Wednesday, January 03, 2007

Soviet Sytle Heatlh Care in Canada

P.J. O'Rourke: "If you think health care is expensive now, wait until you see how much it costs when it is free." Like in Canada, where health care is essentially "free" to patients, and the money spent on health care in Canada outpaces most other developed nations. Further, the total waiting time for medical services in 2006 was 91 percent longer than it was in 1993, adding to the total cost of health care in Canada (Total Cost = Monetary Cost + Opportunity Cost of Waiting). When prices aren't allowed to ration goods and services, waiting time plays a significant factor in rationing, e.g. the long lines at the gas pumps in the 1970s due to price controls.

From an
article in Health Care News about Canadian health care: "It's like the old Soviet system. "Everything is free, but nothing is readily available. Except that we're not talking about lining up for toilet paper in Russia in 1976, but queuing for surgery in Canada in 2006."

And the article points out that "Economists generally agree such "non-price" rationing of resources (queueing and long waiting times) is less efficient than a system that uses prices. One reason is that productivity is lost when people are unable to work due to treatment delays. Also, the risk of death while waiting is higher for serious conditions such as cardiac care."


At 1/03/2007 8:17 PM, Anonymous Keith on the other side of the St. Clair River said...

What the Heartland Institute fails to tell the reader is that the source of the report, the Fraser Institute, is a right wing think tank. So, it's to their benefit to make everything look as gloomy and bad as possible. A quick scan of the numbers on Cancer Care Ontario's web site ( tells me that the average wait time for treatment is 6 weeks. Is that good? No, but if you compare that to the American system where 40 million people do not have health insurance at all, it looks pretty damn good. Health care is a basic human right to which all citizens of a country should have equal access. Money, for once, shouldn't dictate who gets what where. I can tell you that, unlike the Soviets, Canadians are deeply protective of their universal health care, warts and all and are not ready to dump it any day soon. It is one more factor in keeping our society a civil society.

At 1/03/2007 10:03 PM, Anonymous Sudha Shenoy said...

Had I lived in Canada & had to wait as much as 6 weeks for cancer treatment, I would've died. How many people are permanently injured or die on waiting lists? And I notice that the Fraser Institute is simply rubbished. Its _figures_ are all right then?

At 1/04/2007 2:11 AM, Blogger Mark J. Perry said...

Isn't food also a basic human right? Doesn't that then justify government provision of food, produced on government-operated farms, sold in government-operated grocery stores and government-operated restaurants, etc.? They tried that in the Soviet Union and Communist China and millions of people starved to death.

At 1/04/2007 1:09 PM, Anonymous Kit said...

The only basic human right is death all else is a luxury.
In the UK where we have the glorious envy of the world, know as the NHS, we have parts of the country where:
"No patients will be given a hospital appointment in less than eight weeks, and none admitted for elective surgery unless they have waited a minimum of 12 to 16 weeks. Those treated quicker will not be paid for.
...suspension of treatments for varicose veins, wisdom teeth, X-rays of the back, operations for carpal tunnel syndrome, bunions, arthroscopy of the knee, and grommets for the ear, among others.“

At 3/29/2007 7:54 PM, Anonymous Anonymous said...

I'm a bit after the fact, but perhaps others will still stumble on my comment.

This post claims that Canada's health care is expensive and the wait times are long. But Mr O'Rourke neglects to point out that it is much less expensive than in the US. Yes, the wait times are long for non-emergency care, but if we put more money into the system, we might still pay less yet get the equivalent wait times to the US.

Yes, things were better several years ago before the government went on its "get out of deficit" binge (egged on by capitalists). The cost of healthcare went up, but the amount available for healthcare didn't go up as quickly. Being next to the US is also a problem -- we have to pay doctors and nurses more than we might otherwise (e.g. in Europe) in order to keep them from running down to Florida to open plastic surgery clinics and rake in the dough. In the military, we pay doctors about as much as we do generals, and we still have trouble keeping them. (BTW, US Military has Soviet style health care, too.)

Yes, central control makes rationing a bit tricky. But you would probably agree that if there were no waiting, we would be spending too much. Unfortunately, you can't just throw money at the problem. It is not that we don't have enough equipment or surgery suites -- we don't have enough trained people to use them. It takes time to get more seats available in universities, then start graduating medical professionals.

This delay also exacerbated the problem -- by the time the government noticed things were getting out of hand, it was very hard to keep it from getting worse. However, it seems like things are stabilizing and will soon get better. Not that you'll hear that from the Fraser Institute.

Look, Canada may not be the best healthcare system out there. But we are a heck of a lot cheaper than the US one, with nearly identical mortality rates. The UN WHO seems to like us just fine. So you don't have to necessarily pick Canada's. But just get off your ass and pick somebody's and you'll be better off than where you are now.

A comparison of the largest HMO to the US Medicare/Medicaid system will show the latter as being incredibly more efficient. They have a much larger base over which to amortize their single administration staff, and they don't pay their administrators millions of dollars. And whereas a private service tries to maximize profit, a government one tries to maximize health. Which would you prefer?

At 3/29/2007 8:18 PM, Anonymous DNeuman said...

There's one more point I'd like to add to my ones above: Universal health care ensures there is a healthy workforce for all businesses. And that helps keep us relatively competitive internationally. To do otherwise would be the equivalent to allowing private industry to come up with an interstate highway system through tolls. The ones you have were built with an overall vision, and were hugely instrumental in the US productivity. Can you imagine a bunch of private companies coming up with anything remotely like that?

Dan Neuman
d (dot) neuman (at) computer (dot) org

At 4/01/2007 10:00 PM, Anonymous DNeuman said...

The ideas keep coming...

You've heart that an ounce of prevention is worth a pound of cure, no doubt. Most physicians will tell you that preventive medicine is cheaper in the long run.

Except for insurance companies. Each individual insurance company has no assurance that they will reap the long-term benefit of paying for preventive medicine right now. If the insured later goes somewhere else, the company paid that money for no return.

So preventive medicine makes for a cheaper healthcare system. But private healthcare will never come up with that on its own.

At 4/03/2007 10:48 PM, Anonymous Dneuman said...

As a comparison between the largest for-profit health insurer and the Medicare/Medicaid system can be found here. Guess which one is more efficient.


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