• Tag Archives healthcare

  • Canada’s Ailing National Healthcare Is Not a Model for America

    Posted on by Azrael Comment

    Earlier this month, Canadian Prime Minister Justin Trudeau began a US-Canada economic summit designed to improve his country’s economic climate.

    Canada’s political landscape is shifting. After nearly a decade in office, Trudeau has announced his resignation, with the Party leadership election scheduled for March 9. He will leave behind a country that has been grappling with a decade of disillusionment. Trudeau’s legacy will be marred by soaring taxes and a Canadian economy that many now describe as being on “life support.”

    The country’s healthcare provision is the weakest part of its economy. For years, American reformers have idolized Canadian healthcare, touting it as the gold standard for universal care, and a model to replace an American system that is also broken. But the reality tells a starkly different story. In Canada, wait times are unmanageable, access to services is dwindling, and public trust is eroding. Recent data indicate that one in six Canadians lacks a regular family physician, and fewer than half can secure an appointment with a primary care provider within a day or two. This shortage has led to overwhelmed emergency rooms and significant delays in care. In 2023, more than 1.3 million Canadians abandoned emergency room visits due to excessive wait times. Some hospitals have even exceeded 200% capacity, forcing patients into hallways and onto floors.

    As Americans reckon with record deficits and runaway government spending, some voices are once again touting the Canadian example as cheaper and more effective than the US system. One of the loudest cheerleaders for Canada’s model is Wendell Potter, a former healthcare executive turned activist, who has lately been painting a utopian vision of Canada’s government-run healthcare in op-eds and interviews. But like all advocates of socialized medicine, Potter is peddling an illusion rather than reckoning with the harsh realities Canadians face daily.

    Consider the data. Patients in Canada often wait months for critical procedures. According to the Fraser Institute, the median wait time for medically necessary treatments in 2022 was over 27 weeks—nearly double what it was in 1993. For many Canadians, timely access to care is not a guarantee but a gamble. For patients with life-threatening conditions, these delays can mean the difference between recovery and irreversible harm.

    The deterioration of Canada’s healthcare has not gone unnoticed by its citizens. Recent polls show that dissatisfaction with healthcare is at an all-time high, with many Canadians now exploring private care options to bypass the public system’s inefficiencies. Some 75% of Canadians now believe their nation’s healthcare is in crisis. “Free” healthcare costs the average citizen nearly $9,000 a year in taxes, and people who once championed Medicare are acknowledging its shortcomings.

    The problems plaguing Canadian healthcare are deeply rooted in its design. A single-payer arrangement relies on the government (i.e., the taxpayer) as the sole payer for healthcare services, ostensibly ensuring universal access. But basic economics predicts two problems. First, as sticker prices fall (because a portion of the cost is subsidized by taxpayers), demand will increase. Second, as the government does not respond to market forces, there is no incentive for supply to grow.

    When demand outpaces supply, as it has in Canada, the limitations become glaringly obvious. Hospitals face chronic underfunding, staffing shortages are widespread, and technological investments lag behind those of other developed nations. Despite a population of 40 million, there are only 432 MRI machines in the country. The US has more than 13,000. These structural issues lead to the long wait times and reduced access that have become hallmarks of Canadian healthcare.

    Another alarming consequence of these failures is the rising use of Medical Assistance in Dying (MAID). Reports have emerged of patients feeling pressured into considering euthanasia due to inadequate access to care. Since its legalization in 2016, MAID has accounted for 4% of deaths in Canada, and some fear that systemic healthcare failures are influencing these decisions. Scarce resources must be allocated somehow; if markets can’t encourage increased supply, rationing will take place through waiting. Or worse.

    Meanwhile, advocates of Canada’s model argue that the American system is broken because it prioritizes profit over care. There is certainly room for reform in the US. But US healthcare is anything but a free-market wonder (or the market dystopia condemned by its detractors). Before the Patient Protection and Affordable Care Act of 2010 (“Obamacare”), more than half of US healthcare expenditures were already funded by various government sources. If we add a tangled web of regulations and distortions, it’s no wonder that prices are so high. No country’s healthcare is without flaws, but Canada’s current crisis should serve as a cautionary tale rather than an aspiration.

    By romanticizing Canada’s healthcare system, advocates of fully nationalized healthcare gloss over the lived experiences of countless Canadians struggling to access essential care. Their narrative does little to address the failures that have led to this crisis, offering a one-sided view of American healthcare that conveniently ignores the shortcomings of the alternative.

