Acton Institute Powerblog

Sicko and the Sick Man of the Great White North

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Time sure does fly. It’s been almost two years since I called Canada’s government-run health care system “The Sick Man of the Great White North” and wrote:

Canada’s system may be the gold standard for government-run health care, but only if you’re looking for a system that can’t provide essential medical services in a timely manner.

Sadly, nothing much has changed in the interceding time between that post and now. In fact, things are very much the same: Canadians still have a system that has an undeserved good reputation, and those on the left in America still hope to implement a Canadian-style system here in the United States. It was to that end that Michael Moore released his latest “documentary,” Sicko, which essentially serves as public relations for the pro-socialized health care camp.

The idea of “free,” government-provided health care is easy to like, because who doesn’t want everyone to have free health care? Unfortunately, it also seems that many people find that the major problems with socialized health care are easy to dismiss, because, well… who doesn’t want everyone to have free health care?

So it’s important for those of us who see this idea for what it is – a very bad one – continue to remind Americans that while socialized health care is no doubt well intentioned, good intentions are not enough:

Sickoholds the Canadian system out as a model for proponents of universal coverage where health care costs are lower and everyone has free care at the point of service. “While many proclaim Canada’s Medicare program to be one of the best in the world, or suggest it should be the model for reform in the United States,” says one of the Fraser Institute’s study authors, “the reality is that health spending in Canada outpaces that in most other developed nations that, like Canada, guarantee access to care regardless of ability to pay, and yet access to health care in this country lags that available in most of these other nations.”

Because health care is largely free in Canada, demand is likely to exceed supply. It’s just human nature. Thus, waiting lists become the principal way of rationing medical care and holding down spending. And after 16 years of tracking growing waiting lists, the Fraser Institute observes that the problem is probably not a temporary one that can be fixed with a little more money or time. They note that provinces with higher spending per capita do not experience shorter wait times.

Just as we saw in the old Soviet system with its long lines for food and basic services, government central planning does not efficiently match supply with demand. And human beings will always seek more of something that is free. As one free market advocate states, “Long waits and widespread denial of needed care are a permanent and necessary part of government-run systems.”

That link comes via Hugh Hewitt.

Incidentally, how do you think Sicko is doing? Perhaps I’m just out of the movie loop at the moment, but it seems to me to have been as close as Moore has come to an outright flop, at least in terms of media chatter generated for his pet issue.

More: Jordan Ballor passes along a link to the Scriptorium, which provides a solid analysis of what a proper Biblical position on universal health care would be:

Jesus was angered at moral teaching that emphasized outward conformity to rules without moral action flowing from a heart of compassion and virtue, even if such conformity produced good results. Now the state cannot show compassion in the arena of economic justice, because a necessary condition for compassion is that it is freely given and not coerced. The state forces people to conform to rules. It takes their money and gives it to others. But this is not the sort of compassion of which Jesus taught.

Well worth a read in full.

Marc Vander Maas


  • Dan VandeBunte

    “It’s ok, liberals do that kind of thing all the time. They can’t win arguments by actually stating what their position is, so they have to reframe the argument in a such a way as to make all other opinions absurd.”

    I knew I had said this before.

    We’re not pro taking your money and giving it to someone else, we’re pro free, universal health care? Who could possibly be against that?

  • A Currie

    “The idea of “free,” government-provided health care is easy to like, because who doesn’t want everyone to have free health care?”

    The funny thing is that it seems to work in Canada. It sure is easy to just pull up to the emergency ward and get your broken arm put in a cast or to have a CAT scan to diagnose a terminal brain tumour without also having to worry about how you will be able to pay for it. It sure ain’t “free” but neither are city streets and sidewalks. I bet you don’t worry too much about the price of the sidewalks?

    As a Canadian, I am quite happy for the US to keep whatever sort of horse-and-buggy health care “system” that they have. I am even happier to see blogs like this that shrill for the American system. Go ahead.

    However, please try to avoid the pedantic rhetorical style that relies on cutting down the other guy in order to build up your own argument. You will get a lot further in convincing people by telling them about all of the successes of the American system.

    So if you keep your rhetoric to your side of the border than I will keep mine up here. I won’t mention anything about HMOs “rationing” care in the US or list any of the statistics reported in the New York Times about the international last place rankings of the US health care system (

    Lastly, one of Canada’s greatest heroes of the 20th century was Tommy Douglas. He is essentially the father of medicare in Canada. (We don’t hold having Kiefer Sutherland as a grandson against him.) Before turning his hand to politics he was a Baptist minister. I think he would have had a different take on the “proper” biblical interpretation of universal health care.

  • Marc Vander Maas

    I don’t recall arguing at any time that the US health care system is a model of perfection. Far from it. I’m hardly a “shrill” [sic] for the US system.

    And it’s entirely possible that your experience with the system of Canadian health care has been positive. If so, that’s wonderful.

