Having grown up in Saskatchewan, in western Canada, people sometimes ask me, “what health care system do you think is better? The one in Canada?, or the one in the United States? I usually answer that both systems do a reasonable job of providing basic care to most of the people. The differences start to get more dramatic when the health problems get bigger—in Canada you’re at risk of not being able to get the care you need, and in the U.S. you’re at risk of not being able to pay for it. Having said that, let me be clear about which side of the fence I am on. I want the services available to me, and I’ll figure out how to pay for them. That is what most Americans want, and increasing numbers of Canadians want it too. Here is an article about that phenomenon from the Wall Street Journal on September 30, 2009.
Feeling rather grown up and in the prime of my life lately, I have considered myself capable of leadership, even leadership on a big scale, dedicated to solving big problems. For example, in the province of Saskatchewan, there are no private health clinics, surgery centers, diagnostic facilities, or hospitals. Everything is run by the government. And since the government can only forcibly extract so many tax dollars from the citizens before they are at risk of getting tossed out, the main issue with health care in Saskatchewan is that health care services are limited—rationed—by the government.
If I were the Premier of Saskatchewan, I would tell the people that I could fix the problem in 30 seconds if given the mandate to end the government monopoly on the provision of health care. End it, and overnight you would have surgery centers, diagnostic centers, pediatricians, cardiologists, orthopedic docs, and ob-gyn’s opening up private clinics in the larger towns and cities, and family doctors attracted by the pleasant and inexpensive rural lifestyle hanging out their shingles in small, agricultural towns. Fewer of the young doctors, trained at great expense by the University of Saskatchewan, would leave the province for greener pastures. In one stroke of the pen there would be better health care for all, more freedom for all, more jobs and economic activity.
There would be protest, of course. One of the tired arguments for a complete government monopoly is that it forces everyone, rich and poor, to be invested in the system. So the government mandates unnecessary pain and suffering (like waiting two years for a hip replacement) so that everyone is invested in the system. “But that way everything is fair”, the protesters will cry. “Equal access for all. If private clinics are allowed, then there will be two health care systems, one for the rich and one for the poor.”
Does anyone really believe that things are fair under a government monopoly? If the artificially-limited-by-the-government number of pediatricians are booked solid for months, who do you think has a better chance of being “squeezed in.” The young professional couple who count doctors and lawyers and other professionals among their circle of friends, or the poor, young, single mother with no money and no connections. There is no fair. And as for one system for the rich and one for the poor; does the woman in the Wall Street Journal article sound like a rich person? Hardly. More like someone with a modest income who makes a financial sacrifice to improve the quality of her own life. That is fair. That is justice.
2 years ago