In the first public (non-academic) health care talk I ever gave to a Rotary club (in I think 1993) I was laying into the US health care system when some guy stood up and said “when he was sick the Prime Minister of Ontario came to the US for treatment.” Apparently that meant that the entire Canadian health care system was rubbish and the American one was a-ok. Given that the small business people in that room have spent the last two decades paying through the nose for their political representatives’ determination to keep the government out of health care (or something), you’d think that that meme would have less of an impact. And my Canadian friends (with help from Yankee Steve Katz) blew up that “Canadians coming south in droves” myth in their Phantoms in the Snow paper in Health Affairs a few years back.

But no matter, according to Cato et al, the Canadians are dying to become just like us. And really what’s not to love about dragging in the “market forces” which have served our system to become so cheap, consumer friendly and deliver such great outcomes for the money! (Especially if you’re a poor underpaid Canadian doctor).

So I began thinking that those of us on the other side of the spectrum need our own meme. And I think I’ve found it.

Before I tell you what it is, a little bit of background. In 1992 Ian Morrison at IFTF wrote a great piece comparing three Scandinavian health care systems. The three Scandinavian “countries” were Sweden, Denmark and Minnesota—which on all kind of ethnic and social measures, as well as in health care practice, looks far more like Scandinavia than it does the rest of the US. So in my view we can call Minnesota, in health care terms, a foreign country.

Here’s where it gets good. Tennessee has a Democratic Governor, Phil Bredesen, who is a multi-millionaire former HMO executive and the one who managed to basically throw a good chunk of his state’s population off Medicaid. So he’s representative of the prevailing wisdom about American health care. So when Phil got sick, what did he do?

He high-tailed it for Minnesota! American health care wasn’t good enough for him!

I think that’s it. American health care—not good enough for the best and brightest amongst us!

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