Canada vs USA, Public vs Private Healthcare – Mario Seccareccia

https://vimeo.com/430151302 The Canadian public healthcare system has not been perfect, but it's the privately owned facilities that have failed badly. Mario Seccareccia on theAnalysis.news podcast with Paul Jay. Transcript Paul Jay Hi, I'm Paul Jay, and welcome to theAnalysis.news podcast. Mario Seccareccia is an emeritus professor at the Department of Economics, University of Ottawa, where since 1978 he taught macroeconomics, monetary theory, labor economics, and the history of economic thought. He's also the editor of the International Journal of Political Economy. Paul Jay We're going to talk about the Canadian mostly public health care system. I say mostly because there is a public health insurance plan. The hospitals almost entirely with a very odd and very small exception are publicly owned. So this is more than just public health insurance. This is a public hospital system. Look at that to some extent compared to the American almost entirely, either, for profit or big non-profits like a Johns Hopkins, which actually operate as if they were for profit. Paul Jay And there's also some state publicly owned hospitals. But the big players are the for profits and the not profit, not for profits, which act and operate in a very uncoordinated manner, the way all for profits do. And we're going to have some comparison to that to Canada. Then we're going to look at the economic side of things. So, Mario, thanks for joining me.  Mario Seccareccia Glad to be on. Paul Jay So start with comparing how Canada has responded to the Covid pandemic. As I say, a mostly public system as compared to a mostly private system in the United States. Mario Seccareccia Well, it responded in a way, which I would argue was correct. In what sense? In the sense that what our political authorities did, which is not quite what happened in the U.S., at least, is that they decided that they would let primarily the experts in this case, you know, the medical profession, that the experts, the epidemiologists and so on to, you know, to not dictate, but obviously advise and ultimately follow on what they were suggesting to do. Mario Seccareccia So in that regard, what we had. It is a certain respect for those who knew something about what was going on and to follow on that rather than to lead. You know, as I think in the case of the U.S., what happened where you get all these mixed messages coming from the various authorities and conflicting ones at that. There was a sense of unity here. I would argue that was not quite the case in the US and more like what was, let's say you would find in some of these other countries like New Zealand that did so well, for instance, or Australia. Mario Seccareccia There was a sense of unity there. And, in fact, a sense of purpose. And even all political parties to a large extent, they tended to support the government without really questioning anything. I mean, also the government, which is in a rather protectionist position politically because it's been a minority government. You know, we have a parliamentary system here. And as a minority government, they could you know, if there's any, you know, let's say unity within the opposition that could bring down the government. Mario Seccareccia So in that regard, it was in a difficult position to be able to impose very much. So it had to be done by consensus, largely with these other parties.  You know, whether it be on the right, which would be the Conservative Party or on the left, which would be the new Democratic Party. So in that regard, as I said, there was something good about that. Mario Seccareccia I think most Canadians appreciate that. Paul Jay  In terms of the ability of the public system to respond in a way that the private more private system didn't. Did that really express itself and if so, how? Mario Seccareccia Well, it expressed itself pretty well. And in what sense, in that here you had, we have had already access should say something, which is that we have already gone through something, some, what is it, 15 or 17 years ago with the Saar's epidemic that exploded in Toronto. And therefore, we have had already you know, we had let's call we had been trained to some extent in the hospital system to deal with that. Our hospital system was well trained for that. Mario Seccareccia And it did accommodate in fact, we had lots of capacity because at the same time, as you know, we had many people who would rather than go to a hospital avoided during the epidemic. And therefore, we actually had very little problems in dealing with that in most places, not everywhere, but in most places except in the major metropolitan areas. But even there, nothing compared to what happened, let's say, in Europe., or indeed in the United States. Mario Seccareccia So in that regard, it was. Well, I would say not fully prepared, you know. Obviously, nobody was expecting this. But it was prepared as much as one can be in the circumstances. So, again, that is not where the problem lies. Paul Jay I would argue that there was an article in The New York Times about a month ago, I guess, which compared the outcome in British Columbia to the outcome in Massachusetts. And the  the death rate in Massachusetts was significantly higher.  And it was described that the public system was able to marshal resources and coordinate hospitals because the public system could simply order one hospital say specialize in cancer and another hospital could take on more of the Covid load. Paul Jay And at the time, it looked like the Canadian death rates were about 50 percent of the American. Paul Jay But over time, in fact, the numbers have started getting closer to each other. Paul Jay And last I saw that, it was only about a 20 percent difference. Paul Jay And then there was another interesting article, which is, if you take out New York City, which simply doesn't have a parallel in Canada, because the size and the concentration of people that the American numbers weren't all that drastically different. Canada was still a little bit better, but not not as much better as it all looked earlier on. Mario Seccareccia Yeah, I agree with you that the we've narrowed somewhat, but we're still I think the gap is bigger than that. I mean, I was looking at the numbers for June first day, today and whether it be in terms of the cases, as well as the deaths.   France, in the case,  when we look at the cases, I calculated that it was around five point six per 1000 in the U.S. In Canada was two point four per 1000. So it's like double or even lower in the case of the U.S.. Mario Seccareccia In the case of the death, though, it's not as good sort as big  vis-à-vis of it is deaths per 100,000 here. We're thirty two point four in the U.S. While in Canada with nineteen point five. So clearly, we have not been doing well we're doing better. Whatever you want to call it compared to. Yes. Yes. But certainly we were not you know, we're nowhere. There's something to be proud about here.  When was the hard part of the problem here? Paul Jay And it's kind of ironic that, you know, Trump always ridicules China and other places. You can't trust their numbers. Paul Jay But from what I can understand, you really can't trust American numbers because inherently a lot of deaths that really are related to Covid are not being called Covid just to just to make the numbers look bad.  Mario Seccareccia Some countries actually think Russia was the one that was saying there were such few deaths because all of these people died from some other things, which is true. Obviously, they got pneumonia, but which is an opportunistic kind of disease that appears with Covid. Did you? And if you die from that, therefore, you're not dying from Covid or something obviously. No, this is the absurdity of some of these measures. But I mean, I'm assuming that it's similar the way we've defined them between the two countries, which may not be the case. Mario Seccareccia And also, in terms of the coverage, not the testing done. To what extent they are similar. The other problem is we really don't know. Is that the tip of the iceberg or to what extent? These are problems of measurement, God forbid. We don't know here. You know, there's no way of knowing. So we're kind of comparing things that in some cases might be comparing apples and oranges again. You know, we're not. Paul Jay Well, one article that was written about this that was very critical of the Canadian response, said that it's not it's like he didn't say this. Paul Jay I am. It's like shooting fish in a barrel to compare a candidate in the United States. You're comparing a country with the public health care system to a country that's led by a man that thinks you can drink bleach. Paul Jay And it's you know, and if you compare the Canadian's response, an outcome to some of the countries in Europe, even France, Germany and certainly Australia and New Zealand, actually Canada doesn't look all that good. Paul Jay And that the response from the Canadians has not been as coordinated and as measured as it should have been. So what forgetting the comparison to the U.S.?  Mario Seccareccia Yes. Paul Jay What do you make of how Canada's response? Mario Seccareccia Well, I think that's where the problem lies, in the way in which we have what I could call almost a Balkanized system, which sometimes actually works. OK, because, you know, the idea being that if the more it's controlled by a province vis-à-vis the whole federal government, because we have such huge regional differences in Canada.  Sometimes it could actually work in our favor. But in this case, it hasn't worked so well in terms of what things have, you know, how these provincial parties have been handling it.  To give an example,