By Evan Falchuk

How different are Canada and the United States?

Depending on who you ask, they’re neighbours, or neighbors.  So they’re pretty similar.  But if you ask your Canadian neighbour to bring over a case of beer so you can watch a hockey game together, he’ll be very happy to bring over a two-four.  So they’re pretty different.

Still, this is all superficial.  What Americans don’t realize is how different our countries really are (I know Canadians don’t like it when Americans co-opt the word “American” like that.  I’m sorry, I just can’t help it).

You can see this difference most clearly when it comes to health care.  Today’s news supplies a good example.

Yesterday, it was announced that the premier of Newfoundland and Labrador needed heart surgery.  After consulting with his doctors, he decided to have it done at a hospital somewhere in the U.S.

To an American eye, this is a perfectly mundane story.  A person is sick, can afford it, and so decides to get care someplace he thinks is the best. If it weren’t for the health care reform debate, we wouldn’t hear much about this story in the States.  Pundits wouldn’t be using it to make bad implications about the Canadian system, or suggesting this is what U.S. reform promises to create.

But it’s very different from a Canadian perspective.  The story is something of a scandal.  It’s not because a government official has suddenly left office for health reasons.  It’s got to do with the way Canadians feel about their health care system.

Canadians feel very proud of their system of universal health care.  Like every health care system, it is beset by problems, but in a diverse and often fractious country, it is a unifying presence and one of the things most certain to stir patriotic passions.  Unlike the United States, where health care is just another part of the economy, Canadians regard health care as more like a civil right.  I think many consider it part of their civic duty to support it, and they certainly expect that from their politicians.  And so when a leading politician decides not to use the Canadian system for his own health care, it’s treated like something of a betrayal.

To get a sense of this all you have to do is watch the media interviews with the leaders of the provincial government this morning (videos are here).  At least half of a six-minute interview with the acting premier was spent parrying questions like this one:

What can you say about what kind of message it might send to people in this province and elsewhere that [the premier] felt he needed to go not just out of the province but out of the country for this treatment?

And later, the leader of the opposition party spoke about the premier’s decision to go to the U.S. for his care:

So although I know health care is a very private piece [sic] for all of us I think when we’re in a position of public office like he is . . . I think at the very minimum we deserve an explanation for the people of this province and would expect that from him.

From an American perspective, this looks like the usual old political scandal: catching a politician in some hypocrisy in which he makes everyone else live by rules that don’t apply to him.  But I don’t think this is really how this appears in Canada.  The resentment in these comments is about something else:  the idea that the premier is seen as having abandoned a system he is duty-bound to uphold.

So remember, when it comes to health care the differences between the U.S. and Canada run far deeper than just the way each country pays for it.