Dreams of Michael Moore and Some Krummey Truths, eh?

Scott Krummey

I have been waiting patiently for months to write this commentary.Healthcare is a favorite issue of mine because I hope to be involved in the medical field someday post-Colgate, and also it was the issue that sparked my interest in world affairs. Ah yes, flash to the dream sequence. The year is 2001, I am innocently watching Bowling for Columbine – specifically the scene in which Michael Moore plants a deluded plug for Canada’s nationalized healthcare system. While visiting Canada to make some fleeting, circular logic about guns, he asks a man with a bandage on his head how much he paid for his recent care – to which the man unwittingly responds “Nothing.” At the time I was new to the politics of this issue, but this scene made my stomach acid leap into my throat. How can anything, especially a service as specialized as healthcare, cost nothing? Now back to reality. Unfortunately, there are people who entertain the belief that blanket coverage for all Americans will not only cost less but will also guarantee coverage for those who cannot obtain it on their own. All of this is fine and good in theory, but to realize the problems that nationalized care can cause, look no further than our friendly neighbors to the north. The fundamental problem with having zero upfront cost for a service is that demand exceeds supply. In a free market, price would rise until demand and supply were equal again. Somehow demand must be limited, which is often achieved by making people wait for services. Basic care in Canada reflects these whacked-out laws of supply and demand. A 2004 study revealed that the average waiting time between referral from a general practitioner to treatment was 17.7 weeks, up from 16.5 in 2002. Perhaps worse is that diagnostic procedures that are done on demand in America, such as MRI and ultrasound, entail wait times of two to 24 weeks in Canada. Consequently, there are oogles of stories about patients dying or becoming unable to tolerate treatment while on waiting-lists for common and basic procedures. Who could blame the thousands who come south each year for treatment in Detroit, Seattle, or New York?Once this type of cycle begins, it snowballs into increased government control while diminishing the power of patients and doctors. Because of the horrendous wait-time, many patients (cough, with the means necessary, cough) fund private treatment. The response to such a market outside of the public system is to outlaw it, which was attempted in 2003 by Canadian Bill 82 that disallowed payment of clinical fees for private surgery. As harsh as it sounds, having the lower economic levels bound to the social care system while those who can afford it receive better and faster care defeats the purpose of blanket coverage in the first place. Maybe all of this is why Canada lost 10,000 doctors in the 1990s, and has seen medical school applicants plummet. As I have outlined before, the real problem with American healthcare is cost, not coverage. The only way to bring down such a market is through increasing the freedoms of the market. The first steps have been taken in the implementation of Personal Health Accounts and increased freedom of hospitals to specialize. Certainly, these are steps in the right direction – away from the tendency to increase nationalization of care. In hopes of avoiding months-long waitlists for routine procedures, and propped-up real costs, let’s hope we continue in this direction, eh?