Single-payer health care strikes close to home
Yesterday I listened with disbelief as my 78-year-old Canadian mother-in-law expressed her dismay at being unable to see another doctor under Ontario's health care authority. She is not happy with her doctor's level of expertise and feels she would get better care with a more experienced physician. It won't happen.
Before I continue let me make clear that in theory, the Canadian single-payer system does not place constraints on which doctors Canadian patients can see. However, according to the Vancouver-based Fraser Institute, there are fewer doctors per capita and thus fewer choices -- in many regions there are simply no other doctors with open schedules from which to choose. It is no secret that as many of Canada's physicians see their incomes decrease, they opt out, join the "doctor drain" and move south of the border.
How it works
How does the system work? First of all, the term "single-payer" is a liberal code word and means the government, which means taxes on individual income. Secondly, most Americans don't know that in Canada, health care is a provincial concern and not that of the federal government. Ottawa legislated the five principles of the National Health Act and only supports care through federal transfer payments to each of the provinces. Thirdly, care is managed in each province through regional authorities or health districts in order to "promote efficiency and help cut costs," but the sad fact is that there is very little efficiency being promoted.
"Regionalization," as the funding reorganization is called, works this way: Provinces allocate a lump sum of money on a per capita basis to regional health authorities. The authority determines how to use that money to cover the health care needs of the region. Since money saved by closing and merging inefficient hospitals can be spent on other health services such as community clinics, home care and public health activities, regionalization is only effective at driving the number of hospital closures per province.
I have previously described in The B2 Journal how I lost my Canadian sister-in-law because in the 1990s, she was placed on a waiting list for treatment of a brain tumor. The system has deteriorated since then. Last year, more than 800,000 Canadians, or 2.5 percent of the population, were waiting for health procedures. The average wait to see a specialist, according to the Fraser Institute, is nearly 10 weeks.
Nothing is free - somebody must pay
Nothing is free, not even health care in Canada. According to Sally C. Pipes of the Pacific Research Institute, the issue is who bears the costs and how. In Canada, politicians control the monetary costs that show up on bureaucratic budgets by shifting costs to individuals who pay in the forms of increased taxes, increased pain, lost income, and diminished quality of life.
The problems plaguing Canada's health care system -- long lines, lack of access to technology, lack of access to specialists, and a dwindling supply of general practitioners -- are unavoidable in a single-payer system when the money pool is finite. The only way to increase services is to increase revenue, and that means tax increases.
Canadians joke about the system when they say that everything is free but nothing is available. They can also add that access to a waiting list is not access to health care. My family learned that the hard way.