In his recent speech to the American Medical Association, President Obama counseled Americans to beware “dire warnings about socialized medicine and government takeovers; long lines, and rationed care; decisions made by bureaucrats and not doctors.”
Unfortunately for the president, there are a few Cassandras whose warnings are worth heeding. Chief among them are the millions of Canadians who have received substandard care at the hands of a government-run health system.
Before America emulates the Canadian model with a new trillion-plus-dollar health plan, it’s worth examining whether government-run systems are all they’re cracked up to be. As a Canadian by birth, I can assure you they’re not.
A “culture of queuing” dominates my native land. In 2008, the average Canadian waited 17.3 weeks from the time his general practitioner referred him to a specialist until he actually received treatment, according to the Vancouver-based Fraser Institute.
That’s 86% longer than the wait in 1993, when the Institute first started quantifying the problem. In 2008, more than 750,000 Canadians — 2.8% of the population — were on waiting lists.
My mother’s case is instructive. In June 2005, she wasn’t feeling well and thought she might have colon cancer. She asked for a colonoscopy but was told by her doctor that it was unnecessary. The doctor ordered an X-ray, which revealed nothing.
By December, she was 30 pounds lighter, bleeding — and finally eligible for care. She spent two days in the emergency room and two days in a transit lounge waiting for a room. A colonoscopy revealed advanced cancer. She died two weeks later.
Stories like this of care delayed — and thus denied — are common.
Sometimes they’re comical — like the revelation in 1998 that a major hospital had been renting its MRI machine to veterinarians for use on pets, even as people waited for their turn.
In most cases, though, waiting lists are no laughing matter. Former Canadian Member of Parliament Belinda Stronach steadfastly opposed any privatization of Canadian health care while in office.
Yet in 2007, after being diagnosed with breast cancer, she effectively opted out of her beloved public system in order to have surgery in California. For most Canadians, such medical tourism is not an option.
Both Canada and the United States spend ever-greater amounts on health care, thanks to the increased utilization of technology and continuous medical innovation. But the two nations part ways when managing those expenditures.
In the United States’ decentralized system, payers compete to drive the hardest bargains with health care providers. In Canada’s system, provincial governments dictate what will be spent using global budgets. There’s only so much money per person over the course of a year. Rigid budgets naturally lead to rationing.
Sometimes, rationing is implicit. Take my mother’s first pass with her doctor. She didn’t appear on a waiting list but was denied a colonoscopy all the same. At that time, there were 2,858 people in British Columbia awaiting a colonoscopy. The average wait was nine weeks — five weeks longer than considered clinically safe.
At other times, rationing is explicit. In 2001, government bureaucrats told the Queensway-Carleton Hospital in Ottawa to ration babies. The facility was on track to deliver 2,700 bundles of joy. But officials sought to reduce that number by 600, figuring it would save $600,000.
“We felt we were being kicked out, penalized for providing service,” Dr. Paul Legault told the Globe and Mail. “I trained 12 years in order to do obstetrical care, not sit in my office and refuse patients.”
Many U.S. politicians seem blind to the failings of a “government-pays” system. Those who recognize these horrors assure us that things will be different here. Obama has promised Americans that they’ll be able to keep their current health plan if they like it. And many lawmakers have pledged to “build” on the existing private system.
But many of these health reformers are also committed to creating a public insurance program to compete with private providers. This new government plan would be able to tap the public purse to keep prices artificially low.
As a result, more and more patients would be shifted onto the lower-priced federal alternative — until it’s the only option left. This is why most honest analysts admit that a “public option” paves the way for a single-payer system — Medicare for All.
Our neighbor to the north provides a glaring example of what government health care looks like. Let’s hope our leaders take a look before it’s too late.
Pipes is president and CEO of the Pacific Research Institute. Her latest book is “The Top Ten Myths of American Health Care: A Citizen’s Guide.”