love to do more surgeries if they could, but unfortunately the operating rooms are empty half the time due to staffing shortages. So I suspect that some aspects of our system might improve if the US system moves in the direction of socialization.

    And yes, if I had insurance in the United States, I would probably have been covered. But I turned down a six figure job in Portland last year mainly because I suspected that I’d be denied health coverage due to my previously diagnosed high-blood pressure (which is a pre-existing condition, and a reason to deny coverage). So chances are I wouldn’t have had coverage down south, or at least I would have paid dearly for it.

    And I guess the reality is that our system isn’t free, it’s paid for out of tax dollars. But I think the current problems in our system are mainly due to the massive health-care budget cuts that have occurred over the last 10 – 15 years. But I’m fairly certain (and if someone has the numbers please post them) that as a percentage of GDP, the Canadian system is cheaper than the current American one, with the added benefit of allowing everyone to receive coverage when they need it. Yes, it needs to improve, as the care I received wasn’t without its faults. But I’d take it any day of the week over the current US one.

  8. Duane Storey says:

    @Duncan – “That’s not including our higher sales taxes and the lack of deductions against taxable income that Americans enjoy. ”

    I’m not sure how it plays out once you factor in the ability to write off your mortgage, but I found taxes in the states to be amazingly high once you factor in things like FICA (their social security tax). Even in Oregon (without a state tax), I found my disposable income (as a percentage of my total income) would have gone down, and that didn’t even factor in medical insurance. I had a 2 hour introductory session with their HR person, and 1 hour and 30 minutes of that was going through the intricacies of their health insurance plans.

  9. Duncan says:

    I’m in 100% agreement that the US system is flawed and I also believe our own system is equally flawed. I really like the peace of mind living on Canada that I’ll be covered no matter what, no questions asked. I would also like access (and be willing to pay) to the state of the art non invasive surgeries available in the US. Even locally, the False Creek Surgical centre has emerged to offer alternatives to those unwilling to wait in line and seeking the best possible treatment. Sadly we’re in a time where our population is aging and rapidly exhausing our resources. The Canadian Govt has mismanaged health care spending for years and are now playing catch up. Independent surveys have shown that the cost to run our Canadian system is equal and possibly higher and more inefficient than the US model. Because our Government massage the numbers and bury many costs, it’s impossible to know for sure. Bottom line is that both systems are broken. Ours is better for the average person from an affordability point, but how much longer can we sustain this? I believe both Canada and the US are in for a long and sustained recession and there will be no quick long term recovery. This puts pressure on both Governments to make further cuts as they can’t raise enough taxes to cover the deficeit. Capitalism in it’s true definition is passing along wealth to the next generation so their standard of living is greater than the prior generation. Unfortunately in more recent times, many corporations and affluent individuals have forgotton this and “hoarded” their wealth. Thankfully Warren Buffett and Bill Gates have not forgotton what capitalism means. I hope their example and estates are instrumental in shaping our future.

  10. Lynn C says:

    I doubt they are showing these commercials in Canada, but check out the latest propaganda scare tactics:

  11. After two and a half years in cancer treatment, my biggest out-of-pocket expense has been parking at the BC Cancer Agency. I’m not sure anyone in the U.S., whatever their health coverage, could say that.

  12. Tina says:

    Yes part of the cost of the surgery would’ve been covered in the U.S. if you had healthcare but not 100%. There is always a deductible and then the insurance companies decide what the hospital should’ve charged and that is what they pay regardless of what the bill actually is.

  13. Lynn C says:


    A) Sorry about the cancer. I don’t know you but I hope you’re ok.

    B) While Tina has a valid point, some insurance companies wouldn’t even take you as a “customer” if they knew you had cancer, so we’d all have to hope that you got it after you got yourself a nice stable job with decent health insurance.

    Don’t even get me started on the “pre-existing condition” insanity.

  14. Lynn C says:

    Oh, and you’d have to keep working, too, so let’s hope that your cancer doesn’t get too serious or anything.

    Otherwise your nonexistant paycheck will go directly to private insurance premiums.

  15. Kirsten Fleming says:

    As a person who currently works within the health care field, and as someone who has lived in and had first-hand experience with the medical systems in both the US and Canada, I would like to express my opinion regarding health care. While admittedly flawed, I personally feel that the Canadian health care system is superior to the current US one. It is true that in Canada there are long wait lists for “elective” procedures….I experienced this first-hand while waiting for knee surgery. However, for most other conditions, Canadians receive quality health care in a timely fashion. And, they are not bankrupted in the process. According to the World Health Organization Statistical Information System, among 193 member countries, Canada ranks 30th, and the US ranks 37th in overall health care. In 2006, compared to the US, Canadians had a higher life expectancy (81 compared to 78) and a lower infant mortality rate (5 per 1000 live births compared to 7 per 1000 live births). Canadians receive quality health care, and they pay less for it.

