A few years ago, I was invited to participate in a symposium on the disaster of Canadian health care by John Caldara of the Independence Institute.  This event took place in Vancouver and featured the first-hand stories of Canadian patients that were denied or neglected or worse.  You can watch Reason Magazine’s story of one of the patients here.  After listening to these heart-wrenching stories all morning, my wife and I went along to the luncheon, seated at a table with Canadians, primarily.  After making what seemed like a fairly obvious comment about the abysmal Canadian health care system, we discovered what I have since liked to call “Canadian healthcare pride.”  Our new Canadian friends were appalled that we would bash the system they had just picked apart moments before!   I’ve discovered that his nationalistic health care pride insanity is not unique to the Canadians.  On the contrary, it is widespread as I will attempt to show in this blog.  

You see, it is one thing for a Canadian to tell the story about being denied brain surgery in spite of the presence of a life threatening and growing brain tumor.  It is one thing for a Canadian to tell the story about their child denied ear tube placement only to have their life miraculously saved by an American pediatric neurosurgeon in Washington state after they developed meningitis.  

It is another thing entirely for an American to say anything derogatory to a Canadian about their system of health care.  They will almost invariably defend it.  

The Canadian health care nationalism pales in comparison to the Brits, though.  The hate mail I’ve received from the Canadians for criticizing their system pales in comparison to that I’ve gotten from the Brits.  Talk about pride.  All the while the hospital medical staff murders their sick relatives under the guise of the Liverpool Care Pathway, a harmless-sounding euphemism for their brand of euthanasia.   

I can’t leave out American Medicare beneficiaries and their nationalistic “insurance” pride.  The reaction of patients to me years ago when I was happy to provide their anesthetic free of charge, but refused to deal with “their Medicare” was enlightening.  ”What do you mean you won’t take ‘my Medicare?’”  ”Do you think I’m charity?”  The rage I witnessed made no sense to me then.  It does now.  This pride that can only be understood as a type of nationalism much like the Canadians’, explains this emotional and irrational reaction I witnessed.  

The insurance of active duty military, Tricare, is a great example of Jane Orient’s saying that “coverage doesn’t mean care.”  Tricare pays our surgery center almost exactly 1/3 of the cost of the surgeries we do.  That’s right.  Even with our efficiency, they would need to pay us 3 times what they do for us to break even.  Needless to say, no doctors are waiting in line to accept Tricare patients.  Yet in a townhall meeting, I witnessed an active duty military man go toe to toe with Senator Tom Coburn about his proposal to modify Tricare, a proposal that would increase this man’s payment slightly but would actually grant him access to care, care which is currently unavailable to him due to the price controls within this awful “insurance” product.  

Tricare pride.  Medicare pride.  Canadian care pride.  British care pride.  Victimized by their “insurance” the pride remains, nonetheless.  

Contrast that with patients that have come to our facility that are proud of the fact that they have never been insured.  They pay their bills.  They have saved for a rainy day.  They have saved enough money for an open heart surgery ($26,000 here in Oklahoma City).  They have saved enough (it doesn’t take that long when you are not paying $1800/month in insurance premiums) to pay for their hip replacement ($18,000 here in Oklahoma City).  Many of these patients would buy cancer policies or other catastrophic policies if they were available but sadly, thanks to Uncle Sam, these types of policies have been legislated out of existence.  

I guess that if you wrap filth in a country’s flag, the citizens perceive greatness no matter what is inside.  The subordination of the rights of the individual to the whims of the state is a necessary step in any socialist or fascist system of government.  I think that is the common thread in what I have described.  As an individual’s health care becomes the responsibility of the state, its evils tend to be discounted by virtue of their association with the state.  This irony shields government-run health care systems from much of the scrutiny and criticism they deserve.  Once the “healthcare provided by government” step is taken, it tends to be self-fueled, as any criticism of such a system can be painted as unpatriotic, almost treasonous. 

Samuel Johnson said that “Patriotism was the last refuge of a scoundrel.”  He meant by this that to impugn someone’s patriotism was the lowest blow one could strike, a despicable tactic by the accuser.  Let’s keep our guard up for the government healthcare boot lickers that would defend the rationing and euthanizing of the sick for the good of the many.  

G. Keith Smith, M.D.