Out current infatuation with the need for fundamental health system reform in the United States has given us many stories to reflect serious problems in the current system. Many people look north to Canada and think they see a system with better care and less cost. But as in most countries, Canada has very significant problems and some very unhappy consumers. (LA Times Article) The basic issue, as here, is the increasing cost and the difficulty in funding that cost through tax increases. Most Canadian provinces and local health authorities are facing both cost increases and a major budget shortfall. The response is to delay availability of services; in other words, rationing.
For those who think that somehow government operation of the health care system should raise few concerns, the Canadian experience, and that of other national health or national health insurance systems, should raise a few alarms. You can literally wait for months or years to see a doctor or have a necessary surgery, all because your condition is not deemed urgent, acute or an emergency. And who is making those decisions? Not the treating physician. The experience related in the LA Times article, of a person in significant pain which affects her daily functioning, would be viewed by most of us as something that required quick attention, particularly if it was happening to us.
Different methods of handling provision of and payment for health care have advantages and disadvantages and may work better or worse for various nations and their values. In this country, it is very hard to imagine the citizens accepting a government agency deciding when and where, and even whether, they got health services. That accounts for much of the fear surrounding current reform proposals. Some of the concerns may be exaggerated and irrational, but reform proponents need to explain how we avoid ending up in the same position as Canada, given our even worse cost problem. Meanwhile, in Canada people are coming to the US for services and patronizing private facilities to cope with their frustration.