Canada's health-care system is a remarkable political accomplishment that bucks a growing global trend toward "kleptocracy and oligarchy," according to Bernie Sanders.
The popular U.S. senator, and runner-up in the 2016 Democratic nomination for the U.S. presidency, made these remarks and others before a rapt audience at the University of Toronto on Sunday as he tore into "dysfunctional" health-care and political systems in the United States.
"I know that Canadians are well known throughout the world as gentle and kind people. Be a little bit louder: Stand up and fight for what you have achieved," he said.
Mr. Sanders's speech was officially titled What the U.S. Can Learn from Canadian Health Care, but it frequently veered into talk of corporate greed, co-opted politicians and working-class families living below the poverty line – the same themes he hammered home two years ago to challenge Hillary Clinton for the Democratic nomination.
At U of T's Convocation Hall, Mr. Sanders was given several standing ovations by the crowd after being introduced by Ontario Premier Kathleen Wynne, who had spent Saturday touring Toronto hospitals with him. Newly elected federal NDP Leader Jagmeet Singh was in the audience, hugging well-wishers who lined up to see him.
One of Mr. Singh's predecessors, Ed Broadbent, was also there. The speech by the 76-year-old Mr. Sanders was sponsored by the Broadbent Institute, so named for the former NDP leader who is now an octogenarian retired from politics. "It's a pleasure for me to see such energy coming from a much younger man," Mr. Broadbent said during closing remarks.
One key point of policy differentiation between Canada and the United States is universal publicly funded health care. South of the border, most Americans rely on their medical bills being paid for by private-sector insurance plans.
The gaps in coverage still leave many Americans facing the prospect of being bankrupted by health care, said Mr. Sanders, who argued that the U.S. system is less about making people healthy than being "designed to make billions in profit for the drug companies and the insurance companies."
He argued that this reality reflects how unfettered corporate financing of political campaigns is corrupting U.S. democracy.
"In my country and many parts of the world, we are moving away from democracy into kleptocracy and oligarchy. That is, in country after country, we are seeing a small handful of people controlling not only the economies but also the politics of that country," he said during his speech. He added that "if you want to expand and protect health care or education, there are people out there in every country in the world who think it is more important to give tax breaks to the richest people … what we need to do is take those oligarchs on."
What went mostly unsaid during Mr. Sanders's speech is that while Canada's health-care system can look great compared with that of the United States, it can still fare poorly next to comparable countries.
For example, in July, Canada scored ninth out of 11 affluent countries, according to a health-care study commissioned by the Commonwealth Fund, a New York-based private research foundation. That study found that compared with Britain, Australia and several European countries, Canada spent much more money on health care on a per capita basis, despite lagging them in terms of drug and dental coverage, while also having higher infant mortality rates.
However, the United States health-care system ranked last in that same study.
In 2010, the Democrats passed so-called Obamacare legislation that aimed to fill in some of the gaps in Americans' health-care coverage. Republicans have since been trying to repeal that law.
During his speech, Mr. Sanders argued that under the current system, tens of millions of Americans still often have to choose between seeing a doctor and going broke.
"Right now in the United States of America, as many of you know, we have 28 million Americans who have no health insurance; none whatsoever. We have, what you don't now, is even more than that, [there are] people who have high deductibles and high co-payments who are underinsured, which means that when they get ill … they do not and cannot go to the doctor because they do not have the money," he said.
The result, he said, is that someone who might struggle to make a payment of $50 or less may end up putting off visits to the doctor until it is far too late to get treatment.
"There are times when people walk into [doctors'] offices so ill that in fact their situation is terminal," Mr. Sanders said. He added that "we lose thousands and thousands unnecessarily because they did not go to the doctor when they should have."