Loathe as I am to traffic in anecdotes, I cannot resist recounting a conversation that I had around a friend’s dinner table while in Canada for the holidays last week.
The crisis of government-monopoly health care in Canada is fast coming to a crescendo. My previous employer, the Fraser Institute, saw opportunity in measuring waiting lists for diagnosis and surgery. Back in the old days, Canadians knew that something was wrong with the way the government was running health care, but the government hid the relevent information from its citizens. As a result, the Institute has published the Waiting Your Turn survey for 18 years.
Until I left Canada (January 2004), the conventional wisdom was that the crisis was limited to expensive, hi-tech, diagnosis and surgery. Conventional wisdom insisted that ordinary family care was available, without the fragmentation that typifies the employer-based system, which the the U.S. government has absurdly forced upon its citizens. No longer: It is now recognized by politicians, policy analysts, and dinner-table guests, that a growing number of Canadians have no access to primary care. This has lead to a crisis of uninsurance despite so-called “universal” coverage!
My Toronto dinner-party mates included a couple, the husband being a managing director at the Canadian subsidiary of a U.S. investment bank. For them, there is no “crisis”: as well as executive health-care benefits from his U.S. (actually, multinational) employer, the couple has carefully enrolled their children at Toronto’s top private school. According to the wife, their kids’ classmates include the children of no less than 18 physicians. They know this because one of the prime reasons that they enrolled their kids in the school was to have access to the tiny number of specialists in Canada’s largest city.
If they were to have a serious health problem, they’d call “Kevin’s mom” or “Sandy’s dad”! Was it really necessary, I asked? The investment banker’s uncle was the head of a specialty unit at the Toronto hospital nearest the provincial Parliament building: All the top politicians were patients. Surely, I asked, family ties would suffice to get access to good health care in an emergency?
“No,” he answered (with a shrug), “my uncle is the only doctor in Canada who believes in the system. He can’t even get his own son-in-law a general practitioner.”