Let’s Not Repeat Canada’s Healthcare Mistakes
Demonstrators in 50 cities across the country took the streets last month to demand a government takeover of America’s health system.
The Democrats who control Washington are trying to give those activists what they’re asking for, albeit in piecemeal fashion.
In recent weeks, they’ve proposed lowering Medicare’s eligibility age and adding dental, vision and hearing benefits to the entitlement. Democrats in Congress have also offered a plan to provide federally funded health coverage to low-income people in the 12 states that have yet to adopt Obamacare’s Medicaid expansion.
This drive to put the government in charge of an ever-greater share of our healthcare system is misguided. For evidence, look no further than Canada, the country where I grew up and started my career.
Our northern neighbor’s government-run health insurance scheme saddles patients with long waits for low-quality care — when it doesn’t ration care outright.
Even before the COVID-19 pandemic, long delays for treatment were a fact of life for Canadians. In 2019, the median wait time for specialist care following referral from a general practitioner was nearly 21 weeks, according to the Fraser Institute, a Vancouver think tank.
In 2020 — a year in which more than 1.2 million Canadians were waiting for care — the median wait for specialist care grew to 22.6 weeks. In 1993, the median wait was 9.3 weeks.
These long waits are costing lives. Between April 2019 and December 2020, more than 10,000 patients died while waiting for a specialist appointment, a procedure, a diagnostic test or a surgery, according to a recent report from the Canadian think tank SecondStreet.org. Given the dearth of government data, it’s likely that the death toll is higher still.
And there’s no way around the waits. Canada bars private health insurance for anything deemed “medically necessary” by the government. So people who want or need timelier care effectively have to leave the country.
Canadians pay dearly to wait in line. The country’s single-payer system is far from free. Fraser estimates that the average Canadian family of four pays more than C$14,400 (US$11,545) in taxes for their shoddy public insurance coverage.
Then there are the indirect costs associated with waits. Fraser says waiting for care cost patients C$2.8 billion (US$2.2 billion) in lost productivity in 2020. That averages out to C$2,254 Canadian (US$1,796) per patient.
After accounting for lost weekend and evening time, that figure balloons to C$6,838 (US$5,450) per patient.
Canadians also lack access to the latest pharmaceuticals. The federal government’s Patented Medicine Prices Review Board ensures “that the prices of patented medicines sold in Canada are not excessive,” as the agency puts it. In layman’s terms, it effectively caps drug prices.
Thanks to those price controls, pharmaceutical companies are slow to enter the Canadian market.
A separate Fraser report looked at 218 drugs approved between 2012 and 2019. It found that medicines took 469 days longer, on average, to earn a go-ahead in Canada compared to the United States.
According to research published by the Galen Institute, a U.S. health policy think tank, just 44% of new drugs that hit the market between 2011 and 2018 were available in Canada, compared to 89% in the United States.
For a patient whose life depends on accessing a breakthrough drug for some rare disease or a revolutionary new cancer therapy, such delays aren’t just frustrating — they’re potentially fatal.
Simply put, there’s little about Canada’s single-payer system that is praiseworthy, much less worth copying. That was one upshot of the recent World Index of Healthcare Innovation, compiled by the Foundation for Research on Equal Opportunity, a research group.
The study ranked the world’s healthcare systems based on four categories: quality, choice, science and technology, and fiscal sustainability. Canada wasn’t even in the top 20 — despite having the 10th-largest economy on the planet.
The cause of these healthcare woes is no mystery. As with any single-payer system, Canada’s health sector relies on a fixed amount of government funds to meet a complex and unpredictable array of healthcare demands.
When those government resources prove insufficient, rationing, long waits and low-quality treatment are the inevitable result.
What is mysterious, however, is why any American — or lawmaker — would want to import Canada’s healthcare system to the United States. Indeed, if Medicare for All becomes a reality, Americans really will have something to protest.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is “False Premise, False Promise: The Disastrous Reality of Medicare for All,” (Encounter 2020). Follow her on Twitter @sallypipes. Read Sally Pipes’ Reports — More Here.Read More