EDITOR’S NOTE: This piece appears in the July 4, 2005, issue of National Review.
The trouble with most of the Big Ideas is that at heart they’re small, mean ideas applied on a huge scale. Two of them took a colossal knock in recent days, and we should all rejoice. First came the French and Dutch voters’ demolition job on the European Union’s ersatz constitution designed to enshrine permanent rule by a technocratic elite convinced it knows better than the citizenry what’s good for them.
Two weeks later, Canada’s Supreme Court struck down the government health-care monopoly, at least as far as the Province of Quebec is concerned. This has vast implications for the Oscar-winning crockumentary maker Michael Moore, whose forthcoming film Sicko is a savage indictment of U.S. health care leavened with a Bowling for Columbine–type suck-up about how we Canadians do these things so much better. That section may have to be re-edited.
I confess to being something of an agnostic on health care. I’m no fan of “insurance” that bears no relationship to the cost of treatment or your likelihood of getting any particular ailment, or of the defensiveness of a medical system that has to keep one eye on John Edwards prowling the wards for clients.
On the other hand, to spot the drawbacks in your medical treatment, you first have to be getting some. And that’s the design flaw in the Canadian system. As the chief justice, Beverley McLachlin, put it, “Access to a waiting list is not access to health care” — and in Canada you wait for everything. North of the 49th parallel, we accept that if you get something mildly semi-serious it drags on while you wait to be seen, wait to be diagnosed, wait to be treated. Meanwhile, you’re working under par, and I doubt any economic impact accrued thereby is factored into those global health-care-as-a-proportion-of-GDP tables. The default mode of any government system is to “control health-care costs” by providing less health care. Once it becomes natural to wait six months for an MRI, it’s not difficult to persuade you that it’s natural to wait ten months, or fifteen. Acceptance of the initial concept of “waiting” is what matters. . .
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