Posted on 12/07/2002 12:14:01 PM PST by freeforall
December 3, 2002
Public monopoly, health-care hindrance
By RORY LEISHMAN -- London Free Press
According to the Fraser Institute, the time Canadians have to wait for access to health-care services has increased by about 69 per cent since 1993.
Left-wing critics scoff at this estimate: They insist there is no evidence to support the perception of longer medicare waiting times.
What does the Romanow Commission on Health Care have to say?
"The problem is not just one of perception," it concedes. "There is evidence to suggest there are problems in waiting times for some services, but not in others."
To illustrate the point, the commission cites the testimony of a B.C. woman, Carolyn Attridge: "I am one of that great cadre called elective patients. We are not seen as emergencies. I have recently had a hip replacement; I was waiting for that replacement for almost two years.
The word elective is offensive; it isn't as though we're going to the store to buy some shrimp vs. some liver; we have no choice about using the health-care system."
The problem of excessive delays even applies to life-saving treatments.
"There still are instances in some provinces when individuals have to be transferred outside the country to receive care for life-threatening conditions," the Romanow Commission admits. "This cannot and should not be allowed to continue."
However, the commission could not disclose the length of waiting times for health care, because of a lack of information. That's typical.
"Unfortunately," the commission acknowledges, "we lack the basic and critical information needed to measure the results, assess performance and judge the quality of the health-care system."
How can that be? In 1992, the federal and provincial ministers of health established the Canadian Institute for Health Information with a mandate to identify and promote national health indicators.
Over the last eight years, this outfit cost Canadian taxpayers $190 million. Why has it not yet compiled even basic and critical information about waiting times for the full range of medical services in each province?
While the Romanow Commission has not addressed this crucial question, it's a focal point of a tract by the Atlantic Institute of Market Studies (AIMS) entitled, Definitely Not the Romanow Report: Achieving Equity, Sustainability, Accountability and Consumer Empowerment in Canadian Health Care.
The authors, Brian Lee Crowley, Brian Ferguson, Dr. David Zitner and Brett J. Skinner point out: "The underlying problem with the system is that it operates essentially as an unregulated tax-financed, pay-as-you-go monopoly."
Private-sector monopolies are bad enough: Public-sector monopolies are worse, because the government that runs a public-sector monopoly cannot be counted upon to regulate it effectively. Medicare is no exception.
As the AIMS report observes: "The regulatory and oversight function government should play is frustrated by its conflict of interest as the ultimate provider of many health care services."
Nonetheless, let us suppose the new Health Council of Canada proposed by the Romanow Commission will somehow provide Canadians with clear information about the basic performance of the system. Could this reform lead to a reduction in waiting lists and lack of service?
Not at all. The underlying weaknesses of Canada's medicare monopoly would remain. The key to efficiency and consumer choice in the provision of medicare, no less than in the production and distribution of food, clothing and all other material necessities, is private-sector competition.
Romanow never tires of pointing out the gross deficiencies of private-sector medical insurance in the United States. Yet the Swiss, the Dutch, the Swedes and many others have proven it's not beyond the ingenuity of humankind to combine private-sector competition in the delivery of health-care services with a public-sector guarantee of comprehensive medicare insurance for everyone.
Alas, Romanow is blind to the advantages of private-sector competition. Like all socialists and most liberals, he seeks to extend the medicare status quo.
He cannot see there can be no fundamental improvement in the quality of medicare in Canada so long as Canadians have no choice, but a veritable public-sector health-care monopoly.
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