Health Care, Part 1 of 5,467

Some early-morning pontifications on health care, and more specifically, the differences between the systems found in Canada and the United States.

Now, my own personal philisohpical preferences tend to prefer a market-based system to one run by the state. The fact that I'm subsidizing everyone elses's unhealthy lifestyles and unneccessary trips to the doctor isn't something I particularly like. And as is well-documented, the technology available in the US is far superior to that available in Canada (for example, that there are more MRI machines in greater Atlanta than in the entire country of Canada). See Denys Arcand's movie "The Barbarian Invasions" for a french-language perspective on this side of the issue (the best line of the movie is no doubt when the dying father stubbornly says "I voted for socialized medicare, and I'm going to suffer the consequences"). The sheer access to high-end health services in the US seems to confirm the economic theorists' prediction that government-provided health care underinvests in innovation. And yet.... the life expectancy in Canada remains higher than in the US - I'm not sure what influence factors such as the lower murder rate or perhaps, a more active lifestyle, have on this, but it is something that seems to fly in the face of the theory that American health care is "better" than Canadian health care. Per capita spending is lower in Canada (even without the efficiencies of the market), yet the overall result seems to be that people are healthier (at least they are living longer) - or at a minimum, are not suffering greatly because of socialized medicare.

Now I am ignoring, (for the time being) the role of free-riding in this debate, and that is something I will return to at some other time. How much does Canada (and the rest of the world) benefit in terms of innovation and technological advancement from having a quasi-competitive health care market just south of the border? The osmotic gradient of new innovation (espcially in drugs) means that almost anything invented in the US will flow into Canada anyway, so are Canadian simply letting Americans spend the premium on research while we get to enjoy the benefits for free? (This is similar to the argument that can be mad regarding defence spending - that Canada is free-riding on the US's massive resources to defend North America). So to wrap this up for now, I'll just say that I haven't decided which health care system I prefer - my ideology leans toward the American system, yet the evidence (perhaps) points to the conclusion that Canadian health care gets equal (or better) results at a lower cost. And I can tell you, my personal perspective is that it's lot simpler to live somewhere with state-provided health care...the transaction costs associated with choice are usually worth it - but so far I'm not convinced of this for health care.