Today Montana, Tomorrow… The Nation?
by JEFF NYGAARD
Most people in the United States don’t really know what the Canadian health care system is all about. And they certainly don’t know that the Canadian national health care system—called Medicare in that country—began not as a national system, but as a provincial experiment. (A Canadian “province” is like a U.S. state.)
Back in 1961 the socialist governor (premier) in the province of Saskatchewan proposed that the province adopt a “universal, publicly funded medical care—known as medicare.” The law was passed in November of 1961 and took effect the following July 1st. Doctors fought it tooth and nail. According to “Canada: A People’s History” by the Canadian Broadcasting Corporation, or CBC, “The day medicare was born, about 90 per cent of the provinces doctors went on strike.” The strike only lasted three weeks, and within a few years the wildly-popular and effective system was adopted on the national level.
As of 2011, the U.S. spends 88 percent more on health care, per capita, than does Canada. Meanwhile, Canada has a higher life expectancy and a lower infant and maternal mortality than the United States. Or, for a more general indicator of what Canadians are getting for their health care money, the amenable mortality rate is about 40 percent higher in the U.S. than in Canada. “Amenable mortality” is defined as “premature deaths that should not occur in the presence of timely and effective health care.”
Now, 50 years later, Montana has implemented a remarkable program to provide socialized health care to state employees. They don’t call it “socialized health care,” but just put two and two together as you consider the following remarks from a story on National Public Radio from last July:
“Montana opened the first government-run medical clinic for state employees last fall. A year later, the state says the clinic is already saving money.”
Note that Montana’s experiment is not a “single-payer” insurance plan. It’s actually socialized medicine, as the NPR report makes clear without stooping so low as to use the “S” word:
“The state contracts with a private company to run the facility and pays for everything—wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare. Even so, division manager Russ Hill says it’s actually costing the state $1,500,000 less for healthcare than before the clinic opened.”
“Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices. ‘Because there’s no markup, our cost per visit is lower than in a private fee-for-service environment,’ Hill says.”
“Bottom line: a patient’s visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it’s free to patients, hundreds of people have come in who had not seen a doctor for at least two years.”
“Montana recently opened a second state employee health clinic in Billings, the state’s largest city. Others are in the works.”
And, in a telling comment about what can happen when life experience contrasts with the “free market” ideology with which we are constantly propagandized, we have this comment:
“Pamela Weitz, a 61-year-old state library technician, was skeptical about the place at first. ‘I thought it was just the goofiest idea, but you know, it’s really good,’ she says. In the last year, she’s been there for checkups, blood tests and flu shots. She doesn’t have to go; she still has her normal health insurance provided by the state. But at the clinic, she has no co-pays, no deductibles. It’s free.”
Had Obamacare included a “public option” that looked anything like Montana, we might be hearing comments like those of Ms. Weitz from every corner of the USA. Could Montana be our health-care Saskatchewan?
Jeff Nygaard is a writer and activist in Minneapolis, Minnesota who publishes a free email newsletter called Nygaard Notes, found atwww.nygaardnotes.org