February 27, 2006


As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging (CLIFFORD KRAUSS, 2/26/06, NY Times)

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

Dr. Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

"We've taken the position that the law is illegal," Dr. Day, 59, says. "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

Dr. Day may be a rebel (he keeps a photograph of himself with Fidel Castro behind his desk), but he appears to be on top of a new wave in Canada's health care future. He is poised to become the president of the Canadian Medical Association next year, and his profitable Vancouver hospital is serving as a model for medical entrepreneurs in several provinces.

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services. Prime Minister Stephen Harper and other politicians remain reluctant to openly propose sweeping changes even though costs for the national and provincial governments are exploding and some cancer patients are waiting months for diagnostic tests and treatment.

But a Supreme Court ruling last June — it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

"The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services," the court ruled.

In response, the Quebec premier, Jean Charest, proposed this month to allow private hospitals to subcontract hip, knee and cataract surgery to private clinics when patients are unable to be treated quickly enough under the public system. The premiers of British Columbia and Alberta have suggested they will go much further to encourage private health services and insurance in legislation they plan to propose in the next few months.

Private doctors across the country are not waiting for changes in the law, figuring provincial governments will not try to stop them only to face more test cases in the Supreme Court.

So all this time when the Left has insisted that we adopt Canadian-style health care it was really just a secret plan for more privatization?

Posted by Orrin Judd at February 27, 2006 8:50 AM

I'm waiting for the Junior Senator from New York to answer a question from a blogger during Her run for president:

"So, would Hillarycare have forbidden a role for
the private sector in providing health care to

Posted by: John J. Coupal at February 27, 2006 10:29 AM

The Canadian universal health insurance plan hasn't worked because the government has not allocated enough money to cover the needs of the population it's supposed to cover.
If the USA ever adopts universal health insurance coverage it should of course include private insurance that covers the gaps not covered by the government plan as is the case now with medicare.

Posted by: morry at February 27, 2006 11:50 AM

Can't have it all, military and socialized medicine.

Posted by: Sandy P. at February 27, 2006 12:04 PM

"...has not allocated enough money to cover the needs..."

There's an explanation in a nutshell: if only the government would allocate infinite funds, the socialist approach to medical care would succeed; since it won't, it dooms it to the failure we see.

Posted by: Vic at February 27, 2006 1:02 PM

Just what is socialized medicine? As far as I can tell the Canadian doctors are not employed by the Canadian government. They get paid by the insurance carrier which happens to be the local provincial government. I don't know how the hospitals are paid but I suspect that there are severe limitations on them, which is why private hospitals are springing up. And it is why there seems to be enough people willing to spend enough money to make those enterprises successful. Someone has to spend the money if the government won't.
The last time I looked the current American health care system sucks up about 13% of our annual GDP (that's about $13 trillion). The Canadians don't spend anywhere close to that but they need to, and that's why the private sector is stepping into the government monopoly.
A universal health insurance program in the USA would be a whole lot different than the Canadian system.

Posted by: morry at February 27, 2006 4:34 PM

Correction: $1.3 trillion not 13

Posted by: morry at February 27, 2006 4:37 PM

Yeah, that whole "...the Government will provide everything the People need..." thing has worked so successfully, right? In exactly, oh, ZERO PLACES, right?

Posted by: ray at February 27, 2006 5:44 PM