The Fatal Conceit of Canada's Health Care System

Policy Matters has published a collection of short essays discussing possible health care reforms. Included in this collection are essays by Maxime Bernier and Mark Rovere (of the Fraser Institute). Both of them address the primary problem of Canada’s health care system: sustainability. They approach the issue from different directions but they come to the same basic conclusion that the Canada Health Act has to be reformed to allow more policy experimentation.

In contrast, Dr. Jeffery Thurnbull, President of the Canadian Medical Association, failed to address the problems of the Canada Health Act. In his own essay he writes:

Although Canadians report that they are highly satisfied with the care they receive once it is delivered, they all too often have to wait for services such as diagnostic tests and surgery. Justifiably, they are not only increasingly concerned about long waits for services covered by the Act, they also worry about the financial costs of care that falls outside medicare, such as out-of-hospital pharmaceuticals and home care.

Long wait times are indeed an important issue, but it is actually just a byproduct of the problem of sustainability. Provincial governments have cut back on the availability of services in an effort to cut costs and prop up the failing system. Furthermore suggesting that the problem is that the Canada Health Act is not encompassing enough is counterproductive. Increasing the services covered under the Canada Health Act will only put more pressure on the system.

To be fair he does address sustainability as a side issue, but his answer to the problem is entirely inadequate:

The system must be properly resourced in a sustainable manner. It must be resilient, capable of withstanding or accommodating demand surges and fiscal pressures. It must have the capacity to innovate and improve. Monitoring and documentation of emerging health needs and the burden of illness must be undertaken on an ongoing basis. Strategies must be developed and implemented to meet those needs properly.

This is what Hayek called the Fatal Conceit. The idea that government can know what resources should go where, and that the state can predict future needs, is fundamentally flawed. For evidence that it is flawed all you have to do is look at the health care system as it already exists.

Does Dr. Thurnbull think that government isn’t already attempting to “[monitor] and [document] emerging health needs?” Does he think that the government doesn’t already want to develop and implement policy that will “meet those needs properly?” Too often people think that the solution to government failure is that you need to fiddle with current programs or expand government control. Too many people never consider the possibility that there are just some things that government cannot do.

Nothing that Dr. Thurnbull suggests in his essay would fix anything about the health care system. At best he wants to move some incentives around, and at worst he will actually make the situation more drastic. He offers no real change to a system that desperately wants reform.

Only the introduction of private comprehensive insurance would save Canada’s health system, and it is time that the federal government allows the provinces to experiment in ways of getting this done.