Why Single-Payer Won't Necessarily Satisfy Your Medical Needs


Forget medical school. I should have become an economist.

Canada is a tad short of physicians. Eight years ago, the Canadian Medical Association warned that there weren't enough doctors to go around, six years ago, the Fraser Institute said (PDF) "there are too few physician services being delivered in Canada to meet the demand for services," and since then, Macleans has cautioned that waiting lists are likely to get longer since new doctors coming into the sytem are working fewer hours than their predecessors. But, while demand usually drives prices up, which draws new supply as current providers work harder and new providers flock to satisfy customers, a column in Saturday's Globe and Mail tells us why that's unlikely under Canada's single-payer medical regime.

In an overall depressing piece about the poor prospects for people choosing professional educations in the current lousy economy, Margaret Wente writes of what the future holds for those going into medicine:

The trouble is that doctors have just one big client – government – whose ability and willingness to pay is shrinking fast. The booming consumer demand for medicine doesn't necessarily translate into jobs. Even though hospitals need extra surgeons, they aren't hiring them because they can't afford to expand operating-room time. Of all the general surgeons who finished medical school at the University of Toronto in the past two years, only 15 per cent have found work. The rest are pursuing further training, in hopes that something will eventually open up.

Yet in spite of all this higher training, doctors' incomes, too, are heading down. Ontario has just announced a freeze on total funding for doctors, which means that new doctors will have to share the pot with existing ones. The Ontario Medical Association figures that over the next four years, the freeze will mean a total pay cut of 16 per cent.

Under Canada's socialized health care system, unsatisfied demand doesn't result in economic incentives that would spur increased supply. There's little reason to work harder, or to go into the medical field at all, if your compensation is disconnected from the need for your services — especially if it's actually declining.

And so the gap between demand for physicians and the supply is likely to grow.

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  1. but it’s FREE! FREE!!! What kind of monsters are you?

    1. Looking at my tax return… hmm, nope, not free.

      (Also, “it’s free” is false, everyone pays a monthly premium on top of taxes.)

      1. everyone pays a monthly premium on top of taxes.

        If there was only *some* way they could raise more revenue for the system.

        Thinking…thinking harder….Nope, I got nothing.

        1. Fuck that.

          I’d rather have more of this, thanks:

          First Nation eyes private hospital.

          Robert Louie, chief of the Westbank First Nation, hopes to build a private hospital on band lands that would cater to wealthy medical tourists from around the world.

          For two years, the band has been planning the $125-million, 100-bed private hospital facility on a spectacular 15-acre site on band lands overlooking Okanagan Lake.

          1. Fuck that.

            Oh, I agree. But if your only choices are between rationing care and paying more to not ration, and I do believe they are your only choices, I’ll go with Plan B.

            Actually, I’d just get the fuck out.

            1. I do believe they are your only choices

              Currently, yes. But the cracks are starting to appear… from the private hospital mentioned above to rumblings of private clinics and two-tier systems in Alberta and Quebec, hopefully the future will be slightly more free.

              I’d just get the fuck out.

              I did, for a while. If it weren’t for familial considerations, I would again.

  2. New regulations will prohibit sickness. Also, the outlawing of smoking, obesity, and unsafe f*cking will result in perfect health. Those not in perfect health are reactionaries and obviously should not receive care…

    1. Those fucking trotskyite capitalist roaders never quit, do they?

  3. Matt Damon has assured me that people do not work for money but for the satisfaction of a job well done.

    1. You’re just being intrinsically paternalistic.

      (inside joke here at 1:00 http://reason.tv/video/show/wh…..ave-our-sc )

      1. Yeah, that’s actually what I was referencing:)

        1. I never get tired of that video.

          Damon is such a tool.

          1. MATT DAMON!

          2. It’s the gift that keeps on giving:)

  4. Better this than people going without care! You really want Grandma Smith to bleed to death of cancer at the entrance to an emergency room?

