Today I anesthetized a Canadian woman who had waited two years to have a hip operation and had three more years of waiting to go.  No one argued in Canada that she needed surgery, they just weren’t going to do it for five years.  Her condition was one that left untreated, would result in the complete destruction of the articular surface of her hip joint, a situation then treatable only with a hip replacement.  

She found a hospital in Montreal that agreed to do her surgery as a “private” patient for $20,000.  She didn’t have $20,000.  Then she found us.  We did her surgery today for $5500.  She will do well and will be spared a total hip replacement. 

What are the lessons here?  

1)Canadian health care stinks.  Actually, any health care system combined with a governmental role stinks.  The current occupant of the white house believes that more government is the answer in the U.S.  This Canadian woman would disagree.

2)”Private” health care in Canada suffers from a lack of competition.  If a real market were active in Canada, the price would more closely resemble ours.  The Montreal facility charges $20,000, because they can get it.  We are going to assist this facility in discovering a more patient-friendly market clearing price.  Remember the market clearing price is the one at which no surpluses or shortages exist, one where the buyer and the seller exist in perfect equilibrium.

3)Rationing of early care leads to more expensive later care.  DUH.  We have seen this with hernia surgery too, where routine herniorraphy is delayed only to become a life-threatening bowel obstruction.  Routine knee arthroscopy to remove or repair a torn meniscus, delayed long enough, results in a knee treatable only with a total joint replacement.  Lumbar spine surgery delayed long enough results in irreversible nerve damage to the lower extremities or worse.  You get the idea.

4)The “right to health care” in Canada is a myth.  Canadians have a right to a place in line.  They have a right to hope for care.  They have a right to die in line.  That is it.  The “right” to health care is a lie, one that has enjoyed one of the most successful propaganda campaigns ever.  No right can exist, the exercise of which violates the property rights of another.  

5)The Surgery Center of Oklahoma’s fondness of free market principles resulted in this woman’s affordable and high quality surgical experience.  She is not alone.  We have more Canadians on our future surgical schedule now than ever before.  

6) This woman didn’t go to the “not show a profit,” charity, “critical access,” hospital across town.  Enough said.

7) The difference between what we charged ($5500) and what she would have paid in Montreal ($20,000) will be put to unknown use, but would never have the opportunity to be put to use had it not been for the competitive pricing at our facility.  Remember Bastiat’s “What is not seen.”  

8) A pricing system free of interference from the government results in prices that are affordable and quality that is actually better.  Yet the U.S. government has assumed a more active role in health care than ever!

9) This woman’s surgery was cheaper for her than for an American with insurance!  Due to the cartel-like arrangement between hospitals and insurers in the U.S., this procedure would have cost a U.S. citizen significantly more than this Canadian paid at our facility, had it been done at a “not show a profit” facility.

10) Those who continue to deny the facts and embrace a “universal care” model, one like the Canadians and the British and others have endorsed and endured are living in a dreamworld.  That Canadians are coming to our facility is all the evidence one should need to suspect that a government system is a failure.  Period.

11) A physician-owned facility (ours) gave this woman the best pricing she could find anywhere in the world.  Greedy doctors!

I’m sure there are other “lessons.”  I would happily entertain any additions to what I have listed above.

G. Keith Smith, M.D.