Earlier this year, the Canadian Supreme Court struck down the ban on private health insurance in Quebec due to an inability of the province to deliver timely health care. Now the Canadian Medical Association argues that the ban should be revoked throughout the country, and for much the same reasons:

All Canadians should have the right to buy private health insurance to complement their care in the medicare system, the country's leading doctors' group says.

The Canadian Medical Association said, in essence, that a recent Supreme Court of Canada judgment, which struck down a ban on private health insurance in Quebec because patients were not ensured timely access to care, should apply to all Canadians.

In doing so, the CMA, which represents the country's 62,000 doctors, also clearly rejected the notion yesterday that there should be a medicare monopoly. It did so just one day after doctors gave their backing to the existence of a parallel, private for-profit health system.

This does not come unexpectedly. While Americans tend to think of the Canadian health-care system as a model of nationalized medicine, many Canadians have to travel to the US in order to get timely treatment. That requires money, which means that the wealthiest Canadians wind up getting much better treatment than the rest of their fellow citizens. Oddly, that also seems to be the argument that those opposed to legalizing private insurance use:

Atul Kapur, an emergency-room doctor from Ottawa, said only healthy, wealthy Canadians would be able to afford private insurance and the privileged access to care it provides, and that would undermine medicare.

"This is not a solution that will help our patients," he said. "It will help private insurance companies to skim and cream healthy patients."

Dr. Kapur has it backwards. The wealthy might well get better representation with private insurance, but that will allow them to at least stay within the Canadian system for their needs. With the ban, the wealthiest have to flee the country to get the attention needed in the time frame they need. How does that help Canadian doctors? If the doctors create a parallel system of private healthcare, doesn't that take some of the pressure off of the public system, allowing for quicker response time to less-wealthy patients as well?

What Canadians have discovered is that government-rationed health care provides slow and limited options for patients, just like everywhere else it has been tried. The American healthcare system, in comparison, uses the market to ration care and results in much more responsive providers. It also provides higher degrees of innovation and gives doctors incentives to specialize. In Britain, for example, hospitals discarded viable transplantable organs due to a lack of trained physicians to perform the operations -- a shortage caused by the lack of compensation for transplant surgeons despite the increased cost of certification for the procedure.

Market-based rationing may have its flaws, especially in a litigation-heavy arena like health care. However, those rarely get solved by government-based rationing, which not only make the same flaws worse but compound them with a raft of other destructive practices. The CMA should be congratulated for starting to comprehend this pattern. Their patients have already made their diagnosis.

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