Long Lines for Egalitarian Health Care

in the waiting line

(Originally published at LvMIC).

A new report by the Fraser Institute lends credence to what most Canadians seeking specialist medical care already know: wait times for medically necessary treatment remain too long.

The December 2012 report is entitled “Waiting Your Turn, Wait Times for Health Care in Canada.” It reveals that, despite an annual decrease in overall wait times, Canadians are now waiting 17.7 weeks between referral to a specialist and the delivery of treatment. This is 91% longer than in 1993, when the Fraser Institute began studying wait times.

Sadly, the rationing of care that results in long wait times for patients is a predictable economic consequence of government involvement in our medical system. Consumers (in this case, patients) seek out more medical care as its price decreases. This is simply the law of demand. Because patients under government medical “insurance” pay nothing directly, they seek out medical treatment for increasingly frivolous reasons. Squandering of resources ensues. Suddenly, a runny nose during cold season is reason enough to proceed to the hospital. Or an otherwise healthy individual travels to the nearest walk-in clinic on a weekly basis to have the doctor check his blood pressure. Or an elderly widower visits the emergency room on Christmas Day because he’s lonely. Sound familiar?

On the other hand, the sky-rocketing costs associated with increased utilization of the state-funded medical system cause the government to institute price controls on health care services. When prices for health care services are held artificially low, the persistent excess demand contributes to shortages. This in turn leads to rationing of medical care and persistently-high waiting lists. In addition, barriers to entry (e.g. government licensing requirements, accreditation) cartelize various medical professions and further exacerbate circumstances. Ultimately, as Murray Rothbard put it, we run the risk of evolving into a system where “everyone has the right to free medical care, but there is, in effect, no medicine and no care.”

According to the study authors, “After an appointment with a specialist, Canadians wait approximately 3 weeks longer than what physicians believe is “reasonable” for elective treatment.” It is important to note that there is likely a difference between the quantification of “reasonable” wait times by a specialist – especially one accustomed to practising within the Canadian Medicare framework – and an individual patient suffering from a newly-diagnosed illness. For example, while a median 12-week wait time for orthopaedic surgery may seem reasonable to a specialist, it may not be for a bed-ridden long-term care resident awaiting hip replacement surgery.

Amusingly, while wait times are too long for specialists (and likely even worse for patients), these unsavoury results are perfectly satisfactory for government:

(…) Median wait times in many provinces are already within the benchmarks set by
governments in Canada, which means that according to these benchmarks, more than
50 percent of patients in these provinces are already being treated in a time frame that
provincial governments consider “reasonable.”

Currently, Canadians are waiting for an estimated 870,462 procedures. An estimated 0.9% of patients have left the country in 2012 in preference for treatment outside of Canada. With a population largely unwilling to embrace freedom in medical care and options such as critical illness insurance available to help fund out-of-country medical treatment, this option will increase in popularity. The egalitarian goal of equal health care for all simultaneously provides worse care for all.

It wasn’t always this way. According to Rothbard:

Everyone old enough to remember the good old days of family physicians making house calls, spending a great deal of time with and getting to know the patient, and charging low fees to boot, is deeply and properly resentful of the current assembly-line care. But all too few understand the role of the much-beloved medical insurance itself in bringing about this sorry decline in quality, as well as the astronomical rise in prices.

You can read the Fraser Institute report here.

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  • About Gregory Cummings

    Gregory Cummings writes about Canadian monetary and economic policy. His writing has been featured at the Ludwig von Mises Institute of Canada and the Ludwig von Mises Institute's Mises Daily publication. Read more.

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