    Whether the US-Canada summit delivers meaningful solutions or simply serves as a political farewell tour remains to be seen. In any event, Trudeau’s resignation signals a new chapter for Canada, and it is an opportune moment to confront the mythologies surrounding its policies—particularly its healthcare system. Canada offers a cautionary tale of what happens when lofty ideals collide with practical realities. The cracks in Canada’s healthcare model are too large to ignore.

    The lesson is clear for Americans still enamored with replicating Canada’s single-payer arrangement—be careful what you wish for. Promising universal access but failing to deliver timely care is not a model worth emulating. Canada’s healthcare crisis is a wake-up call for its citizens and anyone who believes in the promise of universal care. As Trud­eau’s political legacy fades, the urgent task of addressing Canada’s failures remains. Advocates of full nationalization of healthcare would do well to shift their focus from selling dreams to confronting realities. Only then can the conversation about healthcare reform—on both sides of the border—begin to move in a meaningful direction.

    Healthcare in Canada, the US, and beyond needs more consumer choice, less regulation, and better-aligned incentives—not more socialism.

    Source: Canada’s Ailing National Healthcare Is Not a Model for America – FEE


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  • America Outperforms Canada in Surgery Wait Times—And It’s Not Even Close

    Posted on by Azrael Comment


    hospital
    Canadian Medicare, our northern neighbor’s universal health care system, generally receives rave reviews from proponents of nationalized or socialized health care, but the Fraser Institute found that more than 63,000 Canadians left their country to have surgery in 2016.

    As Americans contemplate overturning our health system in favor of one similar to Canada’s, we must ask why so many leave.

    The Canadian system consistently ranks low or lowest across numerous metrics in the Commonwealth Fund’s extensive survey on health care. With regards to specialists and surgeries, the United States ranked best or nearly best.

    The Fraser Institute study did not examine where Canadians traveled for surgery, but given proximity and our much better metrics, most probably came here.

    Surgeries are scheduled after patients are seen by the surgeon, and most people see surgeons only after a referral by either their primary care physician in America, or their general practitioner in Canada. In the United States, 70 percent of patients are able to be seen by specialists less than four weeks after a referral. In Canada, less than 40 percent were seen inside of four weeks.

    After being advised that they need a procedure done, only about 35 percent of Canadians had their surgery within a month, whereas in the United States, 61 percent did. After four months, about 97 percent of Americans were able to have their surgery, whereas Canada struggled to achieve 80 percent.

    America is significantly outperforming Canada in surgery wait times even as it’s likely that tens of thousands of Canadians come here to use the American system.

    General surgery, procedures such as appendectomies, cholecystectomies, and hernia repairs, make up the largest portion of those who leave Canada for care. Based on the latest available date from the Organization for Economic Cooperation and Development, the total Canadian caseload for many of these procedures is about ten percent of America’s.

    America’s health system is certainly flawed and in need of reform, but there is clearly something working well enough that our system, despite already treating ten times more cases of appendicitis, can absorb the dissatisfied Canadians.

    This has been a consistent trend since at least 2014 when an estimated 52,513 Canadians left for their medical care. In 2015, the number went down slightly to 45,619. 2016 exceeded the 2015 number with an estimated 63,459 patients seeking care elsewhere.

    Moreover, both countries have had comparable rates of private health insurance coverage for the past 20 years, roughly 60-70 percent. But the Canadian private insurance market is entirely supplemental—it covers co-payments for services not covered or not entirely covered by the provincial insurance.

    Primary coverage, which is the predominant form of insurance in America, is all but illegal in Canada and would be under “Medicare for All” as well.

    In the United States, government insurance covers gaps left by the private market. Private insurance is the norm and Medicare and Medicaid provide a health insurance safety net for elderly or low-income Americans.

    In Canada, government-provided Medicare is the primary form of insurance, and private plans merely fill in gaps in coverage for those with more disposable income or employee benefits. The two systems are mirror opposites of one another.

    Health care is a product of the labor of physicians, nurses, technicians, and a whole ecosystem of health care workers. If making the government the primary payer for these services is so smart, why does the universal system next door shed patients by the tens of thousands to ours?

    American health care can be improved and should be; American health care performs about middle-of-the-pack for many other items on the Commonwealth Fund survey.

    There are many inefficiencies, often government-imposed, that increase the cost of health care and restrict the insurance market.

    The administration already has loosened some regulations that will give employers more flexibility in providing health benefits and has begun to push for price transparency, which also should bring down costs.

