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Single-Payer Blues Michael Arnold Glueck, M.D., and Robert J. Cihak, M.D., The Medicine Men Do we really want a single payer medical system? Canada's social system is expected to collapse soon as a result!
An unfortunate consequence of the forthcoming Democratic control of the House and Senate is that the Dems will try to push a single payer medical system. Add to this that Hillary is lining up her ambulances and chasers to again push for a system that was rejected in 1993.
The debate over single payer goes on. It sounds good with one payer rather than hundreds, but the single payer will be the government which almost always leads to reduction of services, "cost saving"(cutting) measures, substitutions, increasing rates, and ultmately rationing.
Advocates of the single-payer system often cite Canada as the paragon of virtue. But there is a slight catch-22. The canadian social structure is on the verge of collapse.
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The biggest Canadian fiscal drain comes from the single-payer medical system. "Current model of health-care delivery leading us down the path to financial ruin," states the lead editorial in the Calgary Sun. Health-care costs would consume 50 percent of Alberta's budget by 2016 (according to the Fraser Institute) or 2017 (according to Aon Consulting, a firm hired by the Alberta government).
Health care would devour 100 percent of the provincial budget by 2030, if present trends continue.
By 2040, the proportion of the Canadian population over the age of 65 will have increased from 13 percent to 25 percent, and will continue to rise, according to optimistic projections by the United Nations.
Canada's birth rate is now 1.5, or more than 25 percent below replacement level, having decreased by 25 percent between 1992 and 2002. It could easily reach 1.0 in another decade.
In 1959, Catholic Quebec had the highest birthrate in Canada, but it is now the lowest. While Quebec separatists, who currently outnumber federalists, say they must secede from Canada to preserve their heritage and culture, that culture is already threatened with extinction by massive debt, low productivity, and abysmal birthrate, stated former Premier Lucien Bouchard.
"We don't work hard enough. We work less than Ontarians and infinitely less than Americans," he said. Quebec could not sustain its social programs while working less and having few children (Joseph D'Agostino, PRI Weekly Briefing 11/10/06).
The conventional government solutions won't be feasible in the long run, stated a Fraser Institute report. These include raising taxes (to 100 percent of income?), borrowing more money, delisting more services, and lengthening waiting times. The Fraser Institute's suggestions (co-payments, permitting private payment, and permitting competition between public and private hospitals) are considered "too right wing" (Calgary Sun 10/8/06).
Although at least 65 percent of Canadians still say they get good care, a recent poll showed that only 53 percent of Albertans were satisfied with recent emergency care. The health authority is hiring more social workers and will provide a 24-hour hotline for suggestions (Calgary and Edmonton Sun 10/8/06). The government has rolled out a high-profile campaign to cut waiting times for cancer surgery. Meanwhile, "line-ups for non-cancer surgeries grow" and "researchers find resources being ‘cannibalized' to reduce cancer waits" (National Post 9/22/06). An estimated 90,000 Canadians sought medical care outside their country in 2005. The cry "no two-tiered system" could be replaced by "set our patients free," stated a lead editorial (National Post 9/18/06). So, although a single-payer system sounds good on paper, in debates and in editorials by newspapers who want more government control, the Canadian experience should make us careful for what we ask. Editors Note: This week's commentary is written by Michael Arnold Glueck, M.D. Contact Drs. Glueck and Chihak by e-mail. Michael Arnold Glueck, M.D., Newport Beach, Calif., writes on medical-legal and allied ethical issues locally and nationally. Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons.
Editor's note:
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