    That doesn’t make me any more comfortable with the idea of implementing a canadian-style health care system in the US, and it certainly doesn’t make me think that Canada’s health care system is any better than it is or has much more chance of indefinite survival [url=]without some serious reform[/url].

    As for Mr. Douglas – he may disagree with my take on the issue, but I think he’s simply wrong on the economics, the sustainability, and the morality of government provided health care.

    And I’m sorry that you found my post pedantic. It certainly wasn’t intended that way, in much the same way that I’m sure you didn’t intend for your comment to be so condescending.

  • Dave

    As a Canadian I sure am amazed at how effective the vested interests in the U.S. are at putting the spin on. If I’m sick or don’t feel well I walk into the nearest clinic and see a Dr. – no concerns, no waiting, no second thoughts, easy, and we just take it for granted.

    I think we can do that in Canada because we just don’t have all that bureaucracy you have in the States – it may be private – all those insurance companies, but it’s still red tape with a vengeance and all those pencil pushers have to be paid – just sand in the machine. As for high taxes in Canada – not so you’d notice, lower I think, again because we don’t have to pay all those middle men.

    A comment on the waiting time thing – I have a friend in the States, works for himself, quite comfortably off, but no insurance. He needed a bypass – he had to save for over 3 years to pay for it – sounds like a waiting time to me. The US system has incredible waiting times (sometimes infinite) for those without insurance.

    And my heart goes out to your manufacturers – having to factor in the costs of health insurance for all their employees – no wonder the US can’t compete with off shore manufacturers whose employees’ health premiums are taken care of by the State.

  • Marc Vander Maas

    Again, I’m not arguing that the US system is perfect. And again, I’m glad that the Canadian system has worked well for you. But again, pointing out that the US system isn’t perfect and noting your personal satisfaction with the Canadian system does nothing to convince me of the long-term viability of government-run health care.

    Please note – the Fraser Center (which did the research upon which the post I linked to is primarily based) is not a US special interest. It’s a Vancouver based think tank.

    And as for wait times, here’s some more from that link:[quote]A cardiologist at the University of Ottawa reported on how delays affected Ontario heart patients. In a single year, 71 Ontario heart patients died before they were able to have surgery and 121 were removed from the surgery list permanently because they had become too ill to operate on. So for 192 people, the wait either led to their death or they became too sick to have surgery before they could work their way to the front of the line. Another 44 who could afford to bear the cost on their own left the province to have surgery – most in the U.S.[/quote]

    That’s built into your system. Pointing out that the American system is messed up doesn’t change that fact.

    Look, I’m not arguing that the US has it right by any means. On this side of the border, we like to pretend that we can keep our big social programs going (social security, medicare, etc) and that nothing’s wrong, but anyone who actually looks at the numbers realizes that eventually these things are just going to collapse unless they’re fundamentally changed. I’m pretty well convinced that the solution to the our health care problem is NOT to turn the whole kit and kaboodle to the same Federal geniuses who are busy ruining the US educational system. I’d much prefer more market oriented solutions that give individuals much more control over and responsibility for their health care decisions and costs.

  • K Christensen

    I’m with A Currie on this one. Keep your system and we will keep ours.
    You may as well have called this article I hate Canadas health care system and Michael Moore
    In fact I fail to see why you wrote this blog at all you have nothing to say about the U.S. system
    You don’t defend it, point out if and how it is better or have any insights on how to improve it and after all is that not what siko is about the U.S. health care system?
    All I see is a petty rant about socialized health care.
    I expected better.
    By the way I may be mistaken. But I don’t recall Jesus asking for insurance before healing the sick

  • Geoff Lloyd

    I’m going to add my 2 bits worth as another satisfied client of the Canadian system. It really does work for most of us most of the time; it’s not perfect but no system is. I would love to go through all of the personal experiences that I am directly familiar with but there just isn’t enough room. Here’s just a snippet from the last 2 years; a friend’s wife had a medical condition which resulted in her delivering her twin girls 9 weeks early. Off they went to the preemie ward at the childrens hospital where they were cared for the next 7 weeks until they were able to be taken home. A colleague was diagnosed with a brain tumor; 2 weeks later he had had all the CAT scan’s done, was booked in and operated on to remove a benign cyst. Another one with level 3 cancer of the colon, same thing, prompt diagnosis and operation, all chemo and care underway. Another friend’s elderly mother was stricken with indeterminate abdominal pain, quick trip to the emerg, scans done, gall bladder removed, 2 days in recovery. Neighbors wife with a breech delivery requiring C-section, all done, 4 days in post op recovery. Expenses to the families… flowers for the room, parking meters, and coffee. All the rest was underwritten by our shared medical system. The key is we all contribute a modest amount in our base fee according to our means, the rest is made up in taxes. The system is actually administered at the provincial level, funding is federal in order to level out the playing field between the have and have not provinces to ensure that all Canadians, regardless of their circumstances, have reliable access to medical care when it is needed. It puzzles me to no end that so many Americans have bought this “private is best” dogma. If so, why not privatize everything, police, fire, schools, military.. Frankly, I worry about a society that believes good work can only be done if there’s a profit involved. The flaw in the market oriented solution is that it resolves everything to a souless quest for dollars. Once there are no dollars to be made, then what..

