Thursday, January 20, 2011

Health Care Reform: A Canadian Perspective

Just as I was writing my previous post about Canada's health care, this story comes to light. It turns out that a Quebec clinic was finding ways to accept payments in order to expedite service or guarantee patients can see their specialist of choice. 

In Canada there are laws that restrict clinic's ability to charge patients for services that can be offered under the provincial plan, but it seems this clinic was creative in their mechanism and it will be difficult to pin anything in specific on them. That is not the issue though, the issue is that this isn't the only case, and clinics and doctors that did not receive bribes or 'payments' report these are offered to them all the time. But the recent story prompted discussion of the need of a system overhaul, at least from the conservative leaning National Post. Critics claim that the issue is unethical practices.

But let's think about it for a second, can we blame the patients for offering such payments for being able to see the specialist they trust before they croak? This is a life and death issue, so nothing can be said about the morality of the patients. How about the doctors? Can we judge doctors or clinics for accepting the please of "please accept this payment and save my life rather than letting me die while I stand in line"? I don't think so... The only thing they can be accused off is failing to comply with their province's (or the federal) draconian healthcare regulations.

So who can we judge morally? There is only one direction we can point to: Government!

Let's compare the healthcare issue to another essential services: Food. After all, we all have to eat. One can easily notice that few people can afford eating at a gourmet restaurant every day while many cannot afford it and instead they eat menu deals at McDonald's or a similar fast food outlet. Some people can barely afford that, if at all. So what does the government do? 

1. Legislate that McDonalds is the only legitimate food provider in the country.

2. Eliminate all higher end restaurants.

3. Limit by law the capacity each outlet can serve.

4. Everyone pays what they could afford before, so the rich still pay gourmet prices (perhaps even more!) while the needy don't pay anything.

5. Install a mass bureaucracy with 0 accountability to oversee this.

What will the outcome be? Well, first of all you are going to see extremely long line ups (will be familiar to anyone who grew up in a communist country). All gourmet chefs will move to another country, where their skills are appreciated. Lastly, there will be a big industry of bribes (legitimate or otherwise) of ways to skip the line-up or to get the highly coveted slice of bacon which is officially cheap, but in short supply.

In the Soviet Union all stores were governmental (with minor exceptions). Officially, everything was affordable, but unavailable. Unless of course you have pull with the local Party connection to get access to the 'lower cellar' where the real goodies are kept.

Communism/Socialism is undoubtedly the greatest economic disaster of the 20th century. It turned whole nations of hard working people into moochers, thieves and crooks, to the point where corruption on a  mass scale was completely normal. So why are we using such a failed model for health care?

A politician can attempt to correct the system, out of the best intentions of his/her heart. But the situation will not change until the entire underlying model of the system is done away with.


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