Canada's Burning! - strain on medical resources caused by 1999-2000 North American influenza epidemic

Washington Monthly, July, 2000 by Theodore Marmor, Kip Sullivan

Why don't our journalists practice such careful reporting more consistently? What explains their penchant for using a single story to suggest system-wide problems without providing comprehensive supporting evidence? Part of the answer is that they are generalists, not specialists in Canadian (or international) medical care. And there's a well-documented tendency for journalists to look for one hot scandal and then expand it into what they think is a universal point. Reporters tend to ignore scientific or polling data in favor of anecdotes and quotations, and, with rare exceptions (see Ron Winslow's May 9, 1990 article in The Wall Street Journal), U.S. reporters do not provide Americans with the comparative data that would help them fairly evaluate the situation. Any reporter writing about Canada needs to understand the context and history of the debate if he wants to be able to offer a level-headed and informative analysis. But American reporters, for the most part, are trained to jump from story to story and speciality to speciality. Just in May, 2000, the New York Times' reporter who wrote about Canada's system during the flu epidemic has also written about gun control, immigrants from Kosovo, the history of Montreal, and the impact of a beer commercial on Canadian national identity.

The problem is compounded because the American media are not terribly interested in foreign experience with public policy and, when they turn to such a subject, it is often because American actors are using such experience to praise or blame some domestic U.S. initiative, program, or point of view. Domestic interest groups provide the spur to such stories, and the richest of such groups overwhelmingly want to attack the Canadian model. To the extent American journalists interpret balance and objectivity as quoting the views of contending parties, the imbalance in what they hear distorts the story they tell.

Precisely because Canada has achieved comparatively good value for money through a government program, it represents an ideological threat to a number of interest groups in the United States. Private health insurance firms play a relatively minor role in Canada, insuring only those services and goods not covered by their medicare. Second, Canadian medicare relies largely on price controls to keep physician fees and drug prices far below those that prevail in the United States. Canada thus poses a threat to the American health insurance industry, to the pharmaceutical industry, and to a substantial portion of the American medical profession. At one time or another, all three groups have conducted lobbying campaigns to discredit Canada's medicare.

In response to proposals by state and federal legislators to limit U.S. drug prices to those that prevail in Canada, the U.S. drug industry recently uncorked the latest anti-Canada disinformation campaign. On March 29, 2000, a drug-industry front group, described without a hint of irony as "Citizens for Better Medicare," launched a multimedia campaign "urging American seniors to reject the Canadian model of health insurance and coverage of prescription drugs." Here is how they pose the issue: "In a system of government price controls, you can't get the price without the government controls," according to Timothy Ryan, the executive director of this campaign. The price Canadians pay, according to Ryan, is enormous and includes controls in a "big government-run system that rations health care, delays access to treatments including new technology and medicines, and harms too many patients." The ad omitted data, such as the statistic reported in the sidebar indicating that "rationing" is far worse in the U.S., and concluded, "if American politicians are going to advocate Canadian-style solutions, then they must be prepared to accept Canadian-style consequences." The ad campaign apparently reflects the judgment of 40 national associations, including such traditional universal health-insurance supporters as the U.S. Chamber of Commerce, the National Association of Manufacturers, and the Pharmaceutical trade association. Most journalists aren't going to believe every word that these industry groups say, but there's no organized support on the other side. And when you've got millions of dollars in advertisements telling you something, and no one is rebutting the information, biases start to sneak in.