A cure worse than the disease

Don't wait, wait, wait to find you've sealed your fate

By Ed Feulner
Emily Morley got some very bad news in March 2006. Her cancer had spread, the doctor informed the 67-year-old Canadian. She would need to see an oncologist.

Then Ms. Morley got some really bad news: She would have to wait several months before she could get an appointment.

Only after her family raised a ruckus, calling the local paper and starting a petition to demand she get care, did the government get her a specialist. Then, it was more bad news: Ms. Morley had only three months to live.

At least she had time to put her affairs in order. "Had her family not intervened," noted provincial lawmaker Don McMorris, "it is quite likely that Emily Morley may have died before even seeing an oncologist for the first time."

But that's how a single-payer, or universal, health care system works (so to speak). Even the very ill routinely hurry up and wait.

Alarmingly, Congress is gearing up to "reform" American health care along Canadian lines - and proponents are trying to take a short-cut to get there. According to former Medicaid Director Dennis Smith, proponents of a government-run health system are hoping to enact a bill by bypassing the usual, lengthy bipartisan review process.

The goal of any reform, supposedly, would be to trigger competition between government-run health care and currently existing private health insurance plans. Yet, Mr. Smith warns, the government will inevitably tilt the playing field to favor its own plan, running private coverage out of business. At the end of the day, Americans could be left with a single, government-run health plan a la Canada's.

So let's take a look at what such a system means for our northern neighbors.

As Sally C. Pipes, president of the Pacific Research Institute and a former Canadian citizen, recently told Congress, today some 750,000 Canadians are on a wait-list for medical procedures. Further, 3.2 million (out of a population of 32 million) are waiting for a chance to see their primary-care physician. Once a PCP diagnoses a problem, Canadians must keep on waiting - 17.3 weeks on average - before they can see a specialist.

Why? "The Canadian government controls costs by rationing care," Ms. Pipes explained. "Canada ranks 14th out of 25 [Organization for Economic Co-operation and Development] countries in MRI machines, and 19th out of 26 countries in CT scanners." Long wait times and lack of equipment force many to seek care in the United States.

Take member of Parliament Belinda Stronach. She strongly supports Canada's health care system. But where did she go when she was diagnosed with cancer in 2007? To California, where she paid for treatment out of pocket. Then there was a mother in Calgary, Alberta, who had to be flown to Great Falls, Mont., to deliver her quadruplets. This relatively small American city had better facilities than any hospital in the wealthy province of Alberta.

Our current system is far from perfect, of course. Millions of Americans lack health insurance, prompting many to put off seeing a doctor until a small, treatable problem has become a larger, more threatening condition.

But the answer isn't to try and cover everyone through a single-payer system. We would be better off changing how the federal tax code treats health insurance (which, illogically enough in our 21st century economy, ties it to our jobs). Such a change would foster genuine competition among insurers by allowing Americans to shop for the coverage that suits them best in an open market.

Current policy provides unlimited tax breaks for health coverage provided through employers. Meanwhile, Americans who want to buy their own insurance must do so with after-tax dollars. Few can afford to do that, especially since insurers are more interested in competing for big group coverage (more lives, more money) rather than individual or family-based coverage.

Lawmakers could change this, and even provide vouchers or other forms of direct assistance to help poorer Americans buy private plans they would own and control. This would also make insurance portable when people change jobs.

Maintaining our standard of care is critical. There's a reason Canadians "fly south" for treatment: Our system, for all its flaws, provides superior quality and access to care. Let's ensure that policymakers, in their understandable zeal to reform health care, don't make changes that weaken the entire system.

Ed Feulner is president of the Heritage Foundation (heritage.org).

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