Nearly everyone who says "health care needs to be reformed" usually follows it up with "we should have a system more like Canada's." This is, as usual, simply because most people really don't know much about Canada's system:

Canada often boasts its universal health care program shows it is more caring than the United States, but the system is creaking alarmingly, with long wait lists for treatment, and shortages of cash and doctors.

Ok, once more, and slowly... this is not unique. All forms of socialized or government-controlled medicine inevitably experience shortages and poor service. All of them. Without exception.

The reason is simple, yet vast numbers of people (including many who read this site) don't seem to understand it... of all the different methods of allocating scarce resources with alternative uses, government has been proven time and again, for thousands of years, to be the worst agent available. Not just a bad agent, the worst.

There are a huge number of "things" that make up the ultimate cost of, say, a medication, or a doctor's time and expertise, or a hospital stay. Because of this, it's effectively impossible for any third party to accurately "set" or "control" the price of (or access to) any one of them, let alone all of them.

Of course, this doesn't stop technocrats from trying, or from discontented citizens from trying to make them. The results are as inevitable as they are depressingly predictable. People consume more when the price is low, so setting an artificial ceiling on how much can be charged for something results in greater consumption of that something than would otherwise be the case. Conversely, people do not produce as much (or at all) when the price they receive for something is below what it costs them to make it, and so production drops. This leads to a simple and incontrovertible axiom:

When price controls are instituted on a good or service, shortages will always follow.

What's worse are the incentives price controls set up. Since profits on goods and services are typically fixed in most price control schemes (when they're allowed at all), there is no incentive to reduce costs. Why improve a dilapidated hospital when you're guaranteed a profit running it as it is now? Innovation is at least stifled, if not halted outright. Why attempt creating a daring new drug when you can't recoup your costs? Quality of service falls, sometimes dangerously. Why should anyone go to the considerable effort of becoming a doctor when your fixed compensation comes nowhere close to the cost?

The ugly truth is that, as perhaps the only free market medical system remaining on the planet, the United States is effectively subsidizing the rest of the world's medicine. Canada's system (and everywhere else governments set the price of things medical) functions as well as it does only because international companies are able to transfer the costs of their artificial and inefficient systems to our free markets, making health care more expensive for us than it otherwise would be. They have access to new and innovative drugs, machines, and procedures only because the United States allows companies and doctors to cover their risk in whatever manner they see fit. The prices of all forms of medical care fall only because the United States provides choice and competition, which pressures providers to become more efficient lest they fail completely.

Is our system perfect? Hardly. If you can't afford a car you can walk or ride a bicycle. If you can't afford a specific cancer drug you die. The simple and inhuman finality of this equation puts a unique spin on markets dealing in human medicine, and creates different pressures and incentives, ones that even cold-hearted economists can't deal with comfortably. Markets in general are always messy, sometimes dangerous, and never a good place for the sick, unlucky, or stupid. As with democracies, they are not the best solution to the problem, they are simply the least worst solution that humanity has found. And as with any human construction, there is always room for improvement.

But anyone who thinks government is the solution simply because Canadians pay less for Viagra than we do is not paying attention.