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red states rule
07-27-2007, 07:15 AM
Another reason why government run health care does not work


A Canadian Doctor Describes How Socialized Medicine Doesn't Work
By DAVID GRATZER | Posted Thursday, July 26, 2007 4:30 PM PT

I was once a believer in socialized medicine. As a Canadian, I had soaked up the belief that government-run health care was truly compassionate. What I knew about American health care was unappealing: high expenses and lots of uninsured people.

My health care prejudices crumbled on the way to a medical school class. On a subzero Winnipeg morning in 1997, I cut across the hospital emergency room to shave a few minutes off my frigid commute.

Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care.

I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic — with a three-year wait list; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.

Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.

These problems are not unique to Canada — they characterize all government-run health care systems.

Consider the recent British controversy over a cancer patient who tried to get an appointment with a specialist, only to have it canceled — 48 times. More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months. In France, the supply of doctors is so limited that during an August 2003 heat wave — when many doctors were on vacation and hospitals were stretched beyond capacity — 15,000 elderly citizens died. Across Europe, state-of-the-art drugs aren't available. And so on.

Single-payer systems — confronting dirty hospitals, long waiting lists and substandard treatment — are starting to crack, however. Canadian newspapers are filled with stories of people frustrated by long delays for care. Many Canadians, determined to get the care they need, have begun looking not to lotteries — but to markets.

Dr. Jacques Chaoulli is at the center of this changing health care scene. In the 1990s, he organized a private Quebec practice — patients called him, he made house calls and then he directly billed his patients. The local health board cried foul and began fining him. The legal status of private practice in Canada remained murky, but billing patients, rather than the government, was certainly illegal, and so was private insurance.

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