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Commentary

Health-care reform: Be patient
Alex Gerber, Washington Times, 3-26-06

Gerber attacks President Bush as an ideologue who can't connect with reality, and calls the U.S. healthcare system a "national disgrace." He then lavishes praise upon Canada's healthcare system and paints it as a high-tech, low-cost utopia that America should emulate as soon as possible.

Because of its advanced technology, Canada spends one-tenth as much as U.S. insurance providers spend for overhead. Indeed, more people are needed to administer Blue Cross Blue Shield in Massachusetts than to administer the entire health-care system of Canada.

Of further significance, Canada's health-care system functions at almost one-half the cost of ours yet boasts lower infant and maternal mortality and longer life expectancy than the U.S.

There is not the slightest chance the Bush administration will consider changing to the Canadian health-care system. Our president is more oriented toward the corporate than the public good. This was well shown when he rammed a prescription drug benefit bill through Congress that disallowed any drug-price negotiation (Canada has negotiated these prices for 16 years).

The answer to our health care dilemmas is single-payer, government-sponsored universal health insurance (UHI)—(Medicare, with an overhead of less than 5 percent, for all age groups. Evolved and improved over the last 25 years, Canada has such a UHI system that provides one standard of care for rich and poor alike, with no additional costs (copayments or deductibles) so economic considerations are not paramount at the time of accident or disease.

Gerber is correct in at least one respect: Canada does spend much less on healthcare for its citizens. However, this is because it rations spending and pushes the cost of rationing (i.e. reduced access to healthcare technology and services, and therefore poorer health outcomes) into the laps of patients and doctors. After all, if a Canadian patient with a heart condition dies before he gets to see a heart specialist or is admitted to a hospital, the government saves a bundle. Healthcare, as we know, is expensive; dying is much cheaper by comparison.

Even with all its cost controls, however, Canada's single-payer monopoly is teetering slowly but inevitably towards failure as patients demand access to private insurance and private clinics, and spending rises despite the best efforts of penny-pinching bureaucrats.

In February 2006, for instance, the New York Times reported that "[Canada's] publicly financed health insurance system... is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine."

Canada's much-ballyhooed healthcare equality turns out to be an equality of poor service—at least for homo sapiens. One doctor quipped to the Times that "this is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years." Last June, in fact, the Canadian Supreme Court overturned Quebec's ban on private health insurance, saying that "the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services." If the Canadian Supreme Court thinks that the system isn't delivering "reasonable services," perhaps American policymakers should approach it with some healthy skepticism.

Canada's promise of universal healthcare is very different from its reality. American healthcare is not perfect, of course, but we should be clear about the alternatives before we jump headlong into a single-payer system. That approach, at least, is reasonable.



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