    Whatever the case may be, reforming American health care should focus on enabling our strengths. Under no circumstance should we tear it down and build it anew to resemble the system whose citizens escape by the tens of thousands just to be treated in a timely manner.

    This article is republished with permission from The Daily Signal. 

     

     

    Kevin Pham

    Kevin Pham, a medical doctor, is a contributor to The Daily Signal and a former graduate fellow in health policy at The Heritage Foundation.

    This article was originally published on FEE.org. Read the original article.


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  • Why a Free Society Cannot Transform Wishes into Rights

    Posted on by Azrael Comment


    medicare-for-all-protest

    Any careful observer of American politics must be struck by the ever-expanding roster of things people have asserted rights to. But when such arguments are seriously considered, there is little to them beyond shared desires or wishes for certain things, which supposedly implies that there ought to be rights to them.

    From there, it is but one further step to legislative, executive, or judicial attempts to create such rights, promoted as social improvements guaranteed by government.

    This “ought implies is” argument about rights reverses the claim that “is implies ought,” which David Hume famously shot down. It ignores that in a world where scarcity is inescapable, our desires always outpace what is producible, which means that newly asserted rights may well be impossible delusions. Further, it ignores that making good on any particular newly created right must violate other’s existing rights to themselves and their efforts. And it, too, deserves rejection.

    Few have thought as carefully about this confusion between wishes and rights as Leonard Read. His insights are particularly well developed in his “Doctor, Whoever You Are,” section in his 1969 Let Freedom Reign. In a world where turning one wish into a political right leads to still more attempts to use the same magic on another wish, and every such step further erodes liberty, Read’s views are worth serious consideration on their 50th anniversary.

    “Now in vogue is a fearful combination of wishes and methods, as fanciful as Aladdin’s lamp…the transmutation of wishes into rights! Do you wish for better housing? Then better housing is a right. Do you wish for…higher returns for goods and services, shorter hours of labor, protection from competition? Then these are rights. Do you wish for free medical care? Then free medical care is a right!”

    “And what is the nature of the jinni called upon to transmute wishes into rights?… government. It extorts from all, allocating the legalized loot to those who effectively make their wishes heard.”

    “How do we go about healing this sickness? We must acquire an understanding that wishes, regardless of how numerous, do not constitute a right. I have no more right to your professional attention than you have a claim on me to wash your dishes. We are dealing with an absurdity.”

    “We live and prosper by specialization and exchange…others tend to encourage me to specialize at what is of value to them, and I tend to encourage them to specialize at what is of value to me. This is how people in a free society exert their wishes. But note that these wishes do not carry with them any right on my part to command what others shall produce or any right to force on them the terms of exchange.”

    “When the notion that a wish is a right is put into effect by police force—the only way it can be done—then specialization is no longer guided by consumer wishes nor are the terms of exchange…Other citizens are then forced to perform labor for which they receive absolutely nothing in return. Exchange is by coercion rather than by free choice.”

    “The fact that many of us wish more medical attention than we can afford does not give us a right to your [physician] services or a right to force others to [finance them]…wishes to the contrary notwithstanding!”

    Benjamin Franklin is said to have written, “If man could have half his wishes, he would double his troubles.” He was referring to the problems our wishes would cause ourselves. But we go far beyond causing ourselves problems whenever we try to transform our wishes into rights.

    We cause all our fellow citizens problems because our efforts to create rights for ourselves must pick their pockets—assert our ownership of their resources rather than acknowledging their self-ownership—despite lacking moral or ethical justification. Leonard Read rightly recognized this as no different than looting enforced by a “might makes right” mentality.

    If not for the corrupting lure of something for nothing, people would long ago have rejected the idea that wishes imply rights. But as ever-more goodies have been added to bait the lure, most Americans seem to have decided to stop thinking about the burdens borne as a result of these invented rights.

    Our reasoning has been warped by a too-narrow view of our self-interest, which ignores what we can achieve jointly only by defending voluntary arrangements, which respect one another’s self-ownership. That makes it particularly important to revisit Leonard Read’s wisdom about wishes and rights, for otherwise our coveting will corrupt and punish us further and further.

    Gary M. Galles

    Gary M. Galles is a professor of economics at Pepperdine University. His recent books include Faulty Premises, Faulty Policies (2014) and Apostle of Peace (2013). He is a member of the FEE Faculty Network.

    This article was originally published on FEE.org. Read the original article.


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