    Also according to the World Health Organization, in 2006 the US spent 15.3% of the GDP on health care compared to 10.0% in Canada. That translates to a per capita total expenditure on health of $6714 in the US and $3672 in Canada. Where does the extra money go to? Mainly to administration fees (insurance companies are big business) and inflated fees (doctors have to be able to pay their crazy malpractice insurance).

    According to the U.S. Census Bureau, in 2007 nearly 46 million Americans were without health insurance. That includes all ranges of society from the unemployed to private business owners and self-employed individuals, and of course those with “pre-existing conditions”. Of those in the middle class who are actually lucky enough to have insurance, many can not afford to actually access it (except in severe conditions) due to the high deductibles. I myself rarely accessed medical care because at that time I could not afford the $1500 per year out of pocket that I had to pay before the insurance company would contribute. Even then I still had to pay 15%. A system based on deductibles discourages primary preventative care, and as a result individuals often don’t come to medical attention until it is too late.

    As a resident physician in Canada, and as a previous health-care consumer in the US, I have seen first-hand the flaws of both systems. While the Canadian system definitely needs major improvements, I believe that overall we Canadians are lucky to have universal health care. When I graduate from my residency program I will enter a higher tax bracket, and thus will proportionately pay significantly higher taxes than low-income earners. Much of this money will go towards health care. I will not begrudge that. As the famous quote goes “Any society, any nation, is judged on the basis of how it treats its weakest members; the last, the least, the littlest.”

  16. Duane Storey says:

    Thanks for the feedback Kirsten. I liked this point you made:

    “A system based on deductibles discourages primary preventative care, and as a result individuals often don’t come to medical attention until it is too late.”

    While I totally agree, and am happy our system is accessible to all, I just want to point out that the opposite is possible true here in Canada – that is, because our health system has few constraints, more people probably seek preventative medicine than probably should, which is why (at least, why I think) emergency rooms are often overflowing and doctor’s offices and clinics are routinely booked up. Obviously the better system in general, but inherently one of the weaker points (from an implementation and cost perspective) of our system.

    I’m also not entirely sold on the claims that our system is timely. I had to wait nearly six months to see a specialist, and then another six months to put my eye back in the right place. Granted, my life wasn’t in jeopardy, but that’s a long time to wait, and I don’t think that delay helped my health or well being at all. When my dad had his heart attack, they kept him on blood thinners in the Chilliwack hospital for nearly five days while they waited for a spot to open up in Burnaby so they could give him an angiogram. Is that timely service after a heart attack? I’m not certain it is.

    Also, just to nitpick a bit, I’m not sure that stats regarding life expectancy and infant mortality are proof that our health care system is better. They’re obviously good stats to have, but I suspect both of those could be attributed to other factors, especially life expectancy (for example, maybe we eat a bit better, or exercise slightly more). But I totally agree with your points, and am obviously glad we have the system we do.

    I’d be interested in your observations regarding the faults of the current Canadian system though. I try to relate some of my experiences to people, along with my impression how the system is underfunded and appears to be in trouble, but often times people don’t believe me entirely. It would help to have some perspective from people on the inside (such as yourself).

  17. Tia says:
    This was a good article contrasting US/Canadian health care from the perspective of a Canadian living in the US.

  18. sarah-renee says:

    I know one of the issues I see today in the states is people choosing not to take advantage of preventative care or even health insurance at all. Everyone places their priorities differently and some people (not everyone of course, but some) choose other things over insurance. I see many people who if they decided to spend their money more efficiently could have excellent health insurance. For example one of my girls at work didn’t choose to take advantage of the free preventative care option we have (we pay $3/mo for dental) 2 years later she needs to have cavities filled and they’ll only pay 80% (approx $100 out of pocket). Now that doesn’t mean she wouldn’t have had the cavities had she gone in every 6 months but the potential is there. In turn I have another girl who has chosen not to take advantage of our $41/mo health insurance and she gets frustrated when she can’t afford to go to the Dr. But she has a pretty new $350 platinum diamond right hand ring. These are two very small examples of close to home situations for me that could have been avoided with a little bit of effort to do the responsible thing.
    I worry that if we switch to this we are just exchanging one flawed system for another.

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