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I’ve actually been itching to say something of the sort on my own blog, but since you beat me to it I’ll just echo you here. Canadian Econoview is a gem!
(And, I wish it allowed for comments, too.)

Count me too as a fan of the site too, I've learned a few things over the past months about healthcare systems.

Plenty of other gems there too, I recall enjoying the African water solutions post a lot, although I am too lazy to find the permalink.

I also tried sending an email a while back, until I realized the formpage I got sent to didn't include the destination address, which is not on the webpage either as near as I can tell.

FWIW, I first found the site from a truedough post once upon a time.

"You know what this story's really about, don't you? It's about the outcome of years - nay, of decades - of detailed, highly scientific long run physician manpower planning by health policy experts on both sides of the Atlantic."

Except that's not how it works. Our shortage of doctors is engineered by the Canadian Medical Association and its various provincial counterparts - it is they who grant a doctor the ability to practice medicine in a province or in Canada. The various tests, procedures and hoops foreign trained doctors need to jump through make it nearly impossible for them to practice. Which is fine by the CMA, because it drives up the wages of its members. Its direct manipulation of the supply of doctors, and thus of a free market, for its own advantage (the CMA also handles the investments and financial holdings of most doctors too - they have a direct finacial interest in restriction doctors numbers so they individually make more money).

So while an auto worker must compete with an auto worker from Japan, Mexico or Korea, a doctor has little or no competition. The shortage then drive up the price. And the government allows these protectionist measures, even though in the end, it ends up costing the government itself more money in medical fees.

Dean Baker has a great solution in "The Conservative Nanny State" - legislate a single test that any doctor anywhere in the world can write and practice medicine in Canada if they pass. We could then come close to what France has - twice as many doctors making 1/2 of the salary as our doctors, able to service more people. In fact, they have enough doctors to have both a public and private system without one or the other collapsing.

In short, have a truly free and fair market in doctors and watch health care costs go down.

But don't go blaming this on "central planing" as if this were the work of some government bureaucrats and some giant miscalculation that we are all paying for. This was the work of the doctors themselves and did exactly what they wanted it to - restrict the supply of doctors to bring the price of their service up.

If this were "central planning", we would be in the situation of Cuba - lots of doctors that are available domestically and lots of extra doctors that are exported the Africa and South America.

So perhaps you can back down a bit on the man crush there...


Ironically, BSF makes my very point in an early post:

When you mess with Supply


BSF was simply pointing out that decades worth of government manpower planning still can't get it right, while taking away government meddling and instill property rights and markets will automatically adjust precisely due to the absence of central planning.

If the government can't get it right after decades of planning, then it is folly to think it ever will. Market set prices are an amazing thing and rebalance supply and demand into an equilibrium without any central planning at all, indeed they need an absence of such planning to work properly.

The only plan the government needs is enforced private property rights for markets to work. Their absence is a government failure, not a market failure, regardless of however Leftist textbooks try to frame it.

"BSF was simply pointing out that decades worth of government manpower planning still can't get it right"

And if you read my post, the point was that there was no "government manpower planning" involved at all - it is not the government that decides who can practice medicine or who can go to medical school, but the medical associations themselves. There are no bureaucrats in Ottawa or Toronto or Edmonton saying "this year we should get X doctors". So the very premise of the remark was wrong. Perhaps you should learn how our single-payer health insurance system works - doctors are, essentially, private individuals billing a single insurance company for services.

I also point to a very clear place where central planning does take place - Cuba - and it it created a surplus of doctors. If this were a case of central planning, it is more likely to create a surplus, rather than a shortage, because a surplus is advantages to the government.

No this is a situation of a government supported monopoly (the CMA) manipulating the market(by restricting the supply) to drive prices (doctor's salaries) higher. That is not a free market in any sense of the word. This is the worst kind of protectionism that you would certainly decry in an instant if it were softwood lumber, cars or TVs.

Perhaps next time you can put the Von Mises book down and try to shake off the "government bad, market good" dogma before you make a comment. Oh, and read the comment you are replying to.

"The only plan the government needs is enforced private property rights for markets to work. "

Speaking of quoting from text books....


Thanks for making my point, albeit in different words. this is a situation of a government supported monopoly (the CMA) manipulating the market.

I'm not sure where the rest of you post came from though. You act as if I'm saying a government supported monopoly is a good thing, when in fact it is precisely that sort of government planning that is the problem. This is hardly a Leftist notion by the way, although if you want to incorrectly frame it that way, then feel free to do so.

Monopolies can only exist over time in a destructive way if the central planners wish it to exist, indeed, only if they mandate it exist by preventing competition.

Perhaps if you put down your Marx and Engels you might see however that you and I and BSF are all making the same point here though, that government regulations are the cause of too few doctors in Canada (and the US for that matter). It may shock you that libertarians such as myself are opposed to corporate welfare (in this case via protectionism for doctors) as much as the Left is.

I should add that I've been reading Brian Ferguson's comments on health policy for a long time, and he's commented at length about how the number of doctors has been made a subject of policy, and how health ministry bureaucrats have made a hash of it:

Why Is Canada's Health Care System In Such A Mess? (Part One.)

Like It Or Not, Shortages Drive Prices Up

This debate between Happyjuggler0 and Mike, where they both seem to be arguing against barriers to competitive entry, reminds of a video I recently watched on the appeal of socialism. It stated well that two reasons for individuals to appeal to socialism include: i) governments can make promises to supply services (eg healthcare), and ii) businesses wish to lobby for protection (through unionization, regulations, etc).

Ironically, as the video points out, businesses are often the worst enemies of capitalism because they are permitted to create barriers to competitive entry (our example here is of course the CMA and the AMA). As long as governments with socialist tendencies support the barriers to competition created by the medical association, the government can continue to expand its scope. The two actions go hand in hand. Why? Because when the Canadian government decided to support the CMA’s regulations, they did so with the understanding that this would “cut costs and reduce unnecessary care,” as BSF explains in Why Is Canada's Health Care System In Such A Mess? (Part One.). This never would have happened if we didn’t have the public healthcare system that we have; the incentive for government to support regulation would not have existed.

I don’t think I’d be so quick to arrive at this view if it weren’t for BSF’s blog and his work at AIMS, so I thought this comment met the spirit of SG’s post. (And, since I’m tossing complements, I’ve also found happyjuggler0’s comments on libertarianism in general to be among the most insightful in the blogosphere – so, thanks.)

Oh, and the video I watched concluded with a nice quote from Thomas Jefferson, saying something like: “natural progress dictates that liberty yields and governments grow.” But, in better words than my own.

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