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Saturday, April 24, 2004

The WSJ on the Canadian socialized health care system:

The hidden costs include the poor quality of services, and the costs imposed on customers (aptly called "patients" in this case) who have to wait in queues.

Quality is subjective and can only be evaluated through consumer choices, but the government won't let consumers make choices and vote with their feet if they are not satisfied. Anecdotal evidence of questionable quality is everywhere. In a recent piece in Montreal's Gazette, a Canadian related her own experience, and contrasted the "kindness, discretion and professionalism" of staff in U.S. hospitals, with the frequent rudeness of unionized personnel in the Canadian system.

Long waiting lines are a fixture of the system. The Fraser Institute, a Vancouver think tank, has calculated that in 2003, the average waiting time from referral by a general practitioner to actual treatment was more than four months. Waiting times vary among specialties (and, less wildly, among provinces), but remain high even for critical diseases: The shortest median wait is 6.1 weeks for oncology treatment; excluding radiation, which is longer. Extreme cases include more than a year's median wait for neurosurgery in New Brunswick. The median wait for an MRI is three months. Since 1993, waiting times have increased by 90%.

Waiting lines impose a real cost, which is approximated by what individuals would be willing to pay to avoid them. Waiting costs include health risk, lost time (especially for individuals whose time is most valuable), pain and anguish. Socialist systems are notoriously oblivious to anguish, discomfort, humiliation and other subjective factors which bureaucrats cannot measure or don't value the same way as the patient does.

A Québec physician, Dr. Jacques Chaoulli, is suing the government for not allowing patients to pay for better care. The Supreme Court of Canada will hear his appeal of lower-court rebuttals in June. Last month, a class-action case was launched against Québec hospitals on behalf of 10,000 breast cancer patients who, since October 1997, have had to wait more than eight weeks each for post-surgery radiation therapy.

This is what happens when a monopoly, given such status by writ of government edict, controls the resources of medical care and their allocation. Such ideas should fail in the court of public opinion based on their sheer absurdity in light of market mechanisms, but, given the woeful state of teaching of economics in the U.S., it is no wonder that so many people can be convinced that "if the government can be given license to provide this service, it will be cheaper and better." That idea is hogwash, and the politicians who push such things know it. This is John Kerry's idea of health care (at least this week, it is), and that is yet another reason not to vote for him in November.


.: posted by Dave 8:16 PM

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