The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t
Posted: 10/16/2003

So in conclusion, ladies and gentlemen, let me just summarize again the Top 10 Things Many People Believe About
Canadian Health Care But Shouldn’t:

• Number One: Canada has the best health care system in the world.

• Number Two: The Canadian public loves Medicare

• Number Three: Canadian Medicare is sustainable

• Number Four: Single payer, Canadian-style, keeps costs under control

• Number Five: More cash is the solution to Medicare’s problems

• Number Six: Under Medicare, people get the health care services that they need

• Number Seven: "Free" health care empowers the poor

• Number Eight: Canadian Medicare is fairer because no one gets better care than anyone else

• Number Nine: Medicare-type spending is the best way to improve health

• Number Ten: Medicare is an economic competitive advantage for business

Now like most Canadians, I believe that our system is superior in many respects to the U.S. system, but it is a system
that staggers under the burden of serious design flaws. Far from sharing Mr. Romanow’s complacency, I am deeply worried
about the long-term sustainability of our health care system, and think that we have much to learn from countries that
ranked much higher than either Canada or the U.S. in the WHO rankings. These countries demonstrate that many of the
fears that Canadians have about significant reform of Medicare — For example, of introducing payments for health care,
of allowing people to pay directly for health care outside the government monopoly, and even of breaking up the
provision monopoly to allow competition and a greater role for the private sector — are unfounded. All reforms can be
carried out within a public policy framework that continues to be pre-occupied by equity considerations, and that gives
Canadians better value for the tens of billions of dollars they so patiently and lovingly devote to public health care
spending in a repeated triumph of hope over experience.

Endnotes

1 The report of the WHO was released in June, 2000. Details are available at
http://lists.isb.sdnpk.org/pipermail/health-list/2000-June/ 000010.html.

2 This Royal Commission was a group appointed by the Canadian federal government to conduct a major inquiry into the
future of Canada’s health care system. It was chaired by former Saskatchewan Premier Roy Romanow, and released its
report at the end of November, 2002. Throughout this talk, when I refer to the Romanow Report, it is to this document
that I am referring.

3 Will the Baby Boomers Bust the Health Budget? Demographic Change and Health Care Financing Reform, C.D. Howe
Institute Commentary 148: February, 2001. www.cdhowe.org.

4 The qualifications are that for a small number of chronic conditions, such as hypertension and vision care, poor
patients in these conditions underspent on care. Part of the advantage of the RAND experiment is in helping us to
identify areas, such as these, where poor patients’ health can be improved by targeted subsidies.

5 Michael Walker and Martin Zelder, Critical Issues Bulletin — Waiting Your Turn: Hospital Waiting Lists in Canada,
Fraser Institute, Vancouver, published annually.

6 Brian Lee Crowley and David Zitner, Public Health, State Secret, Atlantic Institute for Market Studies, Halifax,
2001. Available at www.aims.ca.

7 David Zitner, Canadian Health Insurance: An Unregulated Monopoly: Atlantic Institute for Market Studies, 2002.

8 David Harriman, William McArthur and Martin Zelder, Public Policy Sources #28: The Availability of Medical Technology
in Canada: An International Comparative Study, Fraser Institute, Vancouver, 1999.

9 Brian Lee Crowley, Brian Ferguson, David Zitner and Brett Skinner, Definitely Not the Romanow Report, Atlantic
Institute for Market Studies, Halifax, 2002. Available at www.aims.ca. Crowley the "intellectual architect" of the
committee's report.

10 Op.cit.

About the Author

Note: Brian Lee Crowley is the founding President of the Atlantic Institute for Market Studies www.aims.ca, located in
Halifax, Nova Scotia. Crowley is co-author of two Sir Antony Fisher Award-winning projects on the Canadian health care
system. In recognition of his health care work, he was named to the the most influential provincial health care inquiry
in Canada, the Mazankowski Committee. Former Canadian Deupty Prime Minister Don Mazankowski called Crowley the
"intellectual architect" of the committee's report.

SOURCE: Mackinac Center for Public Policy
http://www.mackinac.org/article.asp?ID=5863

Reference:

Mackinac Center for Public Policy
http://www.mackinac.org/

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