Re: Status quo—not an option
In JAW’s editorial (BCMJ 2006;48[1]:4-6) and G.F.O. Tyers’s letter (BCMJ 2006;48[4]:163), the only possibly factual information given was that only Canada and North Korea have “monopolistic government control of the country’s health services” and that “Canada ranks 2nd in the per capita cost of our system but 30th in the WHO’s measure of quality.” This information would suggest that the US is number one in cost (they have three tiers—private, public, and no care) and that there must be almost 160 countries who rank below Canada in “measure of quality” (elaboration might reasonably be requested) but don’t have “government monopoly.”
Although Dr Tyers refers to the “brutal” regime in Cuba, I suspect that Cuba probably rates fairly far down in rankings of brutality among regimes that have two-tier health care or private-only care (e.g., Saudi Arabia or China). The link between for-profit medicine and brutality is rather tenuous at best.
—Michael Dettman, MD
Vancouver