27 Feb 2006 Socialized Medicine: Learning from Canada

The wave of the future in Canada: Replacing the anachronistic “socialized medicine” health care model with one based on private enterprise.

The New York Times has the story. An excerpt:

…[Canada’s] publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — 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.

Dr. [Brian] Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

“We’ve taken the position that the law is illegal,” Dr. Day, 59, says. “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.”

Dr. Day may be a rebel (he keeps a photograph of himself with Fidel Castro behind his desk), but he appears to be on top of a new wave in Canada’s health care future. He is poised to become the president of the Canadian Medical Association next year, and his profitable Vancouver hospital is serving as a model for medical entrepreneurs in several provinces.

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services. Prime Minister Stephen Harper and other politicians remain reluctant to openly propose sweeping changes even though costs for the national and provincial governments are exploding and some cancer patients are waiting months for diagnostic tests and treatment.

But a Supreme Court ruling last June — it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

As Canadians wake up to the perils of socialized medicine, a disturbing number of influential Americans remain dogmatic believers in government-run medicine.

Ted Kennedy, for example, said in a major speech last year:

…I propose that, as a 40th birthday [of Medicare] gift to the American people, we expand Medicare over the next decade to cover every citizen from birth to the end of life.

It’s no secret that America is still dearly in love with Medicare. Administrative costs are low, patient satisfaction is high, unlike with many private insurers, they can still choose their doctor and their hospital.

For those who prefer the private insurance, we will offer comparable coverage under the same range of private insurance plans already available to Congress.

I call this approach Medicare for all, because it will free all Americans from the fear of crippling medical expenses and enable them to seek the best possible care when illness strikes.

The battle to achieve Medicare for all will not be easy. Powerful interests will strongly oppose it, because they profit immensely from the status quo.

Right-wing forces will unleash false attack ads, ranting against socialized medicine and government-run health care. But those attacks are a generation out of date, retreads of the failed campaign that delayed Medicare in the 1950s and ’60s.

Today we are immunized against such attacks by the obvious success of Medicare. It is long past time to extend that success to all…

Medicare is insolvent. Call me a wacky woman if you will, but I think that limits the degree to which we can accurately call it a “success.”

Writing for the Hoover Institution, Thomas J. Healey (a former Assistant Secretary of the Treasury under Reagan) and Robert Steel (a former vice-chairman of Goldman Sachs) had this to say:

While President George W. Bush remains focused on Social Security, an even bigger fiscal time bomb is ticking away in the United States — Medicare.

The Social Security trust fund is projected to become exhausted in 2041, but the public health system runs completely dry much sooner: in 2020. What is more, to bring Social Security into balance over the next 75 years would require a 15 percent increase in payroll taxes today (or a corresponding reduction in benefits), whereas bringing Medicare into balance would require an immediate 107 percent increase in revenue (or a 48 percent reduction in outlays).Even more significant, the present underfunding of Medicare ($29.7 trillion) is more than seven times that of Social Security ($4 trillion).

Few leaders in Washington seem willing to face the fact that Medicare is a structurally broken system — in far worse shape than Social Security — that could bring the American economy to its knees in a relatively short amount of time.

As accumulating evidence makes abundantly clear, Medicare is not just an undercapitalized system but a severely flawed model. One of its biggest defects is the inherent mismatch between revenues and expenditures…

In my view, it would be foolish to adopt anything like Canada’s government-run health care model — especially as Canadians increasingly are disenchanted with it. At minimum, however, I’d like to think nearly all Americans could agree on this one simple point: The insolvent Medicare system should not be expanded to cover everyone from birth to death when it cannot even afford to cover people 65 and older.

Should Medicare be covering the babies of billionaires when it can’t afford even to cover seniors?

Hat tip: Kevin, M.D.

Labels: Government Health Care, Health Care