An unfortunate consequence of the forthcoming Democratic control of the House and
Senate is that the Dems will try to push a single payor medical system. Add to this
that Hillary is lining up her ambulances and chasers to again push for a system that
was rejected in 1993.
The debate over single payer goes on. It sounds good with but one payer rather than
hundreds.
But the single payer will be the government which almost always leads to reduction
of services, "cost saving"(cutting) measures, substitutions, increasing rates and
ultimately rationing.
Advocates of the single payer system often cite Canada as the paragon of virtue. But
there is a slight catch-22. The Canadian social structure is on the verge of
collapse.
The biggest Canadian fiscal drain comes from the single-payer medical system.
"Current model of health-care delivery leading us down the path to financial
ruin," states the lead editorial in the Calgary Sun. Health-care costs would
consume 50% of Alberta's budget by 2016 (according to the Fraser Institute) or
2017 (according to Aon Consulting, a firm hired by the Alberta government). Health
care would devour 100% of the provincial budget by 2030, if present trends continue.
By 2040, the proportion of the Canadian population over the age of 65 will have
increased from 13% to 25%, and will continue to rise, according to optimistic
projections by the United Nations.
Canada's birth rate is now 1.5, or more than 25% below replacement level, having
decreased by 25% between 1992 and 2002. It could easily reach 1.0 in another decade.
In 1959, Catholic Quebec had the highest birthrate in Canada, but it is now the
lowest. While Quebec separatists, who currently outnumber federalists, say they must
secede from Canada to preserve their heritage and culture, that culture is already
threatened with extinction by massive debt, low productivity, and abysmal birthrate,
stated former premier Lucien Bouchard.
"We don't work hard enough. We work less than Ontarians and infinitely less than
Americans," he said. Quebec could not sustain its social programs while working
less and having few children (Joseph D'Agostino, PRI Weekly Briefing 11/10/06).
The conventional government solutions won't be feasible in the long run, stated a
Fraser Institute report. These include raising taxes (to 100% of income?), borrowing
more money, delisting more services, and lengthening waiting times. The Fraser
Institute's suggestions (co-payments, permitting private payment, and permitting
competition between public and private hospitals) are considered "too right
wing" (Calgary Sun 10/8/06).
Although at least 65% of Canadians still say they get good care, a recent poll
showed that only 53% of Albertans were satisfied with recent emergency care. The
health authority is hiring more social workers and will provide a 24-hour hotline
for suggestions (Calgary and Edmonton Sun 10/8/06).
The government has rolled out a high-profile campaign to cut waiting times for
cancer surgery. Meanwhile, "line-ups for non-cancer surgeries grow" and
"researchers find resources being 'cannibalized' to reduce cancer waits"
(National Post 9/22/06).
An estimated 90,000 Canadians sought medical care outside their country in 2005. The
cry "no two-tiered system" could be replaced by "set our patients free,"
stated a lead editorial (National Post 9/18/06).
So although a single payer system sounds good on paper, in debates and in editorials
by newspapers who want more government control, the Canadian experience should make
us careful for what we ask.
Editor's Note: Michael Arnold Glueck, M.D., wrote this week's commentary
