Canadians clash over Obamacare
A PAID CONSERVATIVE PUNDIT and a public health care expert and social activist exemplify the opposing sides in the U.S. debate
As the United States inches its way toward public health care, two Canadians have emerged as key crusaders in this bruising battle for the heart and soul of the American psyche.
Conservative think-tank director Sally Pipes and public health care expert and social activist Dr. Danielle Martin have come to represent the distant polarities of America’s new health reform law, the Affordable Care Act, otherwise known as Obamacare.
In many ways, Pipes’ and Martin’s roles in this debate betray an American obsession with Canadian health care that has essentially put Canada on trial. The U.S. remains the only industrialized nation that does not supply universal health care to its citizens. Obamacare is clearly the foot-in-the-door to a Canadian system and the Republicans have been fighting tooth and nail to discredit it.
Their champion is Pipes, an unabashed ultraconservative who believes if you can’t fend for yourself, well tough luck.
She opposes any form of public health care, even for the poor and the elderly.
“I believe in small government, freedom and individual responsibility,” she said in an interview.
A native of Vancouver and former member of the Fraser Institute, she is now the president and CEO of a small San Francisco think-tank called the Pacific Research Institute (PRI).
A newly-minted American citizen, Pipes demonizes Obamacare in speeches, books, in congressional testimony, and in her weekly “Pipes Up” column on Forbes.com.
Aside f rom Obamacare itself, her favourite target is Canada. She promotes herself — and is often referred to in the U.S. media — as “a fugitive from Canadian health care.”
Canada’s single-payer health-care system, Pipes said in an interview, “was a big part of the decision in my leaving the country in 1991.”
In public appearances, she rarely fails to recount the story of how her aging mother died prematurely in 2005 of colon cancer while on a British Columbia waiting list for an MRI.
She blames public health care and proffers her anecdote as proof that Canadians are dying because waiting lists deny them access to timely care.
“Understanding health care is similar to unravelling an onion,” she said. “There are just so many layers and many tearful moments. I think if you can tell stories that relate to people’s own situations I think it helps them understand it.”
Pipes is well paid for her advocacy. In the last five years alone, PRI paid her a total $2.3 million US, according to PRI tax returns.
PRI’s $7-million annual budget is financed by donors that include major healthcare companies and the ultraconservative billionaire Koch brothers who have become as dominant a brand name for conservative political financing as McDonald’s is for fast food franchising.
Pipes’ academic and healthcare credentials are thin. Her only degree is a BA in economics.
What counts, she said, is “what you do and how you do your work; is it peer reviewed and is it reliable?”
Pipes, however, appears to fail on both counts.
When asked who reviews her work, she said “we have academic reviewers at PRI. We have an editorial board.”
Reliability has also been questioned.
Even fellow Forbes.com blogger Rick Ungar accused her of publishing “misleading Obamacare attacks.” Ungar criticized her claim in 2011 that a Deloitte survey showed that an overwhelming majority of front-line doctors opposed Obamacare. With the exception of surgeons, the report indicated just the opposite.
During our interview she also proved fast and loose with the truth. She claimed “50 per cent of health care is already in government hands.” The U.S. Census Bureau put the most recent figure at 32.6 per cent.
She also claimed 5.7 million Americans have lost their health insurance because of Obamacare. What she doesn’t say is that the overwhelming majority of the cancelled policies were replaced by cheaper, better plans that meet Obamacare’s higher standards.
Pipes’ misstatements often mirror those made by Republican law makers and conservative-sponsored advertising campaigns.
One recent TV ad featured a Michigan woman claiming she suffered from leukemia and had lost her health insurance, her doctor and could no longer afford her medicines because of Obamacare. “If I do not receive my medicine I will die,” she says. What she doesn’t mention is that she switched to a more comprehensive plan under Obamacare that saves her $1,200 a year — and she still has her doctor. Other ads have featured actors pretending to be real Americans whose insurance had been cancelled under Obamacare.
Mother Jones and other publications have questioned whether Pipes writes her own material.
PRI’s biggest subcontractor is Keybridge Communi- cations, a Washington, D.C. firm that, in its own words, creates “top-notch journalism producers … writing, researching, and creating effective news hooks.”
The company has said it researches, drafts and edits Pipes’ work, which is unusual for an academic think-tank. According to tax filings, PRI paid Keybridge almost $1.5 million from 2008 to 2012.
Pipes said PRI has a small staff of seven and “most of the work that we do is contracted out.”
She added, however, that she uses Keybridge only for the occasional editing job. “Sometimes I will pay them just to review something I have written, to edit it, but not all the time,” she said. “These are all my ideas. I never falter from my views.”
On the other side of the ideological divide is Dr. Danielle Martin, a family doctor and vice-president of medical affairs and health system solutions at Women’s College Hospital in Toronto. Her father, D’Arcy Martin, is a union organizer and educator.
She too has her tearful anecdote, although she rarely unleashes it to support her arguments. Before Canada enacted its universal healthcare system, her grandfather had a heart attack and the hospital bills bankrupted the family.
“You don’t build a healthcare system based on stories,” she said.
Pipes and Martin last month went head-to-head while testifying before a U.S. Senate subcommittee studying what the U.S. health-care system can learn from other countries.
Five other medical experts were on the panel. Two came from Asia and Europe. But the senators’ focus was squarely on Canada.
While Pipes talked about her mother — recounting the story twice — along with other stories of doctors she knows who had quit the Canadian system in apparent disgust, Martin smoothly deflected a barrage of questions from Republicans eager to breach her calm, Canadian confidence and discredit the Canadian system.
Unlike Pipes, Martin has a string of peer-reviewed papers to her name and is an expert in both primary care and hospital administration.
At the end of the hearings, the two adversaries shook hands. Pipes said of Martin, “I thought she was very professional even if we don’t agree.”
Martin blames Pipes for leading a dishonest attack on the Canadian system.
“If the best they can come up with is somebody who brings forward a couple of anecdotal stories and selfpublishes her opinions as facts then those of us who are actually interested in preserving and enhancing and improving the public system don’t have anything to worry about,” she said.