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I definitely see the reasoning behind the Canadian system. If they provided “free” gov’t run hospitals but also allowed citizens to seek private treatment, most people would (after showing up at the gov’t hospital and being told they were being placed on a 14-month waiting list) seek private treatment. This would result in a vibrant, parallel private system. And then, of course, people would go out and purchase health insurance, etc. And then everyone would start wondering why they were paying taxes to support gov’t worthless gov’t hospitals that almost nobody used.

The fact that the Canadian gov’t felt in necessary to criminalize private medicine was basically an open admission that gov’t medicine wouldn’t be able to compete with private medicine, and that the existence of private medicine would undermine the gov’t medical system.

A parallel in the US is Social Security. The Democrats knew that unless they made payroll taxes/Social Security mandatory for everyone - rather than just a welfare system to keep the elderly out of poverty - it would not have broad public support. Further, if we were allowed to opt out of SS, pretty much everybody would. I mean, stuffing 7.5 percent of your paycheck under your mattress is a wiser investment than SS. Just as the Canadians had to make gov’t medicine mandatory, so the Democrats had to make Social Security mandatory.

As to your comments about “rationing,” I agree that we are already rationing medicine. But that’s akin to observing that the sky is blue. We live in a world of scarcity, so everything - not just medicine - is rationed. Every society has some system of dividing up the pie. The only questions are: (1) What is the fairest way of dividing up the pie? And (2) do some methods of dividing up the pie actually enlarge the overall size of the pie such that there’s much more to divide.

I think any rational person would want to emphasize #2. Take, for example, that MD Anderson in Texas (just one hospital) spends more money each year on cancer research than the entire country of Canada. Or that the US as a whole spends more money on medical research than the rest of the world combined. That’s increasing the pie for everyone’s benefit.

Also, I’d like to see statistics on “exclusion of rather cheap interventions for childen.” Almost all states provide free medical care for children.

When people write these stories though, I think they should clarify that we are already rationing health care, we are just doing it based on ability to pay (or to have a job that provides good insurance) or ability to live to be old. Focusing the vast majority of our resources on that second group is somewhat a given since for most people they will face their largest health issues when they are greater than 65. However, the tremendous emphasis on that group–and expensive interventions for that group–to the exclusion of rather cheap interventions for children and young adults is inefficient.