Last week we asked if you had ever considered moving to Canada. Your answer, in a word, was, “Yes!” Over 70% of you said you’d thought about it, and over 50% of you thought about it seriously or already picked up and moved. Looks like we’re a bunch of Canucks over here…

This week, we want to know how you feel about Hamas overthrowing Fatah in Palestine and wheather this may open up new avenues for solving the biggest conflict in the Middle East. So, what do you think? Make your voice heard with your vote in the sidebar at right.

Download audio file (water.mp3)

History can be summarized as a story of undeviating change and renewal. With that in mind, one can safely predict that the way things are is not the way they will be. The future will deal those of us who remain a new hand, the hierarchy of power will shift, and in order to better influence the shape things will take, it is worth our while to deal in hypotheticals. As such, I look towards our neighbor to the North, and, in the assessment, see a once nondescript country on the verge of an historic change.

But first, some backdrop: another trend in history, more apparent of late, is that mankind is growing, simultaneously changing its relationship with the earth’s resources. As a species, we are asking more of Mother Earth than ever before, and the demands increase daily. Currently human population stands at an unprecedented level (app. 6.7 billion), and though the rate of increase has been steadily declining, the CIA fact book still lists the daily world population increase at a headcount of 211,090. Every new mouth born represents many things, among them another strain on the earth’s resources.

Currently one resource garners the most attention, incites more conflict, and is erroneously deemed the lifeblood of our economy, but a rational view of the situation leaves no doubt as to what is most vital. The only possible answer is water. Without it there is no life, and here on earth there is an ominously finite supply. UN scientists say Gaza will have no drinkable water within 15 years. The IIMI (International Irrigation Management Institute) reported in 1999 that underground water levels in India are being consumed at twice the rate they are being replenished. Experts have predicted as many as 523 million people in Africa may soon be without access to potable water. In short, water will be in high demand in the years to come, and that demand drives the price up. No doubt many will be willing to pay in blood.

There is a school of thought that believes many current conflicts, most notably those in Iraq and Darfur, cannot be grasped outside the larger context of their geographical location and the resources contained therein. In the case of Darfur, the arid Sahel region of Africa is an unforgiving environment, and the desire to secure access to its resources (or lack thereof) has, by most accounts, provided at least a partial motivation for the atrocities taking place there. Likewise, the situation in Iraq is often attributed to its bountiful oil reserves. So, will this looming water shortage too bring warfare along with it? It seems likely. To believe a government would balk at fighting over a commodity as vital as oil is naive, and to believe that moral stance would extend to water is indefensible. This fact doesn’t bode well for world relations, as water resources are rarely confined by lines carved out on maps.

Shared water sources means the likelihood for contention between countries is not restricted to Africa, the Middle East, and other parched locales; it will touch even the most affluent of countries. The U.S. and Mexico currently share use of at least 18 aquifers, and efforts to shore up control of water rights in the U.S. and Canada are hindered by the many resources dissecting the shared border. Canada, however, is in a less desperate situation than its two continental partners. Its rates of population growth, water usage and water contamination are consistently outpaced by the U.S and Mexico. There is, however, a more important reason; it is to water what the Middle East is to oil.

Canada on the Rise

Canada is a vast expanse of land, but beyond the area surrounding the US border, it is sparsely settled. All told, it is home to only half a percent of the world’s population. The reason? The climate of the north makes living a modern western lifestyle untenable. That, however, may soon change. Canada’s arctic is warming faster than any place on earth, with some regions seeing average increases of 3-4 degrees Celsius per year. The habitats of some native trees, as well as other forms of vegetation and wildlife, are becoming increasingly unsuitable. When/if this trend continues, more Southern-oriented species will find the Northern areas more hospitable, moving North as colonizers of the plant world. Humans will then follow the trend, and the warmer weather. (This is an admittedly simplified and selective version of what Canada faces from climate change. To get a more in-depth analysis, please see here.)

This is especially bad news for the Inuit, who have been able to avoid the eclipse of their culture and traditions only because the land they inhabit is suited for neither Western European notions of comfortable living, nor commercial development. However, as climate change begins to show its consequences, the land becomes more hospitable. Most notably, the permafrost is melting, making accessible the northern icelands of Canada. This land, seen by many as the “treasure trove,” as Peter Gillin of Tahera Mining Company refers to it, is believed to contain resources as diverse as uranium, gold, diamonds, silver, zinc, copper, iron ore, and sapphires. If the land proves to be as rich as its believed to be, foreign investors and developers will come-a-calling in increasingly large numbers.

However, there still remains the most compelling reason Canada is poised to greatly profit from a parched future. Remember that half percent of the world’s population that Canada houses? Well they sit on top of an estimated twenty percent of the world’s fresh water. On top of the, jobs that are bound to spring up in the area, the prospect of beautiful, sparsely populated space in the North, and the lure of readily available water will make Canada the world’s oasis. And, as the water shortage continues, that appeal will increase exponentially. There is a reason the Qur’an, born of the desert, so often equates paradise with lush gardens and rivers; to people without a steady supply of water, a river is paradise. With all these factors in play, Canada would undoubtedly see considerable population growth, as well as increasing attention from foreign governments and corporations.

