Catastrophe - Dick Morris [51]
Why is the Canadian health care system set up this way? Because the government is trying to offer everything to anyone—and ending up giving too little to everyone. Just as in America, there aren’t enough human resources—doctors and nurses—to go around. Even though we have more medical personnel per capita in the United States than Canada does, it’s still not enough to give everybody full coverage.
Ken Lee of the Conservative Party of Manitoba summarizes the defects in the Canadian system:
Canada’s model of universal health care is failing. With unlimited demand for free services and a virtual monopoly delivering limited health services, the result has been an unsustainable level of public spending (up to 43 percent of gross government revenue is devoted to health care) and increasing rationing of services in the form of waiting lists. The monopoly that delivers health care is dominated by public sector unions that resist alternative forms of service delivery, rendering reform difficult. Bureaucrats determine what services are provided, what drugs can be prescribed, and what procedures can be offered. There is no accountability to the patient. The patient does not necessarily come first; unfortunately, the system comes first.181
So the Canadians, like Obama, want to achieve the ideal of full medical care for everybody. But because they are doing nothing to increase the number of doctors and nurses (and, indeed, disincentivize going into those professions), they can’t deliver.
Neither can Obama.
So we face a choice, as Canada did. We can create a system in which everyone is entitled to everything but the shortage of resources empowers the bureaucrats to limit and control access to services so nobody gets adequate care. Or we can approach health care from the other end—the supply side. We can grant real incentives to encourage young people to go into medicine. We can offer lucrative careers, free of government limitations, and grant special scholarships to those willing to work in underserved areas and to practice general medicine or pediatrics. We can grow our resources and then expand our coverage.
And why won’t Obama follow this prudent course? Because it will take time and by then he is worried that he will lose his political control over Congress and his popularity with the public. Striking while he still has the power may destroy the health care system, but at least he’ll get it passed.
It’s not just wrong to pretend we can extend medical coverage to everyone by legislative fiat without generating more doctors and more nurses—it’s false, and it’s cynical. Even more money won’t solve the problem. Greater financing won’t create more doctors or nurses out of whole cloth. That’s the lesson we must learn from the example of Canada.
We all work to support our families. It’s why we get up in the morning. But if the government tells us that no matter how well we do, how hard we work, how much we succeed, we cannot guarantee our family good medical care—or at least the best available—we will lose a key part of our incentive to work and produce. We surrender control over our own destiny, vesting it in bureaucrats who use statistics instead of human concern to shape their decisions.
This is the brave new world Barack Obama calls “health care reform.” He says he’ll cover everyone. He’ll end up covering no one.
ACTION AGENDA
In 1993, Bill and Hillary Clinton tried to extend full health care coverage to everyone. Like Barack Obama, they used the rhetoric of compassion for the uninsured but covered up what the real-world consequences of their program would be.
They made one big mistake: They said they would change the health insurance structure in a bid to save costs by eliminating the middlemen and brokers. In doing so, they threatened to change everybody’s health care. That scared people—and public sentiment turned against the Clintons on the issue.
Learning from their mistakes, President Obama is anxious to reassure