"…intractable Canadian health-care problems"

The Ottawa Citizen recognizes what many Canadians deny:

Consider the never-changing list of intractable Canadian health-care problems: We have long wait times for a wide variety of medical services. Our emergency room rooms are clogged. Our hospital beds are often filled with people who should be getting long-term care instead.

Most Canadians are not willing to admit this; not so much because their health-care system delivers on its promises, but because they see their health-care model (regardless of execution) as one of the fundamental proofs that they are better than Americans.

Most Canadians think that ~50 million Americans without health insurance is a systemic failure, even if most of these are people who do not want it, haven’t signed up for a government program for which they are eligible or are illegal aliens getting free treatment in emergency rooms. Most Canadians (and Americans) are unaware that 50% of US health-care is already paid for by government, so they think there is actually a free market here. This distorts Canada’s debate and makes change nearly impossible. Such thinking damages them as much as it does us.

The idea of an alternative to the current monopoly on most major forms of health care is critical to the idea of a patient-first system, [Canadian Medical Association president Dr. Robert] Ouellet argues. Without it, there is no real pressure for government health care to deliver timely results and no alternative for patients when it doesn’t. Ouellet himself is a radiologist who runs a private clinic in Quebec providing service to those whose health benefits will cover it.

Ouellet’s point makes sense, but as soon as the words “private health care” are mentioned in this country, we launch into comparisons with the American system, surely the most costly and least efficient in the world. Our universal health-care system is held up as a Canadian value, as if we were the only ones who had it.

The mythos of Canadian single-payer health-care system superiority is more than a Canadian value: It is demonstrably not an American value. Canadians reflexively reject the possibility that their health-care folkways are not morally superior to those of the United States.

In any case, Dr. Ouellett is not advocating adopting an American approach, and I agree that would be a bad idea (see below), but he recognizes that without patient freedom the system fails patients.

As Ouellet envisions it, a somewhat expanded private sector would not be a parallel system drawing away doctors from public health care, but rather an opportunity for doctors to do supplementary work without restrictions on their operating time or long waits for diagnostic tests. The bulk of any physician’s billing would still be in the public system.

Canadians can’t see, any more than can Democrats, that government interference is the problem on both sides of the 49th parallel. In the United States, massive government meddling in health-care is the single most important factor in driving up costs. In Canada, government control of health-care is the single factor causing the “intractable” problems. What is needed in both countries is a plan to gradually and continually increase privatization. This is the only effective treatment for different symptoms of the same basic disease: Statism.