Some already see the marauders coming. The Council of Canadians, objecting to the Security and Prosperity Partnership of North America Agenda (a proposal seen as a mandate to “negotiate sovereignty over national resources”), has renounced government discussions on the future use of Canadian water. Invited to the talks were business groups and lobbyists, but conspicuously absent were citizen groups. This has lead the Council to conclude that, “because Canada manages the largest fresh water resources in the world, companies are lining up to pump, bottle and privatize our water for their profit.” They’ve produced a brochure in response, encouraging citizens to “preserve and protect our water for future generations,” and denouncing “the continentalization of water for market purposes or continental geopolitical considerations.”

Canada’s Environmental Minister has attempted to placate these groups by insisting, “Canada has no intention to enter in any negotiations on bulk water exports or diversions. Canada has restrictions in place to prohibit removal of water, including diversion, backed by serious fines and/or imprisonment.” But many believe these laws are toothless; a plan to run a water pipeline from Northern Manitoba to Texas, suggested by the Washington-based private consulting group Global Water and Energy Strategy Team, currently breaches no Canadian law, says Council of Canadians chairwoman Maude Baird.

One roadblock to federal leniency on the issue of water exportation, however, is Territorial rights — strong at present, and being strengthened. The Yukon currently has full control of its onshore natural resources, with the other two territories negotiating for the same. With the differences in population (the territories contain only 104,000 of the countries 33,000,000 people, the majority Inuit) the possibility, and here we slip further into speculation, that sectarian strife will arise must be accounted for - in Iraq and Sudan, control over resource rich-land has played a role in sowing violence between fractious groups; there is already a movement for independence within Quebec. Could Northern Canadians follow suit if the stakes were high enough? In what may be interpreted as a foreboding move, all three territories, the Northwest Territory, the Yukon and Nunavut, are attempting to develop their natural resources in order to lessen financial dependence upon the federal Canadian government.

Perhaps spurred in part by this sort of forward thinking, Stephen Harper’s government has begun to beef up its military. The nearly thirteen billion dollar increase, spread over five years, represents the fulfillment of the Conservative’s campaign promise. In addition, the Prime Minister has expressed a desire to commission three new icebreakers and a new deep-water port near Iqaluit. These latter additions would work to secure sovereignty over the five routes which cut through Canada’s archipelago. Currently the country sees these Northwest Passages as part of their internal waters. The United States’ government has a different opinion.

Could any of this lead to scenarios such as the United States annexing the great lakes, or even invading its neighbor to North? Most likely not, but if water levels continue to drop worldwide, and once high-and-mighty nations like the U.S. have to go in search of water, there is no telling what could happen. A couple things, however, do seem certain if the scenario presented in this article becomes reality; Africans, Asians and, to a lesser extent, Latin Americans (all of which stand to be the first affected by global water shortages) will look towards Canada as many now do the towards the U.S. or Europe. The resulting influx of immigrants will radically change political debate in Canada, and last of all, Canada will have a whole lot of new-found muscle to flex in the international arena.

(For an informative hub, linking to diverse articles on water shortage and its effects, check out this site. For more information on innovative new ways of water conservation, see here. For info on the potential saving-grace of desalination, see here)

**Thanks to Mos Def for the unsolicited use of New World Water, off his album Black on Both Sides. Thanks to jackrascal for the drawing**

Illustration by jackrascal

Last week we asked you what you thought of the new immigration bill, now dead in the water in Congress. The results were far from conclusive, but extremely interesting. First, no one said they supported the bill as is. This clearly shows that the “grand compromise” Democrats and Republicans were envisioning ended up pleasing neither side. That said, 35% of voters did support the bill, though they had reservations. 60% didn’t support the bill because of those reservations. Most interestingly, however, was that only 5% of voters felt there was no need for any kind of immigration reform. Americans want change in our immigration policy. I hope Congress will see fit to do their job and give it to them.

This week, our question deals with our monthly issue topic, Canada. Very simply, have you ever considered moving to Canada? Let us know what you think, the poll is active in the sidebar!

Mr. Harper’s May visit included a tour of a Canadian-funded school in Kabul, a meeting with Afghan President Hamid Karzai, and a visit with Canadian troops near Kandahar. The Prime Minister stated in his speech to soldiers that he sees Canada “at its best” in Afghanistan, calling his country’s work there “Canada’s most important foreign policy endeavor.”

Yet the trip stirred controversy back at home. While Canada has “historically” been in the minority among NATO countries by having a public strongly in favor of military efforts in Afghanistan, the war is now losing support among Canadians.

First, the Canadian national newspaper Globe and Mail brought controversy to the mission earlier this year when an investigative report revealed that Canadian troops have been turning over detainees to Afghan police, under whom detainees are brutally tortured:

Afghans detained by Canadian soldiers and sent to Kandahar’s notorious jails say they were beaten, whipped, starved, frozen, choked and subjected to electric shocks during interrogation.

In 30 face-to-face interviews with men recently captured in Kandahar province, a Globe and Mail investigation has uncovered a litany of gruesome stories and a clear pattern of abuse by the Afghan authorities who work closely with Canadian troops, despite Canada’s assurances that the rights of detainees are protected.

Mr. Karzai took measures during his recent meetings with Mr. Harper to strongly deny these allegations, stating that he could personally guarantee the Canadian people his government was not involved in torturing detainees. (The Globe and Mail cites numerous other, independent sources that uphold its accusations.)

