Socialized medicine now - without the wait.

• Author: Watzman, Nancy

By now, you've seen a million stories on the Canadian health care system, and perhaps even read a few. If so, you've discovered that they all apply the same formula. First, like a slap in the face, comes the horror story: In Orange County, California, a woman goes into business for herself, giving up her health insurance--and discovers she has breast cancer. She takes to selling flowers from her garden in a desperate effort to keep up with her bills. Next come the terrifying statistics: Americans spend more than $750 billion--or nearly 14 percent of the GNP--on health care each year. If costs continue to rise at current rates, they'll eat up 37 percent to rise at current rates, they'll eat up 37 percent of the GNP by 2030. Yet 28 percent of U.S. citizens lack basic health care; 35 million are uninsured--and nearly two thirds of them have jobs.

Now the emergency is clear, and the stage is set for a hero. But as he comes into focus, our savior looks a lot less like a chiseled Mountie on a galloping steed than a . . . "Worthwhile Canadian Initiative," to borrow the inspirational title for a Most Boring Headline contest in The New Republic a few years back. The stories, you see, are carefully "balanced." On the plus side, they point out that "our neighbors to the north" spend only 9 percent of their GNP on a tax-financed national health program, yet everybody is covered, from the wealthiest businesswoman to the poorest, unemployed IV-drug user. Then comes the downside: Canadians must wait longer than Americans do for high-tech treatments such as coronary bypasses, MRIs, CAT scans, and even cancer treatments. It appears to be a trade-off, conclude The Washington Post, The New York Times, The Miami Herald, and Walter Cronkite. Who can say, they shrug, which system is better? Will America ever reform its health care system, and will Canada be the model? One thing is certain: Only time will tell.

Hey! How about a little American initiative? If our system's broke--as everyone from Physicians for a National Health Program to the Heritage Foundation agrees--let's fix it. That means choosing the best model we've got--the Canadian system--and eliminating the bugs. After all, the Canadians don't have to give us a blueprint, just a beginning.

Despite the utopian claims of universal health care advocates, the problems with the Canadian system are real. Making it right for us will take hard work and, above all, brutal honesty about its flaws. But the end result will be advanced, humane medical care for all Americans. That it will also be billions of dollars cheaper than the jury-rigged, inequitable system we've got now--well, that's just added incentive to do the right thing.

Wealth care

On New York City's Park Avenue, doctors understand the subtleties of putting together a practice. The artwork is understated but expensive, the New Yorkers uncreased and up-to-date. The nurse is as gentle as a Swedish masseuse, the gown as ample as your backside. And the doctor, one of the best in his field, gives you his undivided attention for an hour.

At $200 a visit, this is American medicine at its best. For the worst, walk 30 blocks uptown, to the "Medicaid mills" of Harlem. These "doctors' offices," which actually boast no doctors except on the requisite citi licenses, serve thousands of New York's poorest people. A recent Washington Post story described the care provided at one such institution: A clerk collects a patient's Medicaid card, scribbles out an Rx, and sends him on his way. Given this sham service, why do dozens of people pass through these revolving doors every day? Because many doctors in the city refuse to accept patients on Medicaid.

Now head northwest to the village of Tofino in the Pacific Rim region of Canada's Vancouver Island--one of the few places on earth that harbors more eagles than people. It also harbors the only hospital in 100 miles: a low-slug green building with one doctor, one nurse, one ambulance, one helipad, and nine clean yellow rooms. Inside tonight are an elder of the Ucluelets, an impoverished fishing tribe located several miles away; two injured loggers; and one affluent, 30-year-old ecotourist who escaped from Vancouver to hike the coast and promptly broke his leg. His starchy wife sits, reading Barry Lopez's Arctic Dreams, by the bed.

Universal access like this is the chief rationale for the Canadian system: Instead of some Americans receiving miserable treatment or none at all while others enjoy the best in the world, all would be taken care of. The rub is that universal access also means equal access--that all Americans will meet somewhere in the medical middle, sharing the same waiting room, the same doctor, the same equipment, the same quality of care. That leveling effect is wonderful if you're among the millions of Americans without insurance. It may not be so wonderful if you are accustomed to the Park Avenue touch.

But if you are, you're in a class virtually by yourself. Only 10 percent of Americans approve of their health care system. Meanwhile, according to a recent Harvard study, 56 percent of Canadians approve of theirs. That shouldn't be surprising, since all Canadians enjoy not just access to health care but choice about whom they're going to see to get it.

Opponents of "socialized medicine" always trot out the British system as the prime example of how state control can lead to consumer misery. And they're right--but only because the Brits made the mistake of depriving patients of any say over who peers in their ears, prods their stomachs, or cuts them open. Canadians can make an appointment with any doctor they choose. And what those doctors do for them is clearly working. Canadians are much healthier than Americans. They're less likely to die as babies or from surgical complications, and they live longer.

Mary Lou and Robert Dunn of Brampton, Ontario, have alternated medical crises through the years. Twenty years ago, she was in a car accident that left "the windshield with an imprint of my face." She had nine...