I’ve spent a lot of time this last week talking about wait times. In fact, I’ve been talking about them for years. But I was thinking last night that I’ve fallen into a trap. In debating the existence of, or lack of, wait times, I have failed to put them in proper perspective.
Wait times aren’t like cancer. We know what causes wait times; we know how to fix them. You spend more money.
The wait times that Canada might experience are not caused by its being a single payer system. I can’t tell you how may times I’ve been confronted by an angry opponent of health care reform who lectures me on how much less time it takes to get a hip replaced or a cataract repaired in the US than in Canada. But do you know who gets most of the hip replacement and cataract repairs? The elderly.
Do you know who pays for care for the elderly in the United States? Medicare.
Do you know what Medicare is? A single-payer system.
So our single-payer system manages not to have the wait times issue theirs does. There must be some other reason for the wait times. There is, of course. It’s this:
Canada isn’t some dictatorship. They aren’t oppressed. In 1966, the democratically elected government enacted their single-payer health care system (also known as Medicare). Since then, as a country, they have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome. They could spend more. They don’t want to. We can choose to dislike wait times in principle, but they are a byproduct of Canada’s choice to be fiscally conservative. They chose this. In a rational world, those who are concerned about health care costs and what they mean to the economy might respect that course of action. But instead, we attack.
What disturbs me is that we, in this country, panic about our extreme health care costs and the deficit, while simultaneously attacking other systems for the means by which they control those things. You can hate the high costs or you can hate the wait times for some things, but it’s sort of irrational to think you can have neither.
UPDATE: Edited for clarity.