(Dan Trabue, frequent commenter on "Stones Cry Out", the group blog I run, in a comment here to my previous post on health care, referenced a think tank paper that predicts cost reductions without a loss of effectiveness with a single-payer system, and took issue with my terming this "socialized medicine".  I decided to put my response up as a post.)

From the Wikipedia entry on health care in Canada: "Health care in Canada is funded and delivered through a publicly funded health care system, with most services provided by private entities."  So in Canada, it’s not government-run hospitals but it is a government funded system.  While the writer of this Wikipedia entry insists it’s not truly socialized medicine, the article at the link to the words "socialized medicine" does concede, "The term can refer to any system of medical care that is publicly financed, government administered, or both", I suppose depending on who you ask.

But who’s in charge of the hospitals or what you want to call it is immaterial, as the outcome is the same.  Britain has government-owned hospitals and Canada doesn’t, but the result is still that bureaucracies make medical decisions instead of doctors and patients.  HMOs were the Left’s bogeyman for years, but their solution is to institute the nation’s, perhaps the world’s, largest HMO/insurance company to make our individual health care decisions.  This makes no sense at all.

From the think tank paper cited:

[The Lewin Group, "a nationally respected nonpartisan
consulting firm"] estimates the proposal would cover 99.6 percent of all Americans without raising total national health spending. It would also save hundreds of billions over time – more than $1 trillion over the next 10 years – in national health spending, according to Lewin.

The Lewin Group is inexplicably closing its eyes to the Canadian system, blue-skying his prediction.  The Canadian system uses both government- and employer-based payment system, utilizing private insurance/doctors/hospitals, and they are in crisis.  They are not saving money (Claude Castonguay, quoted in the original post, notes that rationing and "injecting massive amounts of new money" has not helped).  They most certainly do not serve effectively (Wikipedia cites a study showing 57% of Canadians wait 4 or more week to see a specialist).  And it unfortunately affects everyone (read the Wikipedia article sections titled "Government Involvement" and "Private Sector").

Are you really going to believe predictions on the efficiency and cost effectiveness of a massive government program.  No government program of such a size ever comes in under budget; not Medicare, not Social Security, not the Iraq War, nothing

The Lewin Group says that the government could bargain for lower costs, and yet Canada’s are skyrocketing.  They may have gone down at the beginning, but as The Acton Institute’s Dr. Donald Condit notes:

Resource consumption increases when people think someone else is shouldering the cost. Nobel Laureate Milton Friedman observed, “Nobody spends somebody else’s money as carefully as he spends his own.” More than 60 years of “someone else” paying for health care has led to medical expense inflation. Our predominately third-party reimbursement “system,” beginning after World War II for employees and after Medicare in 1965 for the retired, has resulted in out-of-control spending. Increasing the role of government will spur unbridled medical services consumption and further harm the underserved. Medical resources are limited. An expanded government role in health care will necessarily lead to rationing, shortages of health-care providers, delay in treatment, and deterioration in quality of care.

Medicaid is a socialized medicine microcosm. In that system, price controls and bureaucracy result in rationing by deterring provider participation and delaying treatment, with subsequent deterioration in quality of care. Affluent individuals are able to access better health care outside of any government system.

And this "Medicare model" is what the EPI plan wants to take the "best elements" of, which they only enumerate later on as the federal government administering it.  How can the Left possibly say they care more for the less-fortunate in one breath, and in the other hold up health care rationing as "caring"?  This makes no sense at all.

Canada’s system currently compares favorably to the US in terms of a couple of cherry-picked statistics, but that’s like judging a pyramid scheme based on the first few generations.  They are losing on other fronts, like a drain of doctors.  And they are now at the tipping point of that pyramid scheme, where the choice is either returning a bigger role to the private sector (what Castonguay called "radical" and what conservatives call "sensible") or sliding further down the slope to socialism.  The Left, not wishing to have their utopian vision challenged, will no doubt push for the latter.

And when you make these commitments, you have to make good on them.  First, because it’s the right thing to do, even if it bankrupts you (and it may well).  Second, you’ll be painted as heartless by the Left even if you’re trying to undo their failed policies.  The disease will be renamed the cure, and the status quo will be extremely difficult to change. 

When I noted that I would put up a follow-up post on this, Mr. Trabue asked me if I’d have any "objective reporting" on the matter instead of "more opinion of the nature, ‘Here’s some people who don’t like Canada’s plan’".  I’m not sure how I can clear that hurdle.  I quoted the man considered one of the fathers of the Canadian system, who is a true believer in it, coming out and saying it needs to be saved by the private sector.  This is like Billy Graham coming out and saying, "Y’know, this Christianity thing really is untenable without a doctrinal overhaul".  If his opinion doesn’t rise above the simple "I don’t like it because I got shafted", I don’t know what will.

In any event, here are some other views.  NY Times, Nov. 29, 2002:

In a long- awaited report, a government commission recommended today a major increase in federal financing for Canada’s national health care program to shore up its finances and prevent the development of a parallel system of private medical services.

Publicly financed health care for all has been a cherished hallmark of Canadian society since the 1960’s, but ever-longer waiting lists for elective surgery and for M.R.I. scans and other diagnostic services in recent years have provoked concerns that the system cannot be sustained.

Several provinces have begun introducing private clinics, stimulating a debate in Parliament over whether to reinforce the existing system or totally revamp it.

CTV, June 18, 2008:

Canadians continue to suffer from a doctor shortage, according to a new report that found 1 in 5 people have not been able to find a physician to treat them regularly.

A Canadian Community Health Survey (CCHS) released Wednesday found that more than four million Canadians are without a doctor, either because they have not found a family physician to take them on, or because they have not looked for one.

This proportion was up by 3 per cent since the 1996/1997 National Population Health Survey.

The Toronto Star, June 30, 2008:

Their [the veteran health ministers of Ontario and Quebec] tenure started at a time when repairing a battered health-care system had become job one for every government in the country. Indeed, both Dalton McGuinty and Jean Charest were originally swept into office on the promise to fix health care. On that basis, they literally staked the success of their governments on the performance of their health ministers.


But while Smitherman and Couillard [the previous ministers] acquitted themselves well in their political missions, they leave behind a system whose root problems have ultimately defeated their efforts. That is not for lack of throwing money at the issue.

Over the past five years, the federal and provincial governments have reinvested massively in the system, with health-care spending at times outpacing the rate of the growth of the economy by a ratio of two to one.

All that money has bought some relief, but not the lasting cure that was originally contemplated.

On Friday, Yves Bolduc, the doctor that Charest hand-picked to replace Couillard, declared that reducing hospital wait times in Quebec would be one of his top priorities. That has been the mantra of successive Quebec health ministers for the better part of two decades.

And earlier this month, the Health Council of Canada reported that the sweeping reforms that were promised at the time of the 2003 First Ministers’ Accord on Health Care Renewal have failed to materialize.

And here is a round up of articles from the Galen Institute noting, not just opinions, but facts, such as a town in the UK that could only get a CT scanner if a bank donated the money for it (and the uproar that caused) and drugs not being given to patients because of the need for cost savings. 

"Lower costs and more effective health care for everyone."  That’s what Obama is selling — a precise copy of the Canadian system — and the price, we’re told, is instead a savings.  So the question is, who do you believe?  A think-tank trying to sell their plan, or a spot-on object lesson right on our border?

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