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Innovation lags

Critics of a national health program point to a dearth of innovation in medical technology and prescription drugs, which can lead to decreased access to life-saving medical equipment and medications.

Throughout the 1990s, opponents of the Canadian system gained considerable political traction by pointing to the provincial governments that were increasingly constraining their health care budgets, which led to more rationing of services and facility shortages.

For instance, Canada uses its medical-imaging scanners more intensively than do the U.S. or Britain, largely because it ranks low among developed countries in the number of imaging machines available throughout the country.

At the beginning of 2005, Canada had 176 MRI scanners, magnetic resonance imaging machines used to provide clear pictures of the body to detect diseases. Compared with 20 developed countries reporting MRI data for 2005, Canada ranked 12th, with about five MRI scanners per 1 million people, according the Canadian Institute for Health Information.

“The lack of MRI and CAT scan machines in Canada is a direct result of the single-payer system,” said Sally Pipes, president and chief executive officer of the Pacific Research Institute, a San Francisco health care think tank.

The U.S. reported the second-highest number of MRIs, behind Japan, with 27 machines per 1 million people.

A paucity in medical-imaging equipment is not the only consequence of a national health system. Because Canada’s government pays for prescription drugs, prices for the medications cannot reach as high as in a free-market system.

Ms. Pipes points out that as the biotech industry heads toward major breakthroughs in life-saving medications, specifically for cancer, Canadians may not have access to the drugs as quickly.

“There are very few Canadian drug companies, and American drug companies often don’t sell their drugs there,” she said. “Because of the enormous cost of developing a drug, businesses must first recuperate their costs before entering a market that dictates prices, which are lower than other places.”