When Facts Fight Back
Funny thing about facts: they just won’t go away. You can twist and distort them. You can concoct competing data and present them as facts. You can bluff and swagger and bluster and bully. You can flat-out lie. But the facts won’t go away. When the smoke clears, there they are, uncompromising, irrefutable, overpowering.
A North Carolina senator learned that hard truth on Tuesday when he tried to face down an expert witness at a US Senate hearing on single-payer healthcare.
Senator Richard Burr – a Republican of course – came to the fray with a collection of popular myths and loaded questions about Canadian health insurance. Dr. Danielle Martin, a physician and health policy professor from Toronto, came armed with an arsenal of facts and an unflappable Canadian demeanor. Burr’s assault was doomed from the start.
Here’s part of the exchange (from the Los Angeles Times):
BURR: Why are doctors exiting the public system in Canada?
MARTIN: Thank you for your question, Senator. If I didn’t express myself in a way to make myself understood, I apologize. There are no doctors exiting the public system in Canada, and in fact we see a net influx of physicians from the United States into the Canadian system over the last number of years.
What I did say was that the solution to the wait time challenge that we have in Canada — we do have a difficult time with waits for elective medical procedures — does not lie in moving away from our single-payer system toward a multipayer system. And that’s borne out by the experience of Australia. So Australia used to have a single-tier system and did in the 1990s move toward a multiple-payer system where private insurance was permitted. And a very well-known study by Duckett, et al., tracked what took place in terms of wait times in Australia as the multipayer system was put in place.
And what they found was in those areas of Australia where private insurance was being taken up and utilized, waits in the public system became longer.
BURR: What do you say to an elected official who goes to Florida and not the Canadian system to have a heart valve replacement?
MARTIN: It’s actually interesting, because in fact the people who are the pioneers of that particular surgery, which Premier Williams had, and have the best health outcomes in the world for that surgery, are in Toronto, at the Peter Munk Cardiac Center, just down the street from where I work.
(Newfoundland Premier Danny Williams, who owns a condo in Florida, had a heart valve procedure in Miami.)
So what I say is that sometimes people have a perception, and I believe that actually this is fueled in part by media discourse, that going to where you pay more for something, that that necessarily makes it better, but it’s not actually borne out by the evidence on outcomes from that cardiac surgery or any other.
BURR: On average, how many Canadian patients on a waiting list die each year? Do you know?
MARTIN: I don’t, sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all.
In her testimony, Dr. Martin dispelled Republican propaganda about Canada’s health care system, telling the committee:
I do not presume to claim today that the Canadian system is perfect or that we do not face significant challenges. The evidence is clear that those challenges do not stem from the single-payer nature of our system. Quite the contrary…
And adding that:
We do not have uninsured residents. We do not have different qualities of insurance depending on a person’s employment. We do not have an industry working to try to carve out different niches of the risk pool. This is a very important accomplishment and as we watch the debate unfold as to how to address the challenges you face, we are reminded daily of its significance.
Here’s a different kind of exchange, between Dr. Martin and Senator Bernie Sanders, who favors single-payer health insurance (from the Canadian Broadcasting Corporation report):
SANDERS: Is your prime minister a socialist?
MARTIN: No sir, our prime minister is quite conservative.
SANDERS: So obviously as a conservative he wants to implement the American health-care system that the Canadians are very aware of, I gather that is the first thing he did when he took power is that right?
MARTIN: Not exactly.
SANDERS: Why not?
MARTIN: Support for single-payer Medicare in Canada goes across all political stripes.
The CBC reported that Dr. Martin gave the senate “a lesson on Canadian health care.”
Salon.com was less polite. Their headline declared: “Canadian doctor makes anti-Obamacare senator look like a buffoon.”
That’s usually what happens when misinformation goes up against the facts.