Mises Wire

Canadian Healthcare: A Half Century of Broken Promises

“People primordially fear illness and death, and physicians, from shaman to modern scientists, have always been perceived as holding a near-talismanic power over both. With the rise of modern wealth came the potential for enormous tax harvesting, and politicians were quick to see that this power over life and death could generate deep feelings of gratitude and loyalty. Could they take this power unto themselves?” – William D. Gairdner, The Trouble with Canada . . . Still! A Citizen Speaks Out

Yes, they could, and in 1966, Canadian politicians took that power unto themselves, then promptly reneged on their promise to provide universally accessible healthcare for everyone.

The Deception

According to Tom Kent (the government’s senior policy wonk at the time), the Medical Care Act of 1966 was needed because “many poorer people just did not get care when it was needed.”

In an imperfect world, it is probably true that some people did not receive care when it was needed. However, as I have written before, it is doubtful that more people lacked access to care under the pre-1966 private system as compared to the government’s socialized system. Furthermore, in the private system, contrary to Kent’s assertion, healthcare was routinely provided to people who could not afford to pay for it.

Charitable impulses and the pursuit of profits are not mutually exclusive concepts, despite what Kent wanted us to believe, and despite what politicians and bureaucrats still want us to believe. That’s the deception.

Broken Promises

Kent said that the government’s objective with the Medical Care Act was “to make sure that people could get care when it was needed without regard to other considerations.” That sounds good, but as Milton Friedman warned, we should judge policies by their results, not their intentions.

At the beginning of each year, budgets for Canadian hospitals are dictated by the government, and if this predetermined tax revenue is depleted before the end of the year, as often happens, new patients are put on a waiting list for the next fiscal year. Thus, the government breaks its promise “to make sure that people [can] get care when it [is] needed without regard to other considerations.”

Moreover, the government breaks its promise every year, usually more so than the previous year, thereby establishing a trend of deteriorating performance over fifty-plus years, with deadly consequences:

In the 2005 Chaoulli decision, Justices of the Supreme Court of Canada noted that patients in Canada die as a result of waiting lists for universally accessible health care.

Our analysis estimates that between 25,456 and 63,090 (with a middle value of 44,273) Canadian women may have died as a result of increased wait times between 1993 and 2009. (emphasis added)

Year after year, “wait times” in Canada tend to increase, not decrease. It seems that politicians and bureaucrats do not embrace the concept of “practice makes perfect,” no matter how much time we give them.

Private Healthcare? How Dare You!

More than a million Canadians are waiting for the healthcare that the government promised to deliver. And, as we have seen, in 2005, the government, through its supreme court, acknowledged the deadly consequences of its broken promises. The logical solution is to return healthcare to the private sector. However, heartless politicians and bureaucrats ignore this solution, and they cruelly forbid patients on their waiting list from accessing private healthcare options in Canada, thereby condemning many of them to death.

Despite the government’s growing incompetence, a more recent court ruling affirmed the government’s position that people must be denied the freedom to pursue private healthcare options in Canada.

Last year, the British Columbia Supreme Court “dismissed a court challenge by Dr. Brian Day, former head of the Canadian Medical Association, whose surgical clinic in Vancouver provided medical services to patients failed by the public system, in violation of BC law. Dr. Day argued that the province’s ostensible ban on this type of privately funded healthcare violates the Charter of Rights and Freedoms. While the court ruling acknowledged the plight of thousands of patients on waiting lists, it simultaneously denied them the right to do anything about it.”

Shockingly, as Justice John Steeves affirmed the illegality of voluntary exchanges between patients and doctors unimpeded by government conditions, he irreverently declared that this does not violate these individuals’ right to liberty under the Charter.

The Charter is part of Canada’s Constitution. Section 7 of the Charter reads:

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

In his ruling, Steeves wrote: “[L]iberty interests under s. 7 are engaged only where the law or state action interferes with a person’s ability to make fundamental personal choices” (para. 1764, emphasis added).

That sounds good, but then Steeves wrote:

[P]atients are free to spend their money on healthcare services as they deem appropriate (admittedly within the constraints of the MPA [Medicare Protection Act]). Therefore it cannot be said that there is a sufficient causal connection between the impugned provisions and the alleged deprivation…. I conclude that the plaintiffs have not established a deprivation of their right to liberty under s. 7. (paras. 1767, 1768, emphasis added)

To say that this is a deception seems blatantly obvious. Steeves ignores the fact that “the law or state action” necessarily includes the MPA with its acknowledged constraints. Among other things, these constraints include rules about which medical practitioners may offer their services, which services they may offer, and at what prices they may offer these services. This clearly interferes with people’s (patients and doctors) “ability to make fundamental personal choices.” Yet while this deprivation of liberty is beyond dispute, Steeves denies it.

There you have it. Free = Unfree, according to the BC Supreme Court.

The courts will continue to support politicians and bureaucrats. The duplicity of these charlatans is painfully clear. For decades, their bureaucracies have feasted on billions of tax dollars while thousands of dead Canadians wait for the healthcare they were promised. They are dead because the government denied them the right to use their own money to save their own lives by purchasing private healthcare from willing providers in the Canadian marketplace.

The trail of broken promises will grow longer. The inhumane treatment of Canadian patients will become more widespread, and many more will die. Nothing will change until the masses realize that their health and well-being can be greatly enhanced only through the restoration of their freedoms.

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