During a recent trip to Quebec where I spoke to an international group interested in how our facility works and interested in steering as many patients as possible to us, I was interested to hear my new Canadian friends extoll the virtues of their “single payer” system. I have written about this before, amazed that such a failed system (the failure of which is manifested by Canadians traveling to Oklahoma City to have their surgery) nevertheless has the support of its own victims. Why such a government program has the support of its casualties is not the subject of this blog, however. That their “single payer” system is anything but “single payer” is the point I would like to make. Let me explain.
Canadians pay taxes to a central bureaucracy charged with the administration of health care benefits. If this were the only source of payment for the procurement of health related services, this bureaucracy or agency would be the “single payer.” We must keep in mind, however, that Canadians also pay with their time, as to assign no value (or loss, thereof) to a 2 year waiting list for a routine surgery is not an honest accounting of the situation. This waiting list time and its value must be taken into account, either in terms of raw suffering or productivity, take your pick.
Let’s see now….that’s two sources of payment for health care in Canada. We can now proceed to consider the obvious third source, that being the care for which Canadians pay directly, usually outside of Canada. The northern U.S. caters to this crowd, but increasingly Canadians are turning to the medical tourist destinations outside of the U.S., finding affordable and high quality care in many countries.
“Single payer?” HA! I wonder how much folks would brag about this system if leaving the country for healthcare were made illegal? Not allowing this health care “underground railroad” would result in even longer lines. The lines would lengthen even more and as the waiting and suffering mounted perhaps only then would people see the true cost of this central planning.
G. Keith Smith, M.D.
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