Canada's Single-Payer Health Care is Nothing to Emulate

Obama, before running for president, when he could be more candid, favored a Canadian-style single-payer, government-run health care system. Now, he's pulled back--at least until he's elected.

He might want to check on how the Canadian system is working. A new article reports that the chair of the committee that created Canada's single-payer system now says that the system has such serious deficiencies that no rationing of care or mass infusion of tax dollars can solve the problem. He now advocates replacing the system with a private one in which people have more choice. Another article presents another of those nightmare anecdotes in which a patient reports that the Canadian system is so overwhelmed that she couldn't get off the months-long waiting list even though she was losing her sight. And the average wait time to see a specialist is 18 weeks.

And that's in a country that is much easier to provide health care for than the U.S., which has many millions of new immigrants with extraordinary health care needs but with little money to pay into the system.

The Deadly Downsides of Insuring Everyone

The soundbite "Health Insurance for All" generates widespread assent. But like most bumper-sticker rhetoric, closer analysis is required. Let me ask you a question:

It's well-acknowledged that the U.S. health care system is creaking under its weight. For example, over 120,000 people die annually as the result of healthcare-practitioner errors. Now, what do you think will happen when we ask our health care providers to add 47 million uninsured to their patient rolls, a group that has above-average health care needs but pays little taxes and will likely pay little into the new government-mandated system that will almost assuredly be enacted under a Democrat presidency?

Not only will more deaths result, but there will be long waits for health care, and refusal to provide care in such gray-area situations as a 75-year old male needing and wanting bypass surgery. Lest you think I'm making that assertion based only on the well-publicized nightmare experiences of some people in Canada who, for example, desperately needed surgery but couldn't get it, let me refer you to the U.S.'s current experiment in covering everyone: Massachusetts. And lest you think my source of information about the Massachusetts insurance-for-all system is some conservative rag, my source is the New York Times.

I do believe that basic health care is a right, but we cannot provide it for the whole world, including the 13 million and skyrocketing number of illegal immigrants. (And once we do, the number of illegal immigrants will accelerate further.) However we decide to reform health care, it is only right that there be tiers: basic health care for all, but, for moderate cost, other people should be covered for a wider range of procedures, allowed to choose their health care providers, and have faster access to them.

To increase the number of qualified health care providers, we need to realize that doctor, nurse, and allied-health practitioner training programs (currently designed primarily by academics rather than by top clinicians) can be significantly shortened with minimal impact on patient care. In fact, if those training programs were developed and taught by top clinicians instead of by academics, I'd predict that care quality would actually improve.