    1. Joe, how naive of you. Outcomes don’t matter, only intentions. When are you going to understand that?

    2. At least everyone pays their fair share in Canada.

  5. The last time I saw a stat, 11% of Canadian doctors leave the country after residency. If only a wall or something could be built to keep them from leaving…

    1. A wall? Don’t be absurd.

      Exploding hock collars and ankle weights should suffice.

      1. :::sigh::: shock = hock

        1. Works either way, really. A shock directly to your gambrel can be a powerful motivator.

          1. He just watched The Running Man and exploding neck collars are fresh in his mind. Cut him some slack.

            “I can break your neck like a chicken.”

            1. “There’s nothing funny about a dickless moron with a battery up his ass.”

              1. “Uplink underground, uplink underground. If you say that one more time, I’ll uplink your ass, and you’ll be underground!”

                1. “All I see is a bunch of low foreheads who want to change the world with dreams and talk. If you’re not ready to act, give me a break and shut up.”

                  1. “What’s the matter? Steroids make you deaf?”

        2. I thought you had meant cock.

    2. The problem is that they aren’t concentrating hard enough on the finding jobs in Canada.

      What we need is a place for the doctors to stay while they are looking for work. One central location where prospective employers would know they could go.

      We could call them camps where doctors concentrate – or concentration camps for short.

      Guys, I think I’ve got it!

        1. Gawd, man, you’ll fuck anything.

  6. “Necessarily”?

  7. It’ll be different when we do it.

  8. Under Canada’s socialized health care system, unsatisfied demand doesn’t result in economic incentives that would spur increased supply.

    Increased supply can only come to be when price signals in the market warns producers of unsatisfied demand, In a system where prices are not allowed to serve ths function, the result will be shortages and dislocations. In other words: Socialism can’t calculate!

    1. In other words: Socialism can’t calculate!

      If this were really true, you would think someone would write a book about this subject, letting us know so we could learn from their insights. No?

      1. Damn it, I was too late.

      2. I’ll wait for the movie, instead.

  9. Too bad no one has studied this problem before.

    1. Yes. Why hasn’t anyone ever studied that problem? (ha,ha)
      But we fail here to understand the modern Left’s understanding of health care: It is a right, not an economic problem. (Although by default it is a new right, since you couldn’t have a right to say free cancer treatment before it existed.)

    2. Yes. Why hasn’t anyone ever studied that problem? (ha,ha)
      But we fail here to understand the modern Left’s understanding of health care: It is a right, not an economic problem. (Although by default it is a new right, since you couldn’t have a right to say free cancer treatment before it existed.)

      1. You haven’t been around in a while and you come back with a double post.

        jester, I am disappoint.

        1. (hanging head in shame)…and I can’t even blame drinking on this one…the agony!

        2. (hanging head in shame)…and I can’t even blame drinking on this one…the agony!

          1. Excellent. You have returned to a position of joy.

  10. Folks in the Canaders get apocalyptic if two tier systems are proposed.

    In Ontario I cannot choose my family doctor, I feel fortunate to have one at all. If I could afford it why not allow me to pay extra for a doctor that I like and trust?

    Medicare in Canada is basically ‘we all get the same level of shitty care’

    Central control=shortages

    1. Apoplectic. Funny enough, the union I am forced to belong to as long as I chose to work where I do has a two-tiered system of benefits:One for the union management and one for the Brotherhood. I don’t see why everyone in Canada should get so upset about it. Two-tiered works. The people who look out for your welfare work hard. They deserve it.

  11. I know a Canadian doctor who has made it well known to friends and family that if she ever gets sick, they are NOT to take her to the hospital where she works.

    1. Yeah, my wife’s cousin and her husband live in Canada (he was born there), and we hear all of the screwed up stories from them about how bad it is. She came to the US to have her baby, he ended up having shoulder surgery here because he was in severe pain and it was six months just to get an evaluation, not the actual surgury. I was having a conversation with this liberal at a bar who was touting Obamacare (but would have preferred Single Payer) and was telling him some of their stories. Even though he had no facts or evidence to dispute what I was saying he basically implied that I was making that all up.