But in addition to the torture scandal, the number of Canadian soldiers killed continues to rise, reaching 57 since 2002 at the very end of May. (This may seem small compared to the near 3,500 American soldiers killed to date in the Iraq conflict, but consider that Canada’s military is a much smaller, more closely-knit, and rarely deployed operation, having only about 62,000 active personnel, compared the US’s 1.4 million, and a budget roughly 3% that of the US’s military budget.)

Fatalities aside, arguably the greatest challenge to public morale is the growing sentiment that NATO is losing the war in Afghanistan. There are growing indications that Taliban resurgences are suceeding in southern Afghanistan, as the Karzai government exercises little authority beyond Kabul city limits and an abundance of opium revenues keep Taliban rebels better funded and organized than their NATO opponents.

Nevertheless, in his recent visit Mr. Harper reiterated Canada’s commitments to the long haul in Afghanistan: “Yes, there remain enormous challenges,” he stated. “But our determination is strong.”

Such hard-line rhetoric has led more than a few in Canada to call Afghanistan “Canada’s Iraq:” troops committed amongst initial public support; counterinsurgency efforts failing; body count rising; evidence of gross (and desperate) misconduct by troops; spiraling spending; and public support plummeting. The gung-ho head of state remains committed just the same.

Meanwhile, Canadians remain proud of their early decision to abstain from any role in the Iraq conflict. (Few can forget this unfortunate interview with the Canadian Broadcasting Corporation in which Ann Coulter incorrectly insists that Canada sent troops to Vietnam, as they should have in the case of Iraq.) At the outset of the Iraq war, then Canadian Prime Minister Jean Chrétien chose to stick with France and Germany in not joining President Bush’s “Coalition of the Willing,” and publicly criticized Mr. Bush’s decision to go to war without UN approval.

In 2003 the Bush administration made clear that those countries that refused to participate in the Iraq invasion would not be allowed to bid for reconstruction contracts. Mr. Chrétien, that same year, admitted there might be Canadian soldiers deployed alongside British and American troops in Iraq, though he wouldn’t be specific. (The CBC reported over 30 troops were deployed, some of whom, despite Ottawa’s denial, were engaged in combat.)

Then. in 2004, after talks with Canada’s newly elected Prime Minister Paul Martin, Mr. Bush changed this exclusive bidding policy to make a highly visible exception for Canada, suggesting that other dissenting “allies” (such as France, Germany, and Russia) might also be able to join in during later rounds. He cited Canada’s pledge of $240 million to help rebuild Iraq as the reason for allowing Canadian companies to bid, although many speculate it was because Canada did discreetly send troops to Iraq, in addition to acting as an important ally in Afghanistan.

Because Canada is not officially part of the Coalition it is virtually impossible to determine how many Canadian troops have been killed in Iraq. (I was able to find no news sources, blogs, or watchdogs, Canadian or otherwise, with an updated number, and the Canadian Defense Ministry’s website provides no information whatsoever about its personnel in Iraq.)

Following on the heels of his predecessors, Mr. Harper’s strategy toward Iraq and Afghanistan appears to be to stick beside his neighbor to the south, regardless of how the Canadian public feels about it. In spite of Canada’s image of restraint with respect to Iraq, it seems the only real difference between the Canadian and British or American government’s approach to the Iraq conflict is that the former is more careful to keep the public unaware of its involvement. Canadians have been left to guess whether Prime Ministers Chrétien, Martin, and Harper committed Canadian troops and military assistance to Iraq in spite of the publicly-approved decision to keep Canada out of the war, thus bypassing any opportunity for public debate concerning the withdrawal of troops.

Moreover, with its ongoing insistence on increasing aid and military assistance to NATO efforts around Kandahar, Ottawa seems unfazed by the country’s distrust and disapproval of the war in Afghanistan. Despite the well-attended March protests throughout Canada calling for the withdrawal of Canadian troops from Afghanistan (organized in conjunction with anti-war protests in the US), Mr. Harper continues to pursue an all-too-familiar strategy of rosy support for a local government incapable of quelling violence throughout its viciously divided country, while continuing to spend taxpayer money and soldiers’ lives on a losing battle. Indeed, he publicly refuses to consider a parliamentary vote on ending the Canadian mission in Afghanistan, vowing instead that Canada will never “cut and run” from commitments already made.

Illustration by jackrascal

Prime Minister Stephen Harper and the Conservative Party agree: they are opposed to the decriminalization or legalization of marijuana. In December 2005, Harper made his position clear in an interview with a Vancouver radio station: he supports mandatory minimums for drug criminals such as marijuana growers, and he stated that the Conservative Party would “never endorse” the legalization of marijuana.

Vancouver, British Columbia’s largest city, may be the world’s “best place to live.” Under Canadian federal law, marijuana possession is illegal there as it is throughout all of Canada.

Yet it has been said that Vancouver is “on the cutting edge of drug reform in the Western hemisphere.” Marijuana coffee shops and British Columbia’s reputation as the home of high-quality marijuana have brought tourism there, and the city is warmly regarded by the magazine High Times.

