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Heath on Canada's Single-Payer Health Insurance
10/06/2005

Building off Declan's summary of the recent health care ruling, I'd describe it as follows:

  1. "Canadians (Quebecers) have the right to life, liberty and security of the person guaranteed by s. 7 of the Canadian Charter.
  2. "Having to wait an unreasonable amount of time for health care can impact these rights.
  3. "The supreme court considers wait times in the current Quebec health system to be unreasonable."
  4. As a result of the above three points, it is a violation of the plaintif's rights to prevent him from seeking his own remedy outside the public system.

...which actually strikes me as not very surprising.

There has been a lot of good commentary online already, and I've only read a bit of it. Beyond those I've linked to above, I would certain recommend Calgary Grit (and comments), several posts on Sinister Thoughts and Adam Radwanski's June 10 entry.

Just because I feel that the court's decision seems to be a natural one does not mean that I think two-tier health care is a good change for our country. I'm not convinced of that yet, not even after reading arguments in favour such as the one on Bound by Gravity.

Coincidentally, I was searching for something else when I came across an excellent article by Joseph Heath that begins to explain the smart argument for single-payer (link PDF). I'd call this a must-read for anybody who's trying to understand possible changes to our health care system today. Here's an excerpt from the middle:

Markets for private health insurance are subject to extremely severe information asymmetries. This leads to serious adverse selection problems (insurers attract bad risks, forcing firms to refuse insurance to certain groups, and institute costly underwriting practices for others), and moral hazard (cost control is difficult, because it is very expensive for insurers to determine whether claims that they receive are justified). Both of these problems generate enormous transaction costs at best, complete market failure at worst. The Canadian “single-payer” system eliminates the adverse selection problem in one fell swoop, by creating a single mandatory universal plan. It also minimizes moral hazard, by centralizing negotiations over fee structures, and eliminating the collective action problem in enforcement. However, it is extremely important to the structure of the Canadian system that the government delivers health insurance as a public good, not health care. And the reason that government provides insurance of this type is not that there is something intrinsically wrong with buying and selling heath insurance, it is that markets fail to do so efficiently.

He goes on to talk about good and bad types of two-tier.


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