One memorable sound-bite from the 1999 Ontario provincial election was Liberal leader Dalton McGuinty's kickoff press conference, on emergency medical care, in front of a Toronto pizzeria. McGuinty made only one tired, though scary, point -- that emergency care in Ontario is becoming less accessible, with patients waiting hours in hospital emergency rooms for treatment, and consequently riskier to our health. Yet he made it in a novel, clever way.
His cleverness was to contrast emergency care delivery with pizza delivery. Almost all of us in Ontario can buy a pizza anytime, and have it delivered to our home in a guaranteed 40 minutes; why should we tolerate lower standards in a matter so much more important to our lives? Why can't we have medical care as quickly and conveniently as pizza?
Answering that question means discovering the reason for the disparity: what difference or differences between the services accounts for the different service level. One way to determine that is to look at what would happen if the pizza business were run the way the health care business is run in Ontario and across Canada.
That would mean the government adopting a system of free, universally accessible pizza insurance. Citizens would no longer have to pay directly for pizza; in fact, it would be illegal for them to do so. All pizzas would be paid for by one government-run insurance plan. Ability to pay would no longer play a role in pizza consumption: so much so that the plan would not even charge premiums, instead being funded from a special tax on employers, the "rich," or some other third parties.
If pizzas could be obtained for free, one would expect demand for them to rise almost infinitely, and for costs to far outstrip what the special tax could finance. The government first would pump more money into the plan, subsidizing it from other taxes or the deficit (as they have done for health care, and as welfare liberals like McGuinty promise to continue doing). Subsidies, though, cannot increase infinitely; governments cannot increase taxes or the deficit at will. At some point, they would have to start controlling costs, leading to closings and cutbacks.
That would also mean government making further adjustments on the supply side. American-owned pizza chains would be banned; Canadian chains would be allowed, but forbidden to make a profit. (The government would subsidize their losses, or even open its own chain if the "free market" couldn't meet the demand.)
Individual pizzerias would be allowed, but their number would be controlled through licensing. Government would decide how many pizzerias to allow, and where. As the sole payer, government would decide what types of pizzas could be sold, and at what prices. In return, pizzerias would get the new sources of income that come with a monopoly: for instance, it would become illegal to purchase frozen pizza, or even any pizza ingredients, without a prescription from a licensed pizzeria.
For cases of dire need, government could set up Emergency Restaurants (ER's) where the truly needy could receive free pizza without appointment. Hospital cafeterias could easily be turned into ER's.
It is easy to see what these reforms would lead to: pizzas much harder to get, with a limited selection sold only by appointment or at an ER, ER's crammed with consumers waiting in long lines at all hours, and government frantically trying to cope with both declining service and rising costs.
If we want pizza as available as health care, we know which reforms to adopt. Conversely, if we want health care as available as pizza, we know which to abolish.
reprinted from Libertarian Bulletin, 19:4 (Summer, 1999)
Ontario Libertarian Party
www.libertarian.on.ca
©2008 George Dance, all rights reserved. You must have written permission from the author in order to republish this work.
Published: Sunday, July 6, 2008
Last modified: Sunday, July 6, 2008
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Reader Comments:
Posted By: Maria Folsom
Date: 2008-09-03 10:55:35
Great description! Anyone should be able to understand this! Thanks for writing it.
Posted By: RSDavis
Date: 2008-10-22 07:33:18
You're right. These are many of the same points. Great piece!