How Socialized Health Care Works in Canada

As a Canadian, and Cracked's official Overseas Correspondent, I sometimes find myself with a very different perspective on current events than Cracked's readership.* Most of the time when this happens, the events are political, and as such, I generally steer well clear of them when picking column topics. This is at least partly out of a sense of self preservation. American political commentators tend a little more towards the shrieking, hair-pulling, shitting-pants-in-anger style than I prefer to write, and the chance of getting knifed in the kidneys by someone with different views than you seems to be an ever-present threat. Mostly, though, I refrain from adding my two cents out of a sense of politeness - it's not my business how you run your country, even if you are drunkenly swerving out of control and in danger of careening into my country.

*Although Cracked draws an audience from every place in the world with Internet access and lazy office workers, the bulk of our readership still primarily hails from America, the so called "Land of Too Much Free Time on Their Hands."

However, the recent debate about health care has offered me a unique opportunity to shed some light on the conversation. As American politicians muddle their way towards some sort of comprehensive health care reform, the usual television idiots and Internet morons have contributed to the discussion by spraying the verbal equivalent of diarrhea all over each other as they try to frame the debate. A central point being "discussed" is what this hypothetical future health care system would look like. In particular, they ask, spraying loose fecal matter over each other with their mouths, what would government funded health insurance look like?

As Canada has had universal, government funded health care for some time now, this seems like an ideal time for me to explain a bit about how it works. Hopefully this will allow you to see some of the advantages and disadvantages of so-called "socialized" medicine, and allow you and your leaders to make better informed decisions. No, seriously.

First, I might as well discuss the "Death Panels," a subject recently raised by one-time Alaskan governor, Sarah Palin. It's an uncomfortable truth that in any system, there will be a limited amount of resources to be spent on medical procedures - a fact which leads to some difficult questions. Is it right to spend $1 million to save one person, when 100 others can be saved for $10,000 each? Obviously real world examples are never that cut and dried, but nevertheless cost-benefit calculations of that sort have to be made to ensure limited resources aren't misallocated. On old people, for example.

Here in Canada, there's no such thing as a "death panel," but decisions of this sort are handled by a centralized agency, the Canadian Department of Life. There, specially trained bureaucrats, using the most powerful computers available in 1997, work through a decision matrix to see what medical procedures are appropriate for a given case.

An example should help illustrate how this works. For most general medical assistance, Canadians simply visit their local health distribution center. There they wait in a short queue for their Initial 38-point Health Inspection. A doctor then sends the appropriate forms to the DoL, allowing the patient to wait in the comfort of their homes for the six to 18 weeks it takes for the DoL decision. At that point the patient returns to the health distribution center to receive their approved health care.

The entire matrix is about 52,000 pages long, although half of that is just the same thing written in French. I won't print the whole thing, but here is a small sample:

Patient Age
Between 20 years and 65 years
Condition
Broken Thumb
Decision
DECISION-P7985: Set Bone, Install Cast OR Soft cast, 2 Tylenol

Patient Age
Older than 65 years
Condition
Broken Thumb
Decision
DECISION-L3267: Walk it off, 2 Tylenol

Patient Age
Older than 65 years
Condition
Broken Hip
Decision
DECISION-A3779: Throw over town walls to the ice leopards.

Patient Age
ALL
Condition
H1N1 Virus, "Swine Flu"
Decision
DECISION-V1243: Public Health Override directive E76 - Cast into ice volcano.

I should point out this is the "simple" form of the matrix, and not what is actually used by the DoL. In the 1960s, the Supreme Court of Canada decided it was acceptable for the decision matrix to be biased to favor certain desirable social traits, much like the tax code. People with dependent children can thus expect to receive slightly better medical treatment, and people who smoke can expect the opposite. Other criteria deemed to be a positive benefit to society, and thus to receive better health care, include having some university education, voting regularly or owning a thesaurus. Negative criteria include having overdue video rentals, making excessive purchases of light beer or having an interest in wrestling.

As children are the workers of tomorrow, a great deal of care is lavished upon the young; infants in particular. Mandatory vaccinations are delivered weekly to all infants starting at the age of one month, with additional vaccinations provided to infants with particularly desirable genetic traits. Similarly, infants are also tested to see which are at risk of developing particularly expensive medical problems later in life. Contrary to popular belief, these infants are not euthanized, and are instead cared for warmly and compassionately by trained nurses in specially outfitted shipping containers while they're on the way to Burma, at which point they're legally no longer Canadians.

Some Canadians, primarily those who come from the families of merchants, do seek out health care on the black market. It's widely rumored that in the underground, joint replacements can be had in exchange for two or three cartons of Marlboro cigarettes or a pair of Levi's. The government has naturally tried to discourage these insidious flare-ups of two-tiered health care. Nightly newscasts by the Canadian Department of Facts regularly point out that black market health care facilities are poorly maintained, and their workers are faceless monsters who feed on the flesh of the living.

All of the above is common knowledge however - something anyone can learn by opening the Wikipedia page on Canada and reading between the lines. To dig a little deeper then, and get the straight journalistic dope that Cracked readers desperately crave, I also spoke to local Licensed Health Distributor, Doctor Neil Channing. The interview transcript is below.

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Chris Bucholz: All right, the recorder is running. This is Chris Bucholz, Government Journalist ID A26732243, Registered Satirist number 58008. The date is August 8th, 2009. With me is Doctor Neil Channing of Health Distribution Centre PYR-27. Shall we?

Neil Channing: Let's.

CB: We hail the glorious government of Canada. We hail its far seeing leaders who stand vigilant against our numerous enemies.

NC: Death to the bourgeois, may the Canadian people be forever free from their nine tentacles of deception.

CB: Kadosh! -pounds fist into hand-

NC: Kadosh! -pounds fist into hand-

CB: OK then. Doctor Channing, I'm glad you could make time for me.

NC: No problem.

CB: The reason we're talking today is I wanted to get an idea from you what challenges you face, as a practitioner of medicine in a country where the government provides basic health insurance for all citizens.

NC: -louder, speaking into microphone- I face no challenges at all, Chris. The system works perfectly.

CB: Thank you for your time.

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As you can see, the Canadian health care system is the pinnacle of human achievement. With the measures and processes in place, costs are kept under control, average life expectancy is steadily creeping towards 120 and the first generation of flying infants are expected to be born in 2085.

Hail, hail Canada!

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