What Canada can teach America about socialized health care

People on the political Left say it all the time: "Why is the United States the only nation that doesn't provide universal health care for its citizens?" The premise of the question is flawed. Many Americans might not have health insurance, but they retain access to health care, even if they lack the ability to pay for it. American hospitals incur costs as a result of delivering health care to people who can not or do not pay.

Regardless, everyone interested in health care as a public policy issue should take note of a recent ruling by the Canadian Supreme Court, which ruled that some features of Canada's single-payer health care system are unconstitutional.

The court's decision strikes down a Quebec law banning private medical insurance and is bound to upend similar laws in other provinces. Canada is the only nation other than Cuba and North Korea that bans private health insurance, according to Sally Pipes, head of the Pacific Research Institute in San Francisco and author of a recent book on Canada's health-care system.

"Access to a waiting list is not access to health care," wrote Chief Justice Beverly McLachlin for the 4-3 Court last week. Canadians wait an average of 17.9 weeks for surgery and other therapeutic treatments, according the Vancouver-based Fraser Institute. The waits would be even longer if Canadians didn't have access to the U.S. as a medical-care safety valve. Or, in the case of fortunate elites such as Prime Minister Paul Martin, if they didn't have access to a small private market in some non-core medical services. Mr. Martin's use of a private clinic for his annual checkup set off a political firestorm last year.

Socialized medicine, whether it be practiced in Great Britain or Canada or elsewhere, doesn't deliver all the medicine and surgery you can consume or need at no cost. There is an economic limit as to how much health care any society can produce and there is a political limit as to how many resources government will redirect away from alternative uses (such as education, food, transportation, housing, entertainment) so that these resources can be expended on health care.

For example, every doctor who checks the vital signs of a patient is someone who is not teaching algebra to ninth graders. And all of the education that the doctor consumed when he was an undergraduate and in medical school is education that can not be consumed by an electrical engineering student. Resources are limited. So how does America compare to other nations when it comes to allocating those resources? Here's an excerpt from Ronald Bailey's column on the same subject:

Health expenditures in nationalized systems are kept lower chiefly by price controls and the frank rationing of services. In Canada waiting lines for many medical procedures are legendary. Last year, lawyers in Quebec filed a class action suit on behalf of 10,000 breast cancer patients who contend they had to wait too long for radiotherapy. The story is the much the same for Britain's National Health Service where more than 800,000 patients are waiting for NHS operations.

US life expectancy does lag Britain's (77.7 versus 78.4 years), but Britons are four times more likely to die than Americans while undergoing major surgery. Furthermore, the most seriously ill NHS patients were seven times more likely to die than their American counterparts.

A 2001 poll of Britons found that 40 percent would consider opting for private health care. In a 2004 poll, 51 percent of Canadians said that they would support the creation of a private health care system parallel to the government health care system. The first crack in the Canadian provincial monopolies that banned almost all private health care opened last week when the Supreme Court of Canada ruled that private health care was a constitutional right of Canadian citizens. And in Britain the NHS is increasingly contracting out to private providers for surgeries, MRI scans, and radiology treatments in order to cut its monumental waiting lists. Wouldn't it be ironic, if America embraced nationalized health care, just as such systems crumbled abroad?

The much-maligned prescription drug legislation that was signed by President Bush over a year ago did include an important reform of health savings accounts. Recent history has proven that capitalism provides for people better than does socialism. Let's hope the politicians of the United States, Canada and Europe learn this history soon.