Commentary

Free Health Care?

Let’s start out by not quibbling with America’s socialists’ false claim health-care service is a human right regardless of ability to pay and that it should be free.

Before we buy into this socialist agenda, we might check out just what happens when health-care services are “free.” Let’s look at our neighbor to the north — Canada.

The Fraser Institute, a Vancouver, B.C.-based think tank, has done yeoman work keeping track of Canada’s socialized health-care system. It has just come out with its 13th annual waiting-list survey. It shows the average time a patient waited between referral from a general practitioner to treatment rose from 16.5 weeks in 2001-02 to 17.7 weeks in 2003. Saskatchewan had the longest average waiting time of nearly 30 weeks, while Ontario had the shortest, 14 weeks.

Waiting lists also exist for diagnostic procedures such as computer tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Depending on province and diagnostic procedure, the wait can range from two to 24 weeks.

As reported in a December 2003 article by Kerri Houston for the Frontiers of Freedom Institute titled “Access denied: Canada’s health-care system turns patients into victims”, in some cases, patients die on the waiting list because they become too sick to tolerate a procedure. Miss Houston says hip-replacement patients often end up non-ambulatory while waiting an average of 20 weeks, and that’s after waiting 13 weeks just to see the specialist. The wait to get diagnostic scans followed by the wait for the radiologist to read them just might explain why Cleveland, Ohio, became Canada’s hip-replacement center.

Adding to Canada’s medical problems is the exodus of doctors. According to a March 2003 story in Canada News, about 10,000 doctors left Canada in the 1990s. Compounding that exodus is the drop in medical school graduates. According to Miss Houston, Ontario has turned to nurses to replace its bolting doctors. It is “creating” 369 new nurse practitioner positions to take up the doctor shortage.

Some patients avoided long waits for medical services by paying for private treatment. In 2003, British Columbia enacted Bill 82, an “Amendment to Strengthen Legislation and Protect Patients.” On its face, Bill 82 is to “protect patients from inadvertent billing errors.” That’s on its face. But according to a January 2004 article by Nadeem Esmail for the Fraser Institute’s Forum and titled “Oh to be a prisoner,” Bill 82 would disallow anyone from paying the clinical fees for private surgery, where previously only patients were forbidden to do so. The bill also empowers the government to levy fines of up to $20,000 on physicians who accept these fees or allow such a practice. That means it is now against Canadian law to opt out of the health-care system and pay for your own surgery.

Health care can have a zero price to the user, but that doesn’t mean it’s free or has a zero cost. The problem with a good or service having a zero price is that demand will exceed supply.

When price isn’t allowed to make demand equal supply, other measures must be taken. One way to distribute the demand is by queuing — making people wait. Another is to have a medical czar who decides who is eligible, under what conditions, for a particular procedure — for example, no hip replacement or renal dialysis for people over 70 or no heart transplants for smokers.

I’m wondering just how many Americans would like Canada’s long waiting lists, medical czars deciding what treatments we get and an exodus of doctors.

Walter E. Williams, the John M. Olin Distinguished Professor of Economics at George Mason University, is an adjunct scholar at the Cato Institute.