  • Truth Seeker

    After traveling all around the world and seeing the various medical practices and hospitals I am thankful for the medical system we have here in America. Sure, like Marc has argued in these response posts, the US system is not perfect. But after seeing horrible conditions overseas and the lack of basic care I am thankful for the advanced medical care we have. Right now I am dealing with a young man in a Central American country whom, I believe, is suffering from either Typhoid or some other tropical disease. The doctors have simply done one test, it came up negative (typhoid always comes up negative) and they tell his mom to take him to the insane asylum without further testing or getting a second opinion.

    I personally had typoid and here in the states was able to get test after test done to determine what it was. I was not locked away in an insane asylum after a single test. Despite some headache moments and some red tape (some of which is needed to keep free-loaders from abusing the system) I was able to get wonderful care. Wish I could say the same for this other young man who after three weeks they still won’t do anything. And by the way the country he lives in has socialized medicine. I fear if we ever came to that.


  • K Christensen

    “Despite some headache moments and some red tape (some of which is needed to keep freeloaders from abusing the system).” I assume by this comment that you are referring to poor people trying to get free help for there typhoid. Shame on them.
    Which makes me wonder. The young man you are dealing with is he from a wealthy family? What kind of help would he get in the U.S. if he is not? Or would he be one of those “free-loaders you referred to?

    By the way France Italy and San Marino rank Ist 2nd and 3rd In health systems (ranked by the world health organization)all three have socialized medicine – U.S. is ranked number 37

  • Marc Vander Maas

    A) People who need health care in the United States get health care. We don’t have throngs of people turned away from emergency rooms because they can’t pay. I believe that’s against federal law. Now, I realize that in some cases, this can result in really hard times financially for a patient. But you can at least put to rest your concerns that adequate medical care isn’t available to those who aren’t wealthy.

    B) You know what? Statistically, the US is worse than a lot of countries when it comes to infant mortality. How horrifying! It must be because our health care system isn’t like Canada’s!

    Or not. Actually, it’s because statistics can be misleading. Why is our infant mortality rate so high compared to many countries? [url=]Because[/url][quote]…in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive — and the mortality rate for such infants is in excess of 50 percent — that sequence of events will be recorded as a live birth and then a death.

    In many countries, however, (including many European countries) such severe medical intervention would not be attempted and, moreover, regardless of whether or not it was, this would be recorded as a fetal death rather than a live birth. That unfortunate infant would never show up in infant mortality statistics.[/quote]
    So I don’t know. You might do well to check into those statistics. There may be more there than meets the eye.

    Look, you guys can come to me with hundreds of personal stories of how great you’ve been treated by the Canadian system. You can come to me with horror stories about people in America. Rest assured that I can do the same for you guys north of the border.

    It’s also completely beside the point, which is that socialized medicine, just like any socialist system, is STRUCTURALLY UNSUSTAINABLE. In the same way that American socialist programs like Medicare and Social Security are eventually going to succumb to fiscal reality, the Canadian and European systems will have to do so as well. Long term, it just ain’t going to work, folks.

  • K Christensen

    On the fact that socialized systems are unsustainable we will just have to agree to disagree.
    My point is if you disagree with Moores siko Then state why. Wouldn’t time be better spent offering suggestions as to how to improve healthcare everywhere (or at least in your own country) than bashing someone else system or socialized medicine in general. It’s ok to knock something If you can offer a solution or alternative if you can’t then its just bitching (pardon my language).
    AS for the Quote that opens up a whole differnet can of worms which I would love to discuss with you but may not fit into the topic at hand (let me know)

  • Marc Vander Maas

    I guess we will have to agree to disagree. As to why I disagree with Moore – I think we’ve established that I don’t like the idea of socialized health care. You can find reasons why throughout this post, including within the actual body of the post itself. In that regard, I am in strong disagreement with Moore’s advocacy of the implementation of a Canadian-style system in the US. This is all aside from the fact that I’m not a fan of Moore in general, as it’s pretty clear that he has a [url=]serious[/url] [url=]problem[/url] [url=]with[/url] [url=]telling the truth[/url].

    So yeah, we’ll agree to disagree.

  • Jim Nothstine

    I just wonder…if the Canadian health care system is so good, why would a woman who bore quintuplets felt it necessary to have the Ceasarian delivery accomplished in Great Falls Montana? You would think she would opt for the superior and free Canadian health care system to provide for the safe and successful delivery of her precious children. Or am I being too cynical?