Vancouver’s “Four Pillars Drug Strategy,” modeled after policies in Germany and Switzerland, treats drug users with empathy while attempting to preserve public order. Under Four Pillars (Prevention, Treatment, Harm Reduction, and Enforcement) guidelines, Vancouver has increased housing for addicts, provided them with centers where they may use needles safely and cleanly, and has experimented with using prescription heroin to treat users. The program has been exceptionally popular: nearly three-quarters of Greater Vancouver residents support how Four Pillars has affected the drug problem in Vancouver’s Downtown Eastside.

Vancouver residents’ feelings toward drug policy are not atypical for Canadians, many of whom seem to be in favor of liberal drug policies, especially toward marijuana. A 2004 poll (.pdf) conducted by SES Research at the behest of NORML Canada revealed that “almost six in ten Canadians say adult Canadians who possess small quantities of marijuana for personal use should be left alone” and that “a majority of Canadians believe [marijuana] should be treated the same way as beer, wine, or spirits.”

Marijuana usage is also relatively common among Canadians. In 2004, the Canadian Addiction Survey (.pdf) found that among Canadians 15 and over, 44.5% had used marijuana at least once in their lifetimes, 14.1% at least once in the past year.

Politically, demands for legalization have been frequent and sustained. Moreover, they have been heard and considered by the highest levels of the Canadian government. As recently as 2002, a Canadian Senate committee recommended that Canada legalize marijuana.

The law-and-order approach to marijuana emphasized by the Harper government is troubling to some Canadians, who fear how Harper’s policies may affect programs like Four Pillars in Vancouver. Moreover, they ask, what are the international implications of energetic Canadian participation in the US’ hardline anti-drug strategy? Will Canadian troops soon be hunting drug lords in places like Columbia and Afghanistan?

One wonders why the Canadian police view marijuana as their biggest problem - police from around the world, indeed, might find that an enviable position. One wonders, too, why Canadian police do not simply give up their efforts against marijuana, much as British police did in 2001 when they decided they simply had better things to do than pursue small-time marijuana users and smugglers.

But perhaps harsh rhetoric on the part of policy makers is just that. Cracking down on drug users has long been a way for “tough on crime” politicians to demonstrate that they are bold and courageous leaders. Yet handcuffs, courts, and prisons aren’t the only way to deal with drug users. The popularity and seeming effectiveness of Vancouver’s Four Pillars approach should give anti-drug politicians pause.

And perhaps American lawmakers could learn a similar lesson - namely, that progressive drug policies are not strictly the province of “weird Europeans,” but are alive and well only steps from our back door.

Those interested in learning more about marijuana politics in British Columbia can visit the British Columbia Marijuana Party. On a national level, major organizations pushing for marijuana reform in Canada include NORML Canada and the Marijuana Party of Canada. Finally, readers interested in Canadian activists’ struggles can read here about the battle over attempts to extradite activist Marc Emery and his colleagues to the United States, where they face possible life imprisonment for the sale of marijuana seeds.

Illustration by jackrascal

Many liberals look to Canada as a possible example of how our country could begin to provide healthcare to the roughly 46 million uninsured (not counting illegal immigrants, of course, who represent an enormous drain on our health system). But how valid is this comparison? How successful is the Canadian system, and would a similar system be applicable to the United States, which is vastly different in terms of demographics, income, politics, and general philosophy? Would US universal healthcare result in a drastic reduction in medical R&D, as many conservatives claim, and possibly a degradation of care for the majority Americans? These questions aside, what can we learn from the successes and failures of the Canadian system in order to start cobbling together some program that ensures the working poor have consistent access to physicians and a means to avoid the cataclysmic burden of medical debt?

Before I get into this, though, let me bring some oft-recycled wisdom back out of the depths; please bear in mind, dear reader, that, as Mark Twain so eloquently put it, “There are lies, damned lies, and statistics.” A necessary evil, though, these abstract percentages and numbers, but remember that, when it comes down to it, we’re talking about an issue that only seems abstract until you crawl out your shattered front windshield, fall off a ladder, contract hepatitis, or have a baby.

First, the basics. Canada’s healthcare system is about 65-70% publicly funded, both by the federal government and by the provinces. The Canada Health Act specifically outlines which procedures are offered free of charge to Canadian citizens, and most hospital and physician care is covered. The Canada Health Act’s intended purpose is “to facilitate reasonable access to health services without financial or other barriers.” The end result is that most basic medical services are essentially free or relatively affordable to all Canadians. Dental care, prescription drugs, and optometry are not generally covered by the healthcare system, and make up a large portion of the 30% of privately-funded healthcare costs.

That “free or relatively affordable” bit probably sounds good to the millions of uninsured Americans, not to mention those who are burdened with costly insurance or large medical debts (roughly 50% of all bankruptcies are at least partially due to medical costs.) But what’s the actual care like? A free visit to the doctor is great, but if your physician just shrugs and tells you to take a few aspirin and quit whining, something’s wrong. In fact, many critics of Canada’s health plan point to a dearth of modern technology, scarcity of doctors, and long waiting lists as proof that Canada’s system is far from perfect.

