Freeman

ARTICLE

Hospital Food and Socialized Medicine

To Make a Minor Issue a Major Problem, Turn it Over to Government

MARCH 01, 2000 by LAWRENCE W. REED

Hospital food is rarely mistaken for gourmet cuisine anywhere, but at least it’s not an issue over which major political campaigns are waged. Except in Canada, that is.

Last September, a colleague of mine visited Manitoba, a province in central Canada. Electioneering was at a fever pitch, with just a few days left before voting for a variety of public offices. My friend was astonished to observe that the dominant issue was indeed hospital food. It had become a political hot potato, the candidates outdoing one another to express concern and promise action.

The unhappy patients of Manitoba’s hospitals and personal-care homes have complained for months about the introduction of “rethermalized food”—cut-rate meals prepared 1,300 miles away in Toronto, then frozen and shipped to Manitoba, where they are nuked in microwave ovens and served. Peter Holle, president of the Frontier Centre for Public Policy in Winnipeg, explained to me that the rethermalized meals idea was a cost-saving “innovation” of government bureaucrats employed by regional health authorities.

“Never mind that they taste like cardboard,” says Holle. “Never mind that individual tastes and circumstances might dictate decentralized food services. Reheated meals became a symbol of efficiency for the supposedly compassionate do-gooders in government. Why pay hundreds of workers in dozens of Manitoba kitchens when we can just zap up frozen dinners from Toronto? Somebody suggested that the province could save more money by serving these meals in the legislature’s dining room too, but that was one idea that the politicians dismissed as truly half-baked.”

As it turned out, unease with the government’s handling of health care, including vile victuals, was one reason the incumbent government in Manitoba went down to defeat.

How to Politicize an Issue

How does hospital food become a political issue? The same way anything—from the important to the utterly inconsequential—becomes a political issue: socialize it. Take any matter that people normally resolve quickly, peacefully, and privately by their own choices and initiative, turn it over to government, and watch what happens. Factions arise. Conflict ensues. Problems appear.

Indeed, by turning such matters over to government, you can actually ensure that minor problems become big and intractable. Government makes decisions that it finances by taxes and imposes with its police power. That employment of force guarantees that somebody, if not everybody, will be unhappy. If they can’t escape the system because they’re forced into it, then they’ll bicker and fight endless and often silly battles.

This is yet another argument for keeping government confined to a few basic functions like defending life, liberty, and property. Life is too short to waste precious time politicking about hospital food. Can you imagine having to put the affairs of your own home kitchen up for a public vote?

If Washington nationalized the auto industry, we’d get the cars that bureaucrats wanted us to have. If you didn’t like the quality or the color choice or the price, you could hope somebody runs for office and changes things from the inside. In a free market, if you don’t like Ford, there’s no need to go to the polls or bribe your congressman; you just buy something else. Politics is simply no way to run a kitchen or a car factory or a whole lot of other things.

The health-care system Canadians endure suffers from socialization, which explains why hospital food is probably among the least of their concerns. According to a national poll, four out of five Canadians are unhappy with the health-care system and believe it has worsened noticeably in just the past five years. Doctors in Manitoba apparently agree with the majority of Canadians. Almost half of them—an astonishing 1,800—have left the province in this decade alone.

David Gratzer, a prominent Canadian health-policy commentator, published a blockbuster book last year entitled Code Blue, in which he skewers the country’s socialized system. Gratzer reveals in painful detail that the quality of care that Canada’s system provides to ordinary citizens matters less to its apologists than the quality of care it denies to the so-called rich. The egalitarian impulse that drives Canada’s “universal” health-care system calls for treating everybody the same; all patients get “free” care in the public system and are generally denied the option of getting faster or better care for a fee in the private sector.

Gratzer makes a telling point with a rhetorical question: “With health care, is our true goal that Mr. Smith, who owns three cars, not be allowed to get a quick (private) cataract surgery? Or is it that Mr. Jones, who just makes rent every month, gets (publicly funded) heart surgery when he needs it? The way [the system's] advocates carry on, you’d think that it was fine that Mr. Jones suffered crushing chest pain after walking three steps just as long as Mr. Smith had to stumble around blindly for six months.”

Thanks to this egalitarian idiocy, an estimated 212,990 Canadians were on hospital waiting lists for surgical procedures in 1998, a 13 percent increase over 1997. According to the Fraser Institute of Vancouver, British Columbia, patients waited a median of 6 weeks after referral by a general practitioner for a consultation with a specialist and another 7.3 weeks after the consultation to receive treatment. The median total waiting time of 13.3 weeks was up from 11.9 weeks in 1997 and up a shocking 43 percent since 1993.

The gap between the amount of time specialists considered clinically reasonable and the actual waiting time after consultation was greatest for elective cardiovascular surgery, for which the actual waiting time was 8.1 weeks longer.

The Fraser Institute points out that while Canada’s spending on health care as a percentage of gross domestic product is the fifth highest among nations of the Organization for Economic Cooperation and Development (OECD), the country ranks in the bottom third in availability of most medical technology. For example, for every million people, Canada has 1.7 magnetic resonance imagers (MRIs), a cutting-edge diagnostic tool, compared to the OECD average of 4.2 and the U.S. figure of 16. No wonder that when former Quebec Premier Robert Bourassa was diagnosed with cancer, he didn’t stick around to get free care in his home country; he hightailed it to Cleveland.

The lesson from Canada? Politicians shouldn’t be trusted with the health care hospitals provide any more than they should be trusted with the food that hospitals serve.

ASSOCIATED ISSUE

March 2000

ABOUT

LAWRENCE W. REED

Lawrence W. (“Larry”) Reed became president of FEE in 2008 after serving as chairman of its board of trustees in the 1990s and both writing and speaking for FEE since the late 1970s. Prior to becoming FEE’s president, he served for 20 years as president of the Mackinac Center for Public Policy in Midland, Michigan. He also taught economics full-time from 1977 to 1984 at Northwood University in Michigan and chaired its department of economics from 1982 to 1984.

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