Canada and health

Milton Friedman, in his book “capitalism and freedom” highlights the problems of government monopoly. All monopolies are bad, he says, but in certain situations, and for a certain instance in time it is sometimes the only option, what we must do is choose between evils, they are, private monopoly, publicly regulated private monopoly and public monopoly. While he does not believe that a private monopoly would inherently perform and better than a public monopoly, the private one has a distinct advantage to the consumer, in that it isn’t set in stone.

Private monopolies have been built up and have then crumbled before, however, a public monopoly, once set up is likely to remain well past the time at which it would be feasible to create a competitive market. This is shown perfectly in Canada’s public healthcare system that has now outlawed private healthcare in some areas.

A public monopoly on healthcare is often justified by saying that a competitive market can’t offer a satisfactory service to everyone who needs it, that the poor would be too poor to get help. This has never been shown in practice, even at the turn of the 20^th century when capitalism was at its height in America, there were more charitable acts to create and maintain healthcare for the poor than has ever been seen since. Before the creation of the NHS in the UK there were charitable hospitals that attracted the best doctors in the country due to the social prowess earned from helping the poor. Now however, we have bloated healthcare systems that can no longer perform to a satisfactory level, people die in hospital beds because they have to wait too long for an operation, people live in agony for months, even years because there isn’t enough capacity in the system.

These problems could be solved by raising capacity, to do that we need more doctors, nurses and surgeons. How do we do that? We make the profession more attractive, by rewarding people who do well in their jobs, public systems are too inefficient to do that, this is why nurses are leaving their jobs in record numbers. What we need is a private system that can compete with the public system, this would increase the rewards available to the best doctors, therefore increasing the incentive to spend years of ones life in training to join the profession, at last, supply could meet demand. But Canada has realized the consequence of this, once people see the benefit of private healthcare, they won’t want a public system any more, the government monopoly dies, and they won’t let that happen, instead, they have decided to fine doctors up to $20,000 for accepting a fee for treatment. This is the unfortunate reality of government, people dieing on hospital beds is acceptable, a person willing to pay to save their own life is not.