Wednesday, January 19, 2011

Canada's Medicare Gambit

Canada is generally a great place to live. Except for the winter, which I don't care much for, life in Canada is comfortable, fulfilling, and by all accounts good. However, there is one particular area where Canada trails much of the developed world: Health Care!

I know many immigrants who came here for all the goodness that life in Canada can offer, that insist on paying good money in order to maintain their health coverage in the 'old country'. Many of them schedule their seasonal family visits around their need for more than trivial medical procedures, etc.

Why exactly is that?

Canada's socialized healthcare system has become a political 'Holy Cow'. Despite of the terrible service Canadians of all provinces have become accustomed to, no politician can suggest a substantial reform that can reduce costs and improve service without paying a substantial political price. Meanwhile, costs are skyrocketing (about 56% of Ontario's provincial budget), the basket of covered services keeps decreasing, waiting times are unacceptable and the country is suffering a chronic doctor shortage.

Canada's Medicare policy has become subject to Canadian's national pride, especially considering that much of Canada's image of national pride comes from differentiating ourselves with our southerly neighbours. We are so proud of having 'Free' and 'Universal' health care that we go as far as suggesting the Canadian model to the much troubled American system.

But is the Canadian system working? Are we getting good universal service for our money? Most obviously no... Otherwise how can we explain the fact that many Canadians choose to travel to the states and pay good money for speedy service, and many new Canadians travel to their home countries to get service.

Instead of addressing the real problems with our system, politicians keep attacking 'inefficiencies' as the source of all our maladies. But how can we address 'inefficiencies' where the entire system, from the patients, through the bureaucrats to the Health Minister are unaccountable for their actions. Can we really be surprised when something like the eHealth scandal happens considering the minister responsible was unscathed by it and was almost elected the mayor of Canada's largest city?

What we need is fundamental reform of the system. As a first step, the provincial governments must pave the way towards a two-tier system. Second step would be to transition towards a voucher system, where Canadians would be able to choose their providers. Only then, provincial health insurance bureaucracies must be phased out.



  1. Trying to fix Canada's health care system is like the domestic version of the "two-state solution". Politicians keep trying things which have proven to fail over and over for decades rather than admit they've been so wrong from the start.

  2. The old definition of insanity, eh?

    It became my position that Canadians are too docile about things like that (see my kind words on the TTC).

    Until politicians and bureaucrats will be rewarded (or not penalized) for doing the same thing, we will keep getting the same thing.