Weaknesses

So let’s strip away the drywall and get down to bare studs. Every system has its problems, particularly when it comes to healthcare, and Canada is no exception. One of the most common complaints levied against Canadian healthcare is the long wait times many patients face for various procedures. While specific data on wait times is somewhat scattered, given their tendency to vary between provinces and specialties, there are a few statistics that seem to provide rough time frames. The Fraser Institute’s survey (.pdf) of estimated wait times (as provided by surveyed physicians) came up with an median of 18 weeks between initial consultation and the beginning of treatment, a figure that includes a visit to a specialist and necessary testing. Other figures of note include a 12 1/2 week wait for an MRI. Another study by Statistics Canada on non-emergency wait times found that median wait times were about 4 weeks for elective surgeries, 4 weeks for a visit to a specialist, and 3 weeks for diagnostic tests.

Compared to the US, this can seem like quite a long time, given that the US has one of the shortest average wait times of any industrialized country - assuming the patient can pay for the procedure. America is also more technologically advanced, in terms of research expenditure, medical patents, and technological availability (for example, America has 19.5 MRI scanners per million people compared to Canada’s 4.6 scanners per million).

Another common critique of the Canadian system points out that prescription drugs are cheaper in Canada because of government price controls, but the end result of such controls is that Canadian firms are taking US innovations and producing generic versions to sell cheaply. Some would argue that the sale of generic drugs is detrimental to research, and that a similar system in the US would cripple our pharmaceutical industry.

Lengthy Aside (aka - Hey, hippie! Your bias is showing!) - Me, I’m rarely sympathetic to the anguished cries of big business, particularly Big Pharma, since much of their R&D seems focused on the concept of producing a variety of drugs designed to numb our senses and artificially dull our more, ah, extreme emotions. And then advertising those shiny pills to us. It’s like the RIAA telling us that illegally downloading their overpriced songs is going to kill music. Oh, less money into your coffers might just cause a shortage of Zoloft and boybands? Tragedy of tragedies. Gods forbid I’m forced to turn to weed and independent music. Oh, wait…

Also, Canadian citizens are concerned about their nation’s shortage of medical professionals. Canada only has about 2 doctors per thousand people, substantially lower than America’s average of 2.5. Canadian doctors also receive about half the salary of their American counterparts, which has led to occasional articles about a “brain drain,” which argues that some doctors move South for higher pay and more advanced facilities, which is certainly true for some, although the frequency and effect of such moves is debatable.

Strengths

I think the success or failure of a nation’s healthcare can be best judged by looking at availability, effectiveness, and cost, in that order.

Canada’s system is very accessible. The government essentially provides an insurance policy for all citizens, and even waiting times and somewhat scarce doctors don’t change the fact that a Canadian citizen does not have to do the mental math of either “will my insurance cover this” or, worse, “can I afford this?”

Additionally, while wait times for certain procedures are a problem, the most critical part of healthcare, in my eyes, isn’t emergency care or triple-bypasses, but the ability to see a physician before a problem becomes serious. I found it fascinating when a debate between two Washington Monthly writers, Adam Gopnik and Malcolm Gladwell, produced this quote from Mr. Gladwell:

The Canadian health-care system is a health-care system for women. The American health-care system is a health-care system that is perfectly situated for men. It’s the male health-care system. This whole debate about what is better, the American system or the Canadian system, is essentially a variant on the gender war.

The idea behind this statement was that women and children need consistent physician care, while men tend to seek medical help only in the event of catastrophe, in which case America’s emergency care policy (care first, ask for insurance later) is sufficient to provide for their needs. A strange way to frame the comparison, but I had to fit it in here somewhere, since it does, kind of, make sense.

Effectiveness is something that is hard, if not impossible, to judge. A long wait time, for instance can be fatal, and dead patients don’t participate in surveys. Also, demographics, lifestyle, and history can have a strong impact on a nation’s health data. Based on raw statistics, though, Canada seems to be doing alright. While the World Health Organization rated Canada 30th on the list of health systems (the US is 37th), Canadians have a higher life expectancy, lower infant mortality rate, and more nurses per capita than the United States, although fewer doctors and less advanced technology, as noted before.

Cost is also an interesting factor, especially in comparison with the US. The Canadian government spends about 9.9% of its GDP on healthcare. The US, in comparison, spends the most money on healthcare of any nation in the world, roughly 15.2% of its GDP. Of course, Canadians pay higher taxes than Americans, with Canadian taxes paying 37% of the country’s GDP compared to the US’s 27%.

Puttin’ It In Cellophane

An important thing to note, right here, before I get into my rambling conclusion, is that a direct comparison of basic statistics (”damned lies”) really says very little. America has a much more violent existence, both internal and external, than Canada, and also has problems with drug abuse and immigration. A direct comparison of efficiency and cost is therefore somewhat useless, since efficiency is affected by the number of medical cases, and the cost discrepancy can easily be explained by R&D spending, technological investment, and myriad other factors, from malpractice insurance to meticulously honored medical patents.

So now, to present the final point of discussion - medical tourism. An increasing trend in the world is for people from developed countries to seek treatment in countries where procedures are considerably (sometimes many times) cheaper, such as in India, Thailand, or Singapore. Canadians seek medical care abroad to avoid long wait times, while Americans do it to save money. A common belief is that Americans go to Canada for dentistry, optometry, and other relatively simple procedures, whereas Canadians come to America for more complex procedures. While some Americans do go North for some procedures, the number of Canadians that come South is actually pretty small, and those that do come for very critical and complex operations, such as bone marrow transplants or brain surgery. The majority of Canadians who seek care abroad seem to go to India, but exact figures are very difficult to find.

