Solving the Health-Care Crisis

The Commonwealth Fund’s annual health policy survey has ranked Canada very poorly among 31 high-income countries with universal health care for timely access to services.

How to fix our health-care crisis?

The obvious first move is to abandon the odd political shibboleth that we must not permit private care. “No two-tier health care.” Why not? Canada is the only universal-care country that severely restricts private options. In Britain, the rich are publicly shamed if they resort to the public system.

As a practical matter, the Canadian rich currently often head down to the States for private care. This is an unnecessary travel expense for them, and it drains money from the Canadian economy.  Better to let private firms set up in Canada. The rich will be able to “jump the queue,” but as a result, the queue will be shorter for everyone. To object is mere self-destructive envy.

Then if a privately-run clinic or hospital can provide a service for less than the public system does, as may well be the case, the government plan too should cover the private option. 

Most of what doctors do, however, is diagnosis, and prescribing pills. AI can already diagnose and prescribe more accurately than a human doctor. Accordingly, we need much less training than we currently demand for a medical doctor; all we really need is basic computer competence. We need nurses, dispensing pharmacists, and technicians to run the diagnostic machines. We do not really need doctors.

We should also institute a nominal fee, a deductible, for a doctor or hospital visit, to discourage unnecessary use: say $5.

And we should not cover unnecessary non-health procedures like sex changes or abortions.