Medicare: A Few Modest Proposals

In the wake of the Quebec Supreme Court ruling, there is perhaps new incentive to improve Canadian Medicare.

A few modest proposals:

- To prevent abuse of the system, institute at least nominal user fees or deductibles. These could be waived for those on social assistance.

- Stop funding abortions. These are, after all, at best not a necessary procedure, but a purely voluntary one. This is even aside from the moral and human rights issues involved in funding abortions.

- Allow a free market on the supply side. This has no effect on the universality of the system. Competition from the private sector should force down costs. Fund procedures (other than abortions, which, unbelievably, are already funded) at private clinics at the same rate as at public clinics, and the free market should make more care available for the same cost. If not, nothing lost.

- Allow pharmacists to issue prescriptions. They have the training; but the doctors’ monopoly prevents it. This sounds radical; but it is taken for granted in some countries. This would save huge amounts of money paid to doctors simply to renew prescriptions, for which their expertise is not needed.

- Set up and allow diagnosis, prescription, and referral by computer. Computers can do this more competently than physicians, but again the physicians’ monopoly prevents it. You don’t need a trained physician to type on a keyboard. At most you need a nurse or technician to double-check and handle referrals if necessary.

- Stop funding procedures that are not scientifically proven. According to one estimate, only 27% of current medical procedures have a solid scientific basis. But why spend money when we don’t know it is doing any good?

Besides saving a huge amount of money, this would level the playing field between “Western” medicine and alternative therapies: and so, by increasing competition, lower costs for all.