So what’s it all mean? Where’s this thread winding? I’ll say now that my main concern is not with the rising cost of healthcare for middle-class Americans, but rather with those of us who have nothing. Bush’s comment about “gold plated” insurance plans and his plan to tax expensive insurance to help alleviate the cost of middle-class healthcare is an effective way of presenting a plan while ignoring the elephant in the room. The main problem with the current American healthcare is that it leaves 47 million of us (an astounding number in the richest nation on Earth) without insurance (most of whom don’t pay much in taxes, which makes a tax deductible useless), and the fact that even those who can afford insurance often have high co-pays and a maze of limitations and non-covered procedures.

Something must be done, and while Canada hardly has a perfect healthcare system, it is one that provides care to the majority of its citizens. Adopting the Canadian system wholesale would be a ridiculous and useless gesture, but the basic idea of supplying some kind of medical guarantee to all Americans is one that will be adopted in this country eventually, the only question is how long and in what form.

The last of these “damned lies,” and for me the most disturbing. I’ll just cut n’ paste ‘em wholesale, they’re all interesting statistics. This is for all the people that claim that universal healthcare in the US is too expensive or economically foolhardy. These are all problems that are essentially non-issues in Canada:

• The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.
• Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.
• The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300.
• Hospitals provide about $34 billion worth of uncompensated care a year.

A few final thoughts, away from the realm of damned lies. My father goes to Canada for dentistry, because it’s much more affordable there. Also, at the age of 55, he has a 5000 dollar deductible on his health insurance, because it’s much more affordable that way, and he doesn’t have to worry about running out of insurance if he needs major surgery or has a heart attack or something (gods forbid). I have no insurance. Many of my friends have none either. Yeah, we’re tough young bastards who use superglue to hold lacerated flesh together and treat illness with vitamins, tea, and bedrest, but that doesn’t change the fact that I, and many people I know, don’t have a regular doctor.

And the simple fact is that the situation is growing worse, not better. More and more small employers are unable to offer employees health insurance due to soaring costs, and the cost of private insurance is equally high. Not to mention that prices and coverage can vary drastically based on medical history, age, and lifestyle. Canada’s system isn’t perfect, but it does give people a sense of security - the knowledge that you can go see a doctor when you need to. That’s all I want America’s system to do. It seems laughably simple to me to provide health insurance to the working poor, and Canada stands as an example of one possible way to go about it.

Now, I know I just wrote a couple thousand words on healthcare in Canada, but I’m no expert. What do ya’ll think? Would socialized medicine work in America? Is Canada’s system a good example, or should we look to France or Italy (widely regarded as the most successful)? Why has it proven such a difficult issue for America to tackle? Why do we frown on socialized medicine but not on subsidies to agribusiness, airlines, or other big corporations? Does anyone think Bush’s State of the Union proposal holds any water? How are we going to start addressing the massive problems of the uninsured and medical debt in our country if not through universal healthcare? I’d love to hear what people have to say, since I wrote about this, not because I’m an authority, but because I’m curious about it.

Until next, eyes up, knives out, silent steps - Vas.

Illustration by jackrascal

Favorites/Favourites:

1: Hockey…is there any better trophy than the Stanley Cup?

2: The names of cities that make me giggle (I’m thinkin Saskatoon).

3: French Canadian Trappers.

4: The words ‘eh’ and ‘hoser.’

5: It’s bi-lingual.

6: Rick Moranis.

7: Curling…because you know that sport was invented by bored drunk people.

Non-Favorites/Non-Favourites:

1: Kilometers per hour. Give me a break. Kilometers in general for that matter.

2: Alan Thicke.

3: Canadian Football.

4: Their Capital is Ottawa…they’ve kept that a secret apparently.

5: Canadian Beer. It’s awful…give me a Bud can.

6: The word ‘Centre.’ You think you’re better than me or something?

7: Canadian money.

Oh Canada…our great neighbors to the North. It’s not my favorite country in the world (I piss Red, White, and Blue…and excellence) but it’s definitely in the top 10 (just above the United Arab Emirates but below Bulgaria). Canada is an interesting place though, and when you look at its stats next to America’s it makes it hard to imagine that these two countries share a border (kind of like Haiti and the Dominican Republic…that might’ve been a bit drastic). For example, Canada has a ton of political parties, my personal favorite being the Marijuana Party (not that I even smoke, I just find it funny…like a National Beer Party - not to be confused with the one I have in my apartment on Tuesdays).

As in America, though, the top two parties essentially win all the elections. Canada is a little more blunt about what their parties stand for, hence the names ‘Liberal Party’ and ‘Conservative Party’. However, when looking at these two parties as opposing political ideologies it’s hard to imagine what place they would have here in America.

The Liberal Party is pretty much what it sounds like. The Party is described as center-left of the Canadian Political system, which is to say that it’s pretty liberal by American standards. Here are a few nuggets from the Party’s platform in 2006:

National childcare program, a complete ban on handguns and semi-automatic rifles, reducing wait times for health care, additional investment in research and education.

Some of those ideas sound familiar, but they also sound pretty far left when compared to America’s idea of Liberal politics. A complete ban on handguns and semi-automatic rifles? Wow, that’s ballsy considering how much of Canada is not urban or even suburban (I’m thinking Saskatchewan and the Yukon Territory…maybe even an hour north of any major city).

