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A True Tale of Canadian Health Care: Why some patients need to go to the US for surgery

Many advocates of health-care reform are admirers of Canada's state-run, no-opt-out, single-payer system. Indeed, in 2003, President Barack Obama voiced enthusiasm for such a health-care program. Proponents of Canadian-style health care should meet Cheryl Baxter, a Canadian citizen who waited years for hip-replacement surgery, only to be told that her operation would not happen any time soon. Instead of waiting, Baxter did what an increasing number of Canadians are doing: She flew to a clinic in the United States, paid out of pocket, and had a life-altering surgery in a matter of weeks rather than years. Baxter's experience doesn't just throw damning light on Canadian health care. The sort of clinic she went to in Oklahoma suggests a different way of delivering health care in the United States, too: A simple fee-for-service model in which providers openly advertise their prices, service, and reputation. Rather than a frustrating, complicated mess of intermediaries such as employers and insurance companies, US health-care reformers should think about bringing medicine into line with the same dynamics that help deliver great service at great prices throughout most other parts of the economy. While Canadian health care is certainly cheaper than its US counterpart (health care spending in Canada is about 10 percent of GDP versus 16 percent in the United States), it is not necessarily better or more equitable. As a recent National Bureau of Economic Research comparison ...