      1. How do you people have these conversations around alcohol and not go to jail? You must get very small rageboners. Maybe you’re rageimpotent.

        1. I didn’t care enough about him to kill him. He has to go through his entire life being an idiot, I take plenty of satisfaction in that.

        2. I insult them in ways they don’t understand until after they sober up.

          1. I insult them in ways they don’t understand until after they sober up

            One of these days, you’ll run into the very rare “smart drunk.” Let me know how that works out.

            1. Well if they’re smart they won’t be disagreeing with SF so it should work out just fine.

              1. I said “smart”, not “wise”.

    2. I could introduce you to a dozen American doctors who say the same thing.

  12. When will Congress repeal ‘Supply and Demand’?

    Price signals causing goods and services to go where they are most needed? Preposterous!
    Only central planning can accomplish that task!

    1. Wanting and needing goods and services is unpatriotic. You take what your given and be thankful. That’s called being a good citizen. Do really think it’s right that just because you worked hard all your life, that means you should have more than someone who doesn’t want to work? You’re like Hitler or something.

  13. “Why Single-Payer Won’t Necessarily Satisfy Your Medical Needs”

    Huh? Who ever said anything about that? The only thing that needs to be satisfied is the progressives’ collective sense of being Somebodies that Did Something, and single payer achieves this handily. Get with the program.

    1. By the way, the 50 character limit thing seems to be triggered by my attempts to use tags.

      Squirrels please make fix, thanks.

    2. The true goal of all progressives socialists is to be able to pat themselves on the back and congratulate themselves on being such visionary forward thinkers. Results don’t matter as long as they get to feel better about themselves.

  14. Since health care is run at the provincial level, not the national level, in Canada, I’d like to see a province-specific review. Otherwise, it’s like averaging out Mississippi and New York to get a ‘nationwide’ statistic for America.

    1. BC doctor shortage

      Alberta doctor shortage

      …. and now I’ve hit the link limit, but google ” doctor shortage”, and you’ll have no trouble finding a trove of articles.

      (Admittedly some provinces, like Sask., are having trouble because who the fuck wants to live in Sask, rather than funding issues.)

      1. The squirrels ate my < and >.

        “… google <provice/territory> doctor shortage …”

  15. Aww. she is so cute!


    1. Tiggy?

  16. My brother in law is a dermatologist in Toronto, and he’s amazed at the number of patients who’ve trial herbal crap on their skin diseases before they see him.

    It’s because there’s a waiting list–too few doctors willing to do the work for the level of pay, so they have to make do with bark juice or bee pollen or some other nonsense.

    1. I can’t speak to the patients of your BiL, but in the US it’s typical for believers in “alternative medicine” to self-treat until the ailment gets out of hand then seek out proper medical care. This is more because they believe in the woo-woo than because there’s a waiting list.

      1. I can’t speak to the patients of your BiL, but in the US it’s typical for believers in “alternative medicine” to self-treat until the ailment gets out of hand then seek out proper medical care. This is more because they believe in the woo-woo than because there’s a waiting list.

        This. And we must remember that Toronto is where that family which doesn’t believe in gender and refuses to tell their family and friends what sex the child is for fear of improper indoctrination is from, so who the fuck knows what other crazy shit they might engage in in Toronto.

        1. Hey, Toronto has a couple of million people in it and you bring up one couple.

          I used to live in Hogtown and believe me it’s full of normal people. 🙂

  17. The lack of price signals is distorting another part of the medical marketplace. My doctor wife said that there are huge shortages in painkillers such as morphine, since the price-setting by the government is sending signals to the drug manufacturers to not ramp up supply in response to shortages.

    A bad time to be in hospice care or to need anesthesia.

    1. Shouldn’t the Master Planners be telling the drug manufacturers what to make?

  18. Either way, medical care gets rationed.

    In the US, poor people don’t get it. In Canada and other socialized medicine countries, it’s waiting lists.

    Which is better?

    The best way would be to complete de-regulate it, but that’s not gonna happen.

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