San Francisco Chronicle, February 25, 2010
The Greeneville Sun, February 22, 2010

Danny Williams, the premier of the Canadian province of Newfoundland, traveled to the United States earlier this month to undergo heart valve surgery at Mount Sinai Medical Center in Miami. With his trip, Williams joined a long list of Canadians who have decided that they prefer American medicine to their own country's government-run health system when their lives are on the line.

But just as American hospitals are becoming popular vacation destinations for about 40,000 Canadians a year, California's Senate is pressing ahead with its effort to make the state's health care system more like the one in the Great White North. The Senate recently approved a bill sponsored by Mark Leno, D-San Francisco, that would install a government-run, single-payer health system in the Golden State. The Assembly will soon consider the measure.

Lawmakers should take Williams' case to heart. Canada's experience shows that government health care leads to waiting lists, rationing and lower quality of care.

For instance, Canada suffers from a scarcity of physicians. Over the last decade, about 11 percent of doctors trained in Canadian medical schools have come to the United States to practice. Physicians' salaries are set at artificially low levels by provincial authorities: The average Canadian doctor makes just 42 percent of what an American physician does.

Canadian patients also face wait times for medical procedures. Nearly 700,000 Canadians are on a waiting list for surgery or other treatments.

A Canadian patient has to wait roughly four months for the average surgical or other therapeutic treatment. Wait times were similar a decade ago - even though the government has substantially increased health care spending since then.

Canadians also lack access to advanced medical technology. Compared to other developed countries, Canada ranks 14th out of 25 nations surveyed by the Organization for Economic Co-operation and Development in access to MRIs; 19th of 26 for CT scanners; and eighth out of 21 for mammograms.

Canadian women are nearly a quarter less likely to have had a mammogram than are American women.

Despite these visible shortcomings, many American lawmakers want to emulate Canada's system. President Obama's new blueprint for reform would greatly expand Medicaid by adding 15 million Americans to the rolls. Medicaid patients already have trouble finding doctors who will treat them because of low government reimbursements. Nearly a third of physicians nationwide won't accept new Medicaid patients, according to the Medicare Payment Advisory Commission. Expanding the program will only make matters worse.

Congress would also like to beef up government-run "comparative effectiveness research," whereby officials evaluate competing drugs to determine which ones are purportedly most effective for the average patient.

Canada employs these reviews ostensibly to make sure that public money is spent wisely. But such reviews just diminish patients' access to the latest medicines. Publicly insured Canadians have access to half as many drugs as their countrymen with private insurance - and must wait a year longer to gain access to the few new drugs that become available.

America's health care system merits reform - but not of the government-heavy sort favored by the president and congressional Democrats. Expanding government control over the health care system will diminish outcomes for American patients - as well as the occasional Canadian visitor.

Sally C. Pipes, a former Canadian, is president and CEO of the Pacific Research Institute.