Distinguished Professor Gordon Guyatt on the Canadian Healthcare System
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2018/06/03
Professor Gordon Guyatt, MD, MSc, FRCP, OC is a Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact and Medicine at McMaster University. He is a Fellow of the Canadian Academy of Health Sciences.
Here we talk about the big wins from public healthcare compared to private healthcare on most metrics.
Guyatt and I continued the conversations on the societal variables of the United States. Those variables or factors to make the US an outlier compared to other developed nations/rich nations with good infrastructure.
“I think most people would say that the United States in terms of that value that we were talking about earlier. That is, the value one puts on autonomy versus the value one puts on equity or social solidarity. The US public has extremely different values,” Guyatt opined.
The ability to do one’s own thing. The freedom to choose as one wishes. The chance to be an autonomous and self-governing individual. This is a higher value to Americans than Canadians. This plays out in the healthcare system too.
Guyatt stated, “So, that the fact that it could even be an issue that you could legally insist that people purchase insurance for their healthcare in one way or another – by governments making it available to them. It would inconceivable in Western Europe that that would be a question.
That is, there are influences of the cultural trends on the selection preferences of the population with Western Europe and Canada more towards public healthcare tendencies and the United States towards the private healthcare tendencies.
There is an influence of attitudes – or values and preferences in the evidence-based medicine literature vernacular – on the desired social programs “across the spectrum.
“Social solidarity, equity, support for the disadvantaged, so on and so forth, is much more highly valued in Western Europe and Canada than it is in the United States,” Guyatt said.
With background, I stated, “I see this attached to your work with Evidenced-Based Medicine with the part that was added on later in the research with ‘values and preferences.’ Culture influences values and preferences even to the extent of administrative costs being swallowed.”
Guyatt responded, “Yes, you are absolutely right. Way back in 2002, when Roy Romanow did his work on a recommendation to the government about a healthcare recommendation, he surveyed Canadians in a variety of formats.”
Base on the survey collective data set analysis, Canadians placed equity as a high value and not autonomy; where the United States, they value autonomy more than equity. In terms of the implications of the financing and the things people pay for healthcare, Guyatt argues there is misinformation.
He considers Americans horrified with the possibility of not being able to pay for quicker and better healthcare. For social solidarity and equity in contrast to autonomy, Scandinavian nations and the United States of America differ starkly.
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The British Medical Journal or BMJ had a list of 117 nominees in 2010 for the Lifetime Achievement Award. Guyatt was short-listed and came in second-place in the end. He earned the title of an Officer of the Order of Canada based on contributions from evidence-based medicine and its teaching.
He was elected a Fellow of the Royal Society of Canada in 2012 and a Member of the Canadian Medical Hall of Fame in 2015. He lectured on public vs. private healthcare funding in March of 2017, which seemed like a valuable conversation to publish in order to have this in the internet’s digital repository with one of Canada’s foremost academics.
For those with an interest in standardized metrics or academic rankings, he is the 14th most cited academic in the world in terms of H-Index at 222 and has a total citation count of more than 200,000. That is, he has the highest H-Index, likely, of any Canadian academic living or dead.
He talks here with Scott Douglas Jacobsen who founded In-Sight Publishing and In-Sight: Independent Interview-Based Journal. We conducted an extensive interview before: here, here, here, here, here, and here. We have other interviews in Canadian Atheist (here and here), Canadian Students for Sensible Drug Policy, Humanist Voices, and The Good Men Project (here, here, here, here, here, here, and here).
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