And if the issues mentioned above are really the major problems facing Canadians today, then let’s all follow the yellow brick road to happiness. Reducing wait lines for health care? That’s like taking an office poll on whether to add another water cooler here in the States.

I was talking to a friend of mine about this today and she said something very interesting: “I wish we had those problems. Reducing wait lines for health care probably doesn’t even crack the top 100 problems facing America, and that’s just thinking about domestic policy.” I couldn’t agree more. I’m starting to think about buying some land there and becoming a tracker like Tommy Lee Jones in that one movie that involved intense hand to hand combat. Maybe Canada’s Conservative Party will make me rethink that idea…

The Canadian Conservative Party…well, let’s just say I wish our conservatives were more like this. Truth be told, the Conservative Party in Canada is pretty close in ideology to the Liberal Party, especially when it comes to the economy, but they differ when it comes to social issues. But upon further examination it’s easy to conclude that the differences the two main Canadian Political Parties have when it comes to social issues (abortion, gay marriage, etc.) aren’t really that far apart at all. For example, the leader of the Conservative Party, Prime Minister Stephen Harper, is against gay marriage but not against civil unions. Wait a minute…that’s the so-called Conservative Party? In America that was Howard Dean in 2004, and I think we all remember how he got treated. Harper has even gone so far as to state that while marijuana possession should still be illegal, it should be fined rather than result in imprisonment. How ’bout those northern Conservatives! I’m sure there’s a lot I’m leaving out here and since I don’t live in Canada (yet), I’m sure someone out there will criticize me for this, but social issues in Canada don’t appear to really provoke the same level of anger that they do here in the States. For social programs, it appears that the problem isn’t whether to fund them or not, but rather how much to give. Crime doesn’t appear to be a huge issue due to their gun laws and lack of gun related deaths, religion doesn’t appear to play that big of a role in government, and from what I hear people don’t lock their doors.

For the most part the two parties are pretty much center to left-center of American politics and couldn’t really exist on a national level here the way that they do in Canada. That suggests to me that Canada, as an entire nation, is more liberal than America. It reminds me a lot of many European nations such as, obviously, Britain but also Germany. Sure, Canada has its problems just like any other place, but it is also a nation of great prosperity with one of the world’s highest per capita incomes.

I’m sure Canadians could tell you that there’s a whole mess of problems, such as immigration, but from the outside looking north I would gladly trade if they’re up for it. They have problems with the environment just like we do (I’m sure the winds blowing north didn’t help either). There’s really only two options left on the table: We invade Canada and obliterate it in order to make us look better, or we just move there.

According to this easy HOW TO guide, we can become Canadian citizens fairly easily. A $200 fee and a test? That sounds great! Actually becoming a Citizen appears easier than just telling people that I’m Canadian when I travel abroad anyway. British Columbia seems nice. Maybe a large group of like minded Americans could move to Northern Quebec and become trappers. Or even New Brunswick. What’s up with that place? I’m still skeptical of Ottawa though…I’ll just have to get over that, eh?

Illustration by jackrascal.

Revolutionary Birthright

To begin, America was forged during a revolution, while Canada gained its independence gradually from Britain. From the start, America has had its eye on its northern neighbor. America tried to incite revolution in Canada during the American Revolution, and invaded Canada repeatedly during the war of 1812. After the World Wars, Canadian/US relations eased tremendously. However, when comparing the two countries one should remember that Americans look at Canadians as younger brothers, with less of the independent spirit that Americans believe sets them apart. In fact, survey research has shown a distinct “counter-revolutionary” tradition in Canada, compared with a “revolutionary” one in America. While this is a gross generalization, each country’s birthright has no doubt affected its subsequent path in numerous subtle, yet important ways.

Government and Elections

Canada, in a lot of ways, has a less centralized government than the United States. Each territory or province (the equivalent of US states) has control over the universal healthcare and education programs (though these are sometimes centralized in the federal government). Some territories retain their control over things that have nearly always been federally controlled in the US, such as immigration in Quebec. This can lead to a less unified system across Canada, and sometimes leads to problems when richer states feel they heavily subsidize poorer states. However, it speaks to the grassroots nature of Canada’s progressive politics that even though power is less centralized, policies are generally more liberal than in America.

On the federal level, Canada’s Senate is filled with unelected lawmakers who generally serve until they are 75. This changes the way laws are created in Canada (in comparison to the United States), with the Senate often looking after longer-term goals, much like appointed judges do in America. Also, the Prime Minister is directly controlled by his or her party members in the legislature. Unlike America’s President, a Prime Minister elected with a minority of seats held in the legislature can face a vote of no-confidence and be forced to resign or call for a new election.

Election practices vary as well. As alluded to above, Canadians do not directly elect their Prime Minister, only their local representative, and political campaign donations are strictly limited. This means that politicians only have to campaign in a small, local areas and campaigns aren’t nearly as expensive as they are in the US. Consequently, the influence of rich special interests, big business, and organized labor on Canadian politics is severely limited On top of that, though Canada has a “winner-takes-all” election system like the United States, there are four major Canadian political parties of note, while there are only two here in America. Though American and Canadian political parties operate very similarly, Canada has more parties in play, so politics tends to be less dualistic, with more room between and beyond the classic liberal/conservative dichotomy.

