Friday, August 12, 2005
More on Canada....
John Fund in today's Wall Street Journal comments on the Canadian Supreme Court ruling concerning private health care:Canada's 'Free' Health Care Has a High Price Tag
Have a nice weekend. |
John Fund in today's Wall Street Journal comments on the Canadian Supreme Court ruling concerning private health care:Canada's 'Free' Health Care Has a High Price Tag
For many Canadians their 37-year-old universal health-care system is the symbol of their national identity. Last November, Canadian Broadcasting held a contest to pick the greatest Canadian ever. The clear winner out of 1.1 million votes cast was Tommy Douglas, a politician known as the "father" of Canada's nationalized medicine.Yes, lets make our system like Cuba and North Korea. Can we please!!!
But last June, a majority of Canada's Supreme Court struck down a Quebec law that banned private health insurance and held that the public system inflicted cruel and unusual punishment on many of its patients. The Fraser Institute has found it takes an average of 17.9 weeks between the time a patient makes an appointment to see a general practitioner and when he can then see a specialist. He will then be treated by a system that ranks 13th out of 22 advanced countries in access to MRI technology; 17th out of 21 in access to CT scanners and seventh out of 22 in access to radiation machines. The safety valve in the system is that nearby U.S. hospitals can provide treatment for emergency cases and patients willing to pay.
But Canada's public care doesn't save money. As the satirist P.J. O'Rourke once noted, "If you think health care is expensive now, wait until you see what it costs when it's free." When adjusted for the age of its population, Canada vies with Iceland and Switzerland as the highest spender on health care among the 28 most developed nations with universal systems. Dr. David Gratzer, a Toronto physician affiliated with the Manhattan Institute, calculates that a Canadian earning $35,000 a year pays a stunning $7,350 in health-care taxes.
Canada's Supreme Court was scathing in its indictment of the system. "Access to a waiting list is not access to health care," the court ruled. "Delays in the public health care system are widespread . . . in some serious cases, patients die as a result of waiting lists." The court struck down a Quebec law banning private medical insurance, which should lead to successful challenges to similar laws in other provinces. While last week the court stayed the impact of its ruling in Quebec for a year, a nationwide debate on why Canada is the only country other than Cuba and North Korea to ban private insurance and private care has finally broken out.
The prohibition is viewed as bizarre in other nations with universal health care. Sweden has long allowed private insurance for elective services. In Australia, private hospitals provide a third of the nation's capacity. In Germany and the Netherlands, anyone above a certain income threshold is allowed to leave the public system.The old "floor versus ceiling" debate again.
In Canada, the ban on private insurance results in truly loopy law. Dr. Sheldon Elman, the personal physician for Liberal Prime Minister Paul Martin, says the system is "disastrously terrible" in key areas. "You can buy an MRI for your dog and you cannot buy it for your daughter," he told the Montreal Gazette.
You'd think the court's ruling would lead to dramatic changes. A new Ipsos-Reid poll finds that 83% of doctors view the court's decision "favorably." But only 52% of Canadians, who have been conditioned for years to think that their health care is free, share that view. That has led to an abundance of caution among politicians. "The opposition Conservative Party has been extremely timid in proposing changes and this year even called for creating a new prescription drug benefit," notes Michel Kelly-Gagnon, president of the Montreal Economic Institute.Fluff your pillow while you continue to wait?
Take Alberta, the country's energy capital and the province that most represents Canadian individualism. With oil at $65 a barrel, it is awash in revenue and could afford to forego the health-care money it gets from the federal government. But for a decade Conservative premier Ralph Klein has claimed he faced sanctions by federal officials if he went too far on reform. The June Supreme Court decision gave him the legal and political cover to be bold. Nonetheless, his new "third way" proposal to reform health care expressly bans Albertans from buying insurance to bypass waiting lists. It would instead allow them to buy insurance to upgrade to a better hospital room.
"Klein probably misses having the feds to blame for his inaction," says Ezra Levant, publisher of the Western Standard, a feisty Calgary-based magazine. "Luckily, free market entrepreneurs will fill the void, and they'll have the courts on their side if politicians try to stop them."
A milestone in private health care could come this October, when the Copeman Healthcare Center plans to open a Vancouver facility that offers an array of elective services, no waiting times, and even house calls for an annual fee of $2,300 a year. The British Columbia nurses union denounces the clinic as "check-book medicine" and is demanding it be blocked from opening.
Those who believe Canada's debate isn't relevant to the U.S. should think again. The Vermont House has approved a bill to establish a government-run health care system. So too has the California State Senate. Nationally, a 1997 law pushed through by the Clinton administration banned Medicare patients from paying for a medical service covered by Medicare unless the physician agreed to forego reimbursement from all Medicare patients for two years. Regulatory modifications have softened the restriction, but it remains on Medicare's books. Could it be revived under a Hillary Clinton administration?
A good way to prevent bad policy in the U.S. is to encourage reform in Canada. The door is already open. Ontario officials haven't acted on their threats to close the dozens of private clinics operating there. Maybe it's time the Mayo Clinic or another major U.S. health care provider tested the limits of Nafta and floated stories that it wants to enter the Canadian market. The nationalistic feelings that would stir up might finally prompt Canadian politicians to accept home-grown private care.
If Canada wants to stop sending people to an early grave it will have to modify a health-care ideology that its own Supreme Court concludes is "disconnected from reality."
Have a nice weekend. |
