National Opinions

Canadian system rations health care, denies treatments

SAN FRANCISCO — Those who have seen “Sicko” can’t be faulted for thinking America’s northern neighbor offers its citizens a paradise of free medical care.

One tear-jerking segment shows a single mother from Michigan driving to Canada for state-funded cancer treatment. The film also presents a Canadian hospital where patients supposedly don’t wait for treatment. And Moore introduces the audience to his Canadian relatives, Bob and Estelle, who are both terrified of U.S. health care and exceedingly pleased with the Canadian system.

Compelling anecdotes, to be sure. But if Moore is going to rely on anecdotes, it’s a shame he didn’t interview my relatives and me.

The truth is that Canada’s health care system is heartless and uncaring. I know, because I’ve seen it firsthand.

In 1999, my uncle in Vancouver was diagnosed with non-Hodgkin’s lymphoma. I began investigating possible treatments, hoping something other than chemotherapy could help.

I discovered that the new drug Rituxan had shown enormous success in fighting the disease. But it wasn’t approved in Canada, so it was unavailable to my uncle. Had he lived in America, he might have survived.

My uncle’s story isn’t just an isolated incident. It’s typical.

Whereas 100 new drugs were introduced in the United States from 1997 to 1999, only 43 became available during the same period in Canada. When the government pays for health care, saving money is more important than saving lives. So bureaucrats have an incentive to delay — or deny — the introduction of new, costly drugs.

It’s not just limited access to drugs that hastens the deaths of the ill and the elderly. Diminished access to physicians, surgeries and other procedures harm ordinary Canadians, but such rationing is necessary for the Canadian government to keep costs down.

The average wait in Canada between a referral from a primary care doctor to treatment by a specialist was around nine weeks in 1993, but now it takes over four months. That’s almost double what doctors consider clinically reasonable.

Indeed, over 800,000 Canadians are currently on waiting lists for surgery and other necessary treatments. Many Canadians can’t even find a doctor — about 10 percent are currently seeking a primary care physician. Canada now ranks 24th out of 28 countries in the number of doctors per thousand people, according to the Organization for Economic Cooperation and Development. When the government took over the health care system in the early ’70s, Canada ranked second.

Why the decline? Over the last decade, about 11 percent of physicians trained in Canadian medical schools have moved to America.

That’s because doctors’ salaries are paid for by provincial governments and subject to cost-conscious budget analysts. In fact, the average Canadian doctor earns only 42 percent of what his U.S. counterpart earns.

But it’s not just about money. Doctors feel they can’t practice the type of medicine they’re trained for due to budget restrictions set by bureaucrats.

These problems struck home two years ago, when I fought Canada’s health care bureaucracy on behalf of my mother. Despite my best efforts, the government deemed her too old and sick to merit a doctor who could deliver the highest quality care. She died soon after.

Even if health care is declared a “right” by Moore or others, there’s a limited supply of it. And when that good can’t be allocated by price, it must be delivered by government rationing.

Sure, under Canadian health care, everyone is equal — or, at least, equally miserable. As Madame Chief Justice Beverly McLaughlin said following the Canadian Supreme Court decision of June 2005, “Access to a waiting list is not access to health care.”

Pipes is the president and chief executive officer of the Pacific Research Institute (, a free-market think tank funded in part by the health care and pharmaceutical industry and based in San Francisco.