- The Washington Times - Wednesday, January 26, 2000

Getting medical help in Canada isn't as simple as going to the hospital. Earlier this month, a Toronto man distraught over his infant's condition and the long wait to see a physician about it actually took a doctor hostage to speed up the process. Unfortunately, the New York Times reports, the police arrived before the care did and shot the man to death. Interminable waits and untimely death are what's left of the free, universal health care the Canadian government once promised citizens there.
Canada's problems are worth considering in the wake of President Clinton's latest prescription for the health care system in this country. The man who once announced that the era of big government was over now boasts of making the "largest investment in health care since the establishment of Medicare in 1965." Given the financial instability of the tottering Medicare program and given the regulatory constraints it imposes on patient choice and physician service, one would have thought that the very last thing anyone would want to do would be to increase Americans' dependence on it. But when President Clinton gives his State of the Union remarks Thursday night, that is exactly what he plans to do. With tax receipts rolling into the U.S. Treasury, apparently there is no program too big or too unwieldy to suit the president's legacy.
Among other things, the president's plan would open Medicare's doors to persons as young as 55 and offer a 25 percent tax credit to encourage them to take advantage of the offer, even though the program was going bankrupt just trying to cover the physician and hospital costs of seniors. He would expand coverage of the Medicaid program to include persons in group homes, an entitlement for low-income persons with its own financial strains. And he calls for expanding a states-based program now insuring children to include their parents.
These are all incremental steps, but together they help guarantee that government remains this country's largest purchaser of health care. Nowhere does Mr. Clinton's plan show any recognition that more government is the problem here, not the solution. So long as government insists on treating health care as something other than a service to be "governed" by supply and demand much as food is regulators will continue to do the job with all the Postal Service-like efficiency and cost-control one has come to expect from them.
So what if health care costs a lot? Some things are too important to measure by mere price, the argument goes. No doubt that's what the Canadians argued when the government took over health care in the 1970s. But "free" care there has turned out to be expensive in ways government advocates never expected.
Those who don't put a gun to doctors' heads to speed up service there can face surreal waits. The Times interviewed a 58-year-old grandmother who had been waiting for open-heart surgery for five years. Prior to the surgery she had spent the night on a gurney in a hallway, exposed to icy drafts and raving drug addicts when ambulances arrived with new patients. Another 66 patients spent the same night in the same hallway. The new arrivals were lucky, though. In Toronto, overcrowding one day this month forced hospitals to turn away ambulances at 23 of the city's 25 hospitals. In Vancouver, officials at a local hospital report that delays are so serious now that some 20 percent of heart-attack patients who need treatment in 15 minutes must now wait an hour or more. Unable to meet demand, Canadian doctors are encouraging their patients to go to the United States for treatment.
The only practices where there are no problems are dentistry and veterinary medicine, both of which allow for private medicine. "So we have the absurdity in Canada," a medical historian wrote in a Canadian paper, the National Post, "that you can get faster care for your gum disease than your cancer, and probably more attentive care for your dog than your grandmother." The shortage of care resulted from the rising demand for and costs of "free medicine." Unable to reduce that demand, government officials there arbitrarily reduced medical services. Hence the long waits.
President Clinton's proposal takes the United States another step toward the Canadian model, another step toward the day when the sick feel obliged to take hostages to receive care. No matter how inexpensive Mr. Clinton says his plan is, America can't afford it.

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