New York -- Every couple of weeks or so I get a call from a friend or colleague in Canada saying something like: "How can they lie the way they do about our health-care system? Almost every Canadian thinks we have a much, much better system than you do."
"I know, I know," I answer. "But everyone from Bill Clinton on down is afraid that if we talk 'single-payer,' the insurance companies and the doctors will start screaming 'socialized medicine' again."
The screaming from the insurance companies begins because they could be eliminated if the United States did what everyone else in the world does: use government as the single-payer to guarantee universal health care. To avoid that, President Clinton has proposed a middleman system with insurance companies providing universal care on a competitive basis.
I am certain that he rejected single-payer -- knowing it would cost less and probably work better -- because he believed Americans would never accept anything like the Canadian system. He is a professional politician who believes in double-talk and half-loaves -- even if his wife and most of the people around him say single-payer is the only way to guarantee universal care without raising the overall cost of health care.
Now, amazingly, the American College of Surgeons has become the first big player (60,000 member surgeons with an average annual income of $244,000) in the health-care game to say single-payer is better.
As their friends at the Wall Street Journal put it Friday, perhaps a bit grudgingly: "A single-payer system is attractive to the surgeons today because it would preserve patients' rights to choose their physicians, reduce bureaucracy more than any other health-reform proposal, and best foster the autonomy of physicians to make their own medical decisions."
Wow! The truth, the whole truth and nothing but the truth -- something that has been in short supply from all sides in the "health crisis" confrontation.
It was only a week ago that new surveys indicated that Americans pay 60 percent more for the same medication than do the British with their single-payer system. Valium, for instance, costs 10 times more in the United States (where it was developed) than in the United Kingdom.
Pharmaceutical-company spokesmen immediately said the studies were irrelevant because you can't compare prices in "the best health-care system in the world" to "one of the worst."
But you can try. That "worst" system in Great Britain, according to the latest available figures, costs $711 per capita, accounting for a little more than 6 percent of gross national product, and produces average life expectancy of 75 years and an infant-mortality rate of 9 deaths per 10,000 births.
The "best" system, ours, costs $1,926 per capita, accounting for more than 11 percent of GNP, and produces the same life expectancy, 75 years, and a higher infant mortality rate, 11 per 10,000 births.
The Canadian system, by the way, costs $1,370 per capita, accounting for 8.5 percent of GNP, and produces a life expectancy of 77 years and an infant mortality rate of only 7 per 10,000 births.
So that makes us the best? It does at the very top of the line. If you can afford it, the U.S. private medical system has the highest technology and the best-trained physicians in the world -- for example, the 60,000 members of the American College of Surgeons.
Having said that, here is a Canadian view friends have been urging on me, written by Diane Francis in McLean's magazine:
"Canada is a caring country with a superior society and, in many ways, more opportunities for its people. By contrast the United States, the wealthiest country on earth collectively, condemns millions of its citizens to ignorance and poverty because of regressive social structures. . . .
"It is only a matter of time before Americans realize what Canadians realized long ago. If expenses are spread across the entire society, as is the case here and in virtually every other industrialized country, unit costs would drop dramatically and society can provide efficient and relatively cheap care for all."
Well, some smart Americans have realized that now. Real brain surgeons. Maybe we'll all wise up soon.
Richard Reeves is a syndicated columnist.