Adding to that, Canada is dominated by Anglicans and Roman Catholics, while America has a much higher proportion of evangelicals. Due to the differing church models, America has seen many more political/religious movements than Canada, and religion in America tends plays a much larger role in public life, elections, and politics.

Lastly, Canada stands in contrast to America with respect to Quebec. No US state has such a powerful government whose ruling party’s stated goal is independence. Puerto Rico may be on the fence with respect to this issue, but there has been nowhere near the amount of succession talk as heard in Quebec. The fact that Canada would likely let Quebec go if they voted to secede speaks volumes about the differences between these two countries.

Market Size and Economics

Canada’s market is smaller than America’s, thus causing some significant differences in economic policy between the two countries. For example, there is virtual free trade between the US and Canada, with Canadian industries making products for a unified US-Canadian market. For the few industries that are still protected by tariffs, some Canadian companies hold monopolies over an industry because Canada’s market is not able to support more than one major player. By and large, Canada has not been overly aggressive in breaking up these monopolies.

Perhaps because of this smaller size, Canada has been much more likely to legislate for the “public good” than to allow market forces to decide prices and competition levels. Canada is more apt to enact legislative fixes to social problems (healthcare, broadcasting, etc…), and is more likely to stick to a balanced budget. Contrary to American politics, Canadians are much less likely to hold up “the market” as the perfect economic example. This makes Canadians less susceptible to anti-communist rhetoric thrown around in America in response to universal healthcare initiatives (socialized medicine), welfare (handouts), and market regulation (intervention).

On the other side, the breadth of the American market also contributes to Canada’s brain drain, as Canadians emigrate to the US to find opportunities that are just not available back home. Also, because of the inefficiencies inherent in Canada’s smaller market, Canadian workers are on average 18% less productive than their American counterparts.

Social Issues: Drugs, Poverty, Health, and Race

Canada’s looser drug enforcement policy (pdf), without mandatory minimum sentences or a national “war on drugs,” means that Canada has a dramatically lower incarceration rate (pdf) than the United States. While the US incarcerates over 700 criminals per 100,000 people, Canada incarcerates slightly over 100. Without as many drug arrests, and without the kind of “three strikes” laws that mandate long sentences for repeat offenders, Canada’s crime rate is many times lower than America’s. With less crime comes less cost to the government charged with arresting, housing, and feeding inmates, and fewer ex-convicts (with all the social and economic stigma that go with incarceration) in the general population.

Working with that, Canada does not have a history of institutionalized slavery like America does. Though there were slaves held in Canada, especially during the colonial years, by the early 1800s slavery was gradually being abolished and Canada was a destination for many escaped slaves travelling on the Underground Railroad from America’s South. Consequently, race relations in Canada are less divisive and more complex than in the US, dealing more with the ramifications of indigenous populations and immigration than American race relations, which have focused almost exclusively on African-American equality.

Also, due to a myriad of factors such as different taxation rates, different costs-of-living, different social programs, different education policies, and different ways of measuring, Canada has a lower poverty rate than the US. This is important to keep in mind when discussing welfare, universal education, and crime solutions in the two countries, as the cost and scope of these programs and problems can vary dramatically in relation to the percentage of the population living in poverty.

Lastly, on the health front, Canada has fewer smokers than America, less obesity, and less physical inactivity, all resulting in fewer health problems. These three indicators are some of the main preventable causes of later disease. The fact that they are less prevalent in Canadian society means that Canada’s healthcare costs are inevitably lower than America’s. This, in turn, affects the debate when talking about adopting Canadian universal healthcare policies to the US.

Foreign Policy and Energy

Because of Canada’s smaller size, it often has no choice but to act diplomatically and come to consensus when dealing with international problems. Simply put, unilateral military action like the current US-led war in Iraq is unthinkable in Canadian military circles. Consequently, Canada has fostered strong diplomatic ties to many nations and in general believes heavily in international governing bodies like the United Nations and the World Bank, organizations that many Americans inherently distrust.

Helping that multinational outlook, Canada is a net exporter of energy, even though the cost of heating is generally higher (because of Canada’s cooler climate), and the cost of transportation is generally higher (because of Canada’s sparse population). In contrast, America must import energy because our natural resources cannot keep up with demand. This means the US and Canada react differently to geopolitical concerns relating to energy and energy prices, the latest example being Canada’s refusal to enter into the conflict in Iraq. These differences also mean that higher energy prices tend to grow Canada’s economy and stock market, while depressing ours.

Dare To Compare?

There is no reason Canadian solutions can’t work for the United States, but some adaptation will be necessary. Michael Moore, in his latest documentary “Sicko”, is only the latest in a long line of activists (free registration required) calling for Canadian style healthcare for American citizens. Moore has also cited Canada as an example of how to deal with gun control in “Bowling For Columbine.” However, the complexities of such an adaptation quickly add up. Take the comparison of gun control policies for example: One must remember that Canada does not have the same level of independent spirit present in America, Canada has far less drug crime (because drug use is more tolerated by authorities), and far less crime in general due to liberal sentencing laws and sparser population.

The problems are complex and the solutions are never easy. And for the record, no, it’s not Canadia. What are your feelings on the differences between Canada and America? What key points have I left out?

Illustration by jackrascal.

Click to go to our Canadian issue.