David Henderson, in reviewing John Goodman's book on the economics of healthcare, takes a well-deserved swipe at the current Canadian health care system:
These data, plus the fact that Canadians wait so long to see a doctor and to get surgery, help to make another point that Goodman discusses: the supposed "right to health care." When I hear people say that people have a right to health care, I take on the moral issue with moral reasoning, questioning whether health care is something that a person can truly have a moral right to. Goodman does it differently--and effectively. He points out that Canadians don't have a right to health care. How can you say it's a right if people aren't guaranteed to actually receive the health care service they need? The right to get in line for care, which is really all that Canadians are guaranteed, is not much of a right.
When I first moved to Canada over 40 years ago, the health care system was much better for several reasons. We rarely had to wait very long for any service. Two important things happened, however:
- In an effort to control costs and reduce what people feared would be supply-induced demand, the number of doctors put through the system was actually restricted. It should come as no surprise that we now have shortages of physicians, especially since present-day doctors tend to put in fewer hours, on average, than did physicians back then.
- Extra billing was eliminated. When I first moved to Canada, doctors were allowed to charge more than the stated fee schedule if they wanted to. Some did (especially if they thought the patients could pay more -- a classic example of the improved efficiency that follows from price discrimination). The elimination of extra billing drove some physicians to the US and induced others, especially newer ones, into the specialties with more lucrative fee schedules, leaving shortages elsewhere. Surprise, surprise: when the price was pushed to zero by the gubmnt, the quantity demanded increased and the quantity supplied decreased.