A safety valve for 'single payer'

Last month, 60-year-old Danny Williams, premier of the Canadian province of Newfoundland and Labrador, learned he had a leaky heart valve. Doctors said he needed immediate surgery.

The surgery he ultimately had at Mount Sinai Medical Center in Miami was less invasive, involving incisions in the armpit, as opposed to more traditional approaches that involve cracking open the sternum. Paying for the surgery was apparently not an issue for Mr. Williams, who donates his premier's salary to charity.

Some Canadian surgeons are now arguing the less-invasive procedure could have been performed in Ottawa. They're also arguing that the premier, given the urgency of his condition, would not have had to wait in line more than a week.

Several Canadian defenders of the premier have commented that he was in a no-win position, because it would have been "political suicide" had he remained in Canada but been perceived as "jumping the queue" to get his surgery ahead of less-notable citizens. Such commentators seem to rebut the argument that an average citizen would not have had to "wait in line" for such surgery in Canada today.

All politics aside, we'd like to wish Mr. Williams a speedy recovery. But this doesn't mean we have to ignore the obvious: Canada has a "single-payer" system in which people who are not government bigwigs often have to wait in line for months for the kinds of routine medical testing that -- here in the United States -- saves lives by leading to earlier interventions.

Canadians who are not independently wealthy still struggle to raise the cash to avail themselves of superior medical care "south of the border" whenever they consider the problem serious enough. Why is that, if the Canadian system is so good that we should emulate it, as Barack Obama insists?

Medical innovation continues in the United States because it's profitable. Medical innovation has stagnated in Canada because it's not, and because the best doctors and researchers have fled to countries where they can still make money at their trade -- most notably, the United States.

If the United States adopts a Canadian-style, rationed, inferior medical system in which more people die while waiting in line, where will Americans go in pursuit of better care? Where will Canadians go? And won't that lead to precisely the "two-tiered" system -- better care for those with enough money to hop a plane -- that Democrats claim to oppose?

Or will they just refuse to let us leave?