walid khalfallah vs the province of british columbia

It is no measure of health to be well adjusted to a profoundly sick society." - Jiddu Krishnamurti


Enraged by the tragic story of Walid Khalfallah, who was crippled by a two year wait for needed surgery, CMA President Dr. Brian Day is taking the province of British Columbia to court. Day and Walid are being bankrolled by the Canadian Constitutional Foundation and the cost of this legal challenge could run in the millions. At issue is whether or not Canadians can purchase medical services outside of the nationalized system. But is a two tiered system really the best Canadians can do? Or do advocates of a parallel private system not go far enough in suggesting health care reform?

Despite the constant pronouncements of officials and politicians about the supremacy of socialized medicine the history of the 20th century speaks loudly as to the efficacy and morality of central planning. If government control the manufacturing of widgets is so terrible then why is the health care industry uniquely suited for planning? If a price system derived from consumer preferences on the basis of supply and demand is so apt at organizing the rest of society why then does planning become superior when it comes to doctors and surgeries?

The orthodox communist position, that all industries are suitable for government take over, is scarcely worth refuting. Who can look at the history of the Soviet Union, or Cambodia, or Cuba, or Vietnam and sing hosannahs to central economic planning? There have been countless experiments in the 'common store of goods' approach throughout the human experience and all of them have ended in abject disaster. But the more nuanced view, that certain industries should be under state control, and the rest left to the free market (subject of course to regulation at the behest of our benevolent and ever wise rulers, of course) which is so prevalent today requires more careful consideration.

One of the myriad arguments put forth for single payer health care is an attack on 'profits'. Since profit is kept out of the equation health care will cost less. Of course profit isn't really kept out of the equation, since certainly the countless bureaucrats employed by the various Ministries of Health are not working for free. But is profit really such a dirty word? Entrepreneurs obtain profits only by serving consumers. By providing what people want when they want it. They are an essential means of ensuring that scarce resources are allocated towards their most efficacious ends. Ironically loss makers are often coddled by the government and profit makers assailed, when the former have proven themselves incompetent and the latter invaluable.

Another common argument is that health care should be universal and free to the end user.  That everyone, regardless of income or stature in society deserves the same treatment. But what if the only way this is possible is by dragging everyone down to a mediocre level? Let's say level of care is on a scale of 1 to 10, where 10 is absolute perfect care and 1 is horrible care.  Would it really be better to have everyone at a 3, instead of people at a scale ranging from 1 to 10 depending on the ability to pay?  Is it right to force those who could pay for a 9 level of care to have inadequate treatment, excessive waiting etc. just so that a bum can go from no care to mediocre care? We accept that beggars will not eat like a rich man. That's why instead of sitting around begging you go out and work hard, so that you can enjoy the finer things in life. So why should not someone who works hard, providing a valued good or service to the community enjoy the fruits of his labour when it comes to medical attention? Why must we all be dragged down to the same inadequate level, sacrificed at the altar of equality?

And what happens when health care is made free to the end user? When cost is zero demand is infinite. Why not go to the doctor for every runny nose when doing so costs you nothing? Why should the person who rarely goes to the doctor pay the same as the hypochondriac who runs to the hospital constantly just in case? Wouldn't a more rational means of paying for health care be an out of pocket expenditure in the case of basic care and insurance for catastrophic treatment?

Another much needed reform is an end to compulsory licensure of physicians. Why shouldn't a nurse practitioner, foreign trained doctor (or, *gasp*, a physician with a non-allopathic view of medicine) be able to practice his craft here in Canada? Compulsory licensure serves only to prevent competition and harm the public while benefiting doctors. Certainly anyone concerned about the level of care provided by these doctors would be free to only purchase services from someone who is accredited on the same licensing basis (or one that is even more strict) as exists presently.

Instead of advocating for a private system to co-exist alongside public care it behooves us who are in favour of the free society to set our sights a little higher and aim for a market based approach. There is no question that eliminating the state's control over healthcare would dramatically improve the quality and quantity of healthcare in this country. Shortages do not exist on the market where equilibrium pricing ensures that supply meets demand. There is no need for individuals like Walid to languish in perpetuity desperately waiting for surgeries which never arrive.