The truth about health care makes us sick

In a shocking breach of etiquette the Canadian Medical Association just proposed loosening the governmental stranglehold on health care before the patient, having turned blue, becomes completely unresponsive. Much virtuous swooning ensued.

As it spiralled toward the drawing-room floor, the Globe and Mail led off a Tuesday news story, under the headline “MDs launch fresh bid for two-tier care,” by gasping that “Canada’s doctors want to be able to work simultaneously in both the public and private systems, a flexibility that critics say could lead to queue-jumping and further depletion of public health care.”

When “critics say” appears in the first sentence of a story, we old-timers diagnose opinion disguised as news. And before bothering us with trivia like what the CMA actually suggested, the piece continued, “It’s also a proposal that puts the medical community on a collision course with Prime Minister Stephen Harper, who argues that physicians would have an incentive to stream patients into the private portions of their practice.” So there. Even hard-right neo-cons think this is right-wing lunacy. We’re just saying.

On Wednesday, the paper still had the vapours, editorializing (at least it was in an editorial this time) that: “Perhaps the key reason that the Canadian health system costs less than the U.S. system is that governments pay the tab for hospitals and physicians. That monopoly power as a single purchaser has enabled governments to restrain those costs while the bills for privately funded medical products such as prescription drugs have gone through the ceiling.”

Forsooth, my equilibrium is returning. Wave away those rubes who think governments have restrained costs by restricting services through such short-sighted measures as reducing medical school enrolment and underpaying doctors who then leave (one in nine Canadian-trained doctors is practising in the U.S.) or retire. Four million Canadians don’t even have a general practitioner? Mention it not; such vulgar persons are hardly the sort with whom prestigious editorial writers associate.

Instead on Wednesday the Toronto Star chimed in editorially that: “Once again the Canadian Medical Association, the national lobby group for Canada’s doctors, has started beating the drums for two-tier health care.” With the sang-froid of Marie Antoinette, the Star scorned the proposal: “It rests on two flawed assumptions: First, that medicare is broken, and second, that it is too expensive for governments to fix.”

Dismiss the rustic jibe that if medicare looks like this when it isn’t broken, I shudder to think how it will look when it is, and for once I shouldn’t have to wait long to find out, with one in three Canadian doctors already over 55 and one in nine over 65. Instead, Wednesday’s Globe ran a gravely sublime academic opinion that: “The CMA says the public would benefit from shorter waiting lists. But long wait times and suboptimal care are, in large part, a function of doctor and nursing shortages. For-profit clinics would not lead to the training of a single additional doctor or nurse. Indeed, such clinics would suck desperately needed personnel from not-for-profit hospitals and clinics. Physicians practising in public and private settings have a vested interest in keeping waiting lists long in publicly funded facilities.”

‘Twere ill-mannered to quote Henry Hazlitt, 60 years ago, that: “Today is already the tomorrow which the bad economist yesterday urged us to ignore.” Or that “governmental policy almost everywhere today tends to assume that production will go on automatically, no matter what is done to discourage it.” The state may have caused the shortage of doctors but, gad Sir, everybody knows continuing to bleed the patient is the way to restore strength. And who among us, righteously collecting our own salaries, does not resent doctors who dissipate their youth in hard study, disport themselves all day preserving life and health then presume to request a decent reward? Dedicated professionals in despair over their inability to provide proper care within our Soviet-style system? Pshaw. They’re just sinister, self-interested miscreants.

Should vertigo return, focus on the soothing reflection that it must be doctors in private practice who create waiting lists due to their own deplorable self-interest. Resolutely deny admission to any thought that, in mere shabby reality, the state did it and, by happy coincidence, thereby saved itself a big stack of cash on treatments it didn’t provide.

Should some yokel blurt that only public systems have waiting lists, pass, prithee, the smelling salts. They mask not just the displeasing odour of heresy but the far worse stench of ill breeding.

[First published in the Ottawa Citizen]