Single-Payer Health Care Is Anything but Free

The Ayn Rand Institute has released the following OpEd, written by myself:

"Single-Payer" Health Care Is Anything but Free

By Paul Hsieh

Michael Moore's latest movie "SiCKO" sings the praises of the Canadian "single-payer" socialized medical system. Some Americans want a similar system implemented in the United States. Defenders of the Canadian system frequently claim that patients don't have to worry about money when they're sick -- the health care is free. But is this really true?

No.

First, it is ludicrous to think the system is free. Each citizen is forced to pay for his neighbors' medical care in the form of high taxes. (As a percentage of GDP, total taxation is 28 percent higher in Canada than in the United States.) The government, rather than individuals, then decides how that money is spent.

Even worse, in the name of "equal access" the government generally forbids patients from purchasing medical services outside of its system. Canadian law makes it difficult or impossible for citizens to spend their own honestly earned money on medically necessary care for themselves or their loved ones, even when both the doctor and the patient are willing.

To control costs, the government restricts access to crucial medical services via infamous waiting lists. This imposes a second, hidden, cost on patients: their time.

According to the Vancouver-based Fraser Institute, "Canadian doctors say patients wait almost twice as long for treatment than is clinically reasonable, ... almost 18 weeks between the time they see their family physician and the time they receive treatment from a specialist."

Because of the waiting lists, mortality rates for treatable conditions such as breast cancer and prostate cancer are significantly higher in Canada than in the U.S. A Canadian woman who discovers a lump in her breast might wait for months before she receives the surgery and chemotherapy she needs, with the cancer cells multiplying rapidly as each week goes by. If she lived in the United States, she could receive treatment within days.

This tax on time is especially cruel because the burden falls hardest on the sickest patients, i.e., those with the least time to spare.

Consequently, Canadian patients routinely suffer and die while waiting for their "free" health care. The National Center for Policy Analysis notes, "During one 12-month period in Ontario, ...71 patients died waiting for coronary bypass surgery while 121 patients were removed from the list because they had become too sick to undergo surgery."

To guarantee "free" health care, a government must force the individual to pay for everyone else's medical care and limit his freedom to pay voluntarily for his own. With bureaucrats deciding who receives what, the individual is therefore forbidden from spending his money according to his own rational judgment (and the advice of his doctors) as to what's best for his health. When a government forces people to act against their own interests, it's no surprise that the results are misery and death.

Fortunately, Canadians are starting to recognize the problems inherent in "single-payer" health care and are taking very small steps towards limited private medicine. America must not repeat Canada's mistakes. As P. J. O'Rourke said, "If you think health care is expensive now, wait until you see what it costs when it's free."


Paul Hsieh, MD, guest writer, is a practicing physician in the south Denver metro area. He is a founding member of the Colorado group Freedom and Individual Rights in Medicine (www.WeStandFIRM.org). His e-mail address is: paulhsiehmd@gmail.com. The Institute promotes Objectivism, the philosophy of Ayn Rand -- author of "Atlas Shrugged" and "The Fountainhead."

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