Losing Patients

A film questions Canada's nationalized health care.


The Barbarian Invasions, recently released on DVD by Buena Vista Home Video, offers a disturbing vision of state-run medicine. The Canadian film won two awards at the 2003 Cannes Film Festival (best screenplay and best actress) and took home this year's Oscar for best foreign-language film. It is the story of a man with a terminal disease who renews his relationships with his friends and family, especially his adult son. Much of the action takes place in a hospital in Montreal, Quebec, where director and screenwriter Denys Arcand dissects the Canadian health care system.

The film opens with a nun struggling down the corridor of a crowded ward to administer Holy Communion. Patients, health professionals, even electricians, are tripping over each other, packed into an environment of general confusion. And yet there is another floor of the hospital that is completely closed, thanks to a government directive.

The dying man's son is a successful investment banker in London. He's the kind of guy who can wriggle around anything. First he wrangles his way into the hospital's management offices without a pass and corners the manager, who is completely isolated from the chaos outside. He offers her a bribe to get his father moved out of the zoo and into a private space on the empty floor. She quietly takes the bribe but points out that she can do nothing without the hospital employees' union. The son pays off the union boss to prepare a private room on the empty floor. Painters, carpenters, and other workers quickly make it up.

Then, because there is virtually no access to PET (positron emission tomography) scans in Canada, the banker takes his father to Vermont to get one. One of the son's friends in Baltimore—one of many Canadian doctors who have emigrated to the U.S.—examines the scan and informs him his father will have a much better chance in Baltimore than in Montreal. Remarkably, the father will have none of it: "I voted for socialized health care," he proclaims, "and I'm prepared to suffer the consequences!"

With this line, the father speaks for too many Canadians, who often wrap their national identity in nationalized health care. This is why Canadian politicians have not had the courage to give Canadians more health freedom. But the pain and inhumanity caused by the Canadian system are starting to make even the most nationalistic of us reconsider the amount of control over health services that we've ceded to our government.

The Barbarian Invasions tells us a lot about the consequences of government monopoly health care. The hospitals are poorly managed, the doctors and nurses confused, the unions who really run the show thuggish, the patients all but ignored.

The film has sparked a debate in Canada about the role of the state in health care. Any American who thinks health care in the United States would be improved by implementing a single-payer system would learn much from it too.