David Frum - National Post

On Oct. 30, 1997, Philip Georgiou, a 61-year-old resident of Kelowna, B.C., checked into his local hospital complaining of pain in his chest. An angiogram showed the need for immediate surgery. Despite Canada's famed medicare system, no beds were available and Georgiou was forced to wait. And wait. He waited for 12 days, bumped again and again by "more urgent" cases. "It'll be tomorrow," doctors told his wife. But, she told reporters later, "tomorrow stretched into another day, and then another." On Nov. 11, Mrs. Georgiou learned by phone that her husband had suffered cardiac arrest and was undergoing emergency surgery. He was dead by the time she reached the hospital.

An isolated instance? Hardly.

Three months later, Jeannine Lacombe, 66, checked into Montreal's Maisonneuve-Rosemont Hospital with chest pains. Doctors put her on a gurney and rolled her into a corridor: The ward, designed to accommodate a maximum of 34 patients, was jammed with 63. Four hours later, somebody stopped by to take a look at her. She had died without anybody noticing.

Canadians are endlessly told their health-care system is the best in the world. Many Americans believe it, too: Hillary Clinton's health-care plan collapsed in 1994 largely because more than one-third of the Democrats who then controlled Congress wanted to go all the way to a Canadian-style health monopoly.

But any lingering illusions that the Canadian system is either humane or efficient should be smashed to bits by a brilliant and tightly researched new book: Code Blue by David Gratzer, a student at the University of Manitoba medical school, who writes with surgical coolness and a keen eye for the deadly fact. As he tells it, Canada's government-run health-care system is disintegrating into a nightmare out of the pages of Atlas Shrugged.

At any given moment, more than 100,000 Canadians are waiting for a medical procedure. Only 20% of Canadian patients diagnosed with cancer are seen by an oncologist within the recommended period of four weeks. Once radiation therapy is prescribed, Canadians typically wait between 35 and 45 days; Americans can expect treatment in 10. When asked what he would do if diagnosed with cancer, the author of the survey that identified these delays replied, "I would go to Buffalo."

Delays stretch even longer for conditions that do not threaten life, even when they are very painful. A 1993 survey of candidates for hip-replacement in the province of Ontario found that 40% of those patients who suffered "severe pain" waited more than 13 months for their surgery. Another 40% of the severe pain group waited between seven and 12 months. Only 14% of the patients in severe pain waited less than four months.

The Canadian system shuns modern technology. Canadians wait an average of 150 days for an MRI scan; Americans, only three days. Canada has fewer MRI scanners relative to its population than South Korea.

Young doctors are fleeing the country. Nearly half the doctors who graduated from Canadian medical schools in 1997 have left, mostly for the United States. Meanwhile, unionized unskilled labourers in Canadian hospitals -- cooks, janitors and laundry aides -- earn between 25% and 50% more than their counterparts in the private sector.

The crumbling medical system has begun to exact a toll on human health. While total life expectancy has risen in Canada over the past two decades, the number of years that a Canadian can expect to live in good health has fallen since 1978 -- by 2.3 years for women and 0.4 years for men.

Defenders of the government monopoly typically blame them on the allegedly dire "budget cutbacks" of the 1990s. In fact, though, spending on health care in Canada rose by 33% between 1990 and 1998, and even faster spending increases are expected over the next few years. Medicare already consumes more than 21 cents out of every dollar earned by working Canadians, and as the baby boomers age, that burden threatens to grow.

The situation is desperate -- but not hopeless. Freedom and competition can deliver better care at reasonable cost, and Mr. Gratzer offers a clear and concise guide for reform. His illusion-shattering book can be purchased direct from the publisher at www.ecw.ca/press. It should be read by everyone who has ever glibly said that health is too important to be trusted to the greed of the marketplace. To the contrary: Health care is so important that it can be trusted to nothing else.