Health care is a prominent issue that affects the lives of all Canadians. With rising costs, budget cuts, an ageing population, and waiting lines plaguing every hospital, it appears the Canadian state monopolized system cannot be sustained. Malcolm Gladwell, who is in favour of the American health care system, argues that the Canadian Medicare does not have the most important feature of any health care system: a tier for upper middle class citizens, where every health care innovation comes from.

Gladwell makes an excellent case in favour of the American health care system, arguing in favour of high-quality care, as it provides technological advancements and new methods of treatment, improving all aspects of health care around the world. However, I believe Gladwell fails to sufficiently attack the Canadian single-payer system in the debate. There were few instances where Gladwell described the problems Canada faces on the issue of health care, arguing that anxiety exists in Canada because of health care funding. I believe Gladwell should have further developed this point in order to make a strong case against Canadian Medicare. With the health care summit only last week, it seems the Canadian solution to fixing health care is to pump more money into the system. The current problem with health care in Canada today is that “reforms” consist of merely increasing funding to the health care system. This is not the manner in which we should improve health care and decrease waiting times.

First, health care should cease to be a federal responsibility. The Canadian constitution designates health care as a provincial responsibility. When Medicare was first implemented, Tommy Douglas introduced it in Saskatchewan in 1962. The program was a success, and gradually spread to the rest of Canada. However, with the Health Care Act passed in 1984, health care funding became a federal responsibility. The underlying idea of central planning results in an inefficient health care system that lacks accountability.  To make the control of the health care system more accountable, the federal government must allow the provinces to independently fund health care, and decrease taxes to accommodate the provincial tax increase.  This would in turn free the provinces from central control, allowing them to experiment with reforms and privatization.

Currently, our “universal” health care system is very inconsistent. Since 2000, eighty-two doctors in Quebec have become private doctors. In contrast, seven private clinics in were bought by the Province of Ontario, to “save Canada’s health care system”. Not only has the single-payer health care system compromised the health of Canadians, it is undermining the rights and freedoms of Canadians by shutting down or buying out clinics that are not under the control of the government monopoly. In one of the videos that were shown to the class, a doctor from a private clinic pointed out that the Canada Health Act is like saying in the Soviet Union that people cannot sell bread, because the government sells bread. In a democratic and free society, citizens must be offered choice, instead of a system where the only alternative to the poor level of treatment offered in Canada lies outside of the country, in America. To improve the Canadian health care system, we must allow a certain extent of privatization to create a two-tier system. Under a free-market system, individuals and groups recognize that there is a demand for high quality health care, and solve problems such as long waiting lines by investing and setting up an alternative to the existing market. By allowing the private sector into the Canadian health care system, waiting lists will be reduced, and competition from the private sector will make the public sector more efficient, improving the overall quality of care.

However, these reforms cannot be possible under the current Liberal government, who has shown no signs of willingness to accept health care reforms. Liberals are clinging desperately to our government monopolized health care system and fear changes or reforms. Many liberals conflate the idea of health care reforms with the unlikely prospect of Canada adopting an American-style health care system. However, this is not the case. Many Canadian conservatives, including Frank Klees, who recently lost to John Tory in the leadership race for Ontario’s Progressive Conservative Party, believe the private health care option should be given to those who can afford it. This view is often confused with the support for a free-market system. However, Frank Klees argues that “We need to add a principle of choice to the Canada Health Act.” The opinions of Malcolm Gladwell and Adam Gopnik are extremely polarized, yet the issue of health care allows for a centrist view that encompasses different aspects, benefits, and problems of different systems. The two-tier system is the status quo in Europe, yet in Canada, the only alternatives portrayed by the mainstream media and liberal politicians are opposite extremes: the current state monopolized system in Canada, and the free market system in the United States. To reform health care, Canada must emulate only certain aspects of the American system, such as high-quality care that allows for technological advancement, and look to European two-tier systems that both reduce waiting times and provide care for the poor.

Gladwell states that “one of the principal functions of a health care system is to offer all of those in the system the greatest possible chance of survival in the event of some extraordinary occurrence.” I believe neither the Canadian nor the American health care system has achieved this. In Canada, long waiting times ensure that no Canadian receives proper treatment, while in the United States, the uninsured have little chance for survival, and are left with hundreds of thousands of dollars of debts and medical bills in the event of an extraordinary occurrence. To reform the Canadian health care system, we must find a happy medium between these two extremes.

I was disappointed that the issue of reforms did not come up in the group or class discussions, yet the discussions were interesting nonetheless. I anticipated a heated debate at first, since I had barely introduced the issue in the first two minutes when a certain Lenin-idolizing socialist at my table interrupted me and launched into a diatribe about the 43 million Americans who are without health insurance. However, for the rest of the tutorial, most of the members of my group were subdued. This changed when the issue of responsibility was brought up, leading another group member to start another diatribe, this time about how this group member was paying thousands of dollars of taxes on cigarettes, and therefore deserved treatment for lung cancer in the future. I completely reject this argument, since smokers are consciously making a decision to neglect their health and as a result, are putting themselves in a hospital bed. In doing so, they are crowding the health care system unnecessarily, and taking hospital beds away from patients who are the victims of extraordinary occurrences, not suffering from a preventable disease as a result of their own bad judgment or blunders. The Canadian health care system creates a sense of entitlement among Canadians, while the American system puts pressure on citizens to live a healthy lifestyle.

I enjoyed this tutorial, because it is a very relevant issue to Canadian and American politics today. In Canada, we face the problem of an ageing population, which will increase the strains on the already-overworked state monopolized health care system. Reforms may be necessary in the future, as this issue becomes increasingly important. It is important to realize that the American free-market system is not the only alternative to the most socialized health care system in the world. Furthermore, Gopnik “cannot imagine any possible political circumstances in which you could possibly return to an American-style system in Canada.” In Canada, it is extremely unlikely that our health care system will come full circle. However, it is very likely that increasing funding will not solve the country’s health care anxieties, and that reforms are possible. The idealistic single-payer system of Canada will eventually fail, and will be forced to allow privatization until it more closely resembles the current European systems.