Tim,
When did it occur to you that this thread veered off into politics?
Bryan,
Sorry, your supposition is wrong. You did not come to mind in my ill-advised attempt to reply to Jon. I was not "juxtaposing" communism to the Canadian one-payer system by virtue of the two appearing in subsequent sentences. Instead, I was noting that in a Communist system such as Cuba's, the state allocates resources without prices. In its command economy, most workers get paid the same amount, 100 pesos a month I think, and they are given ration cards for staples and other necessary goods. In response, the workers pretend to work and the country has been in a continual decline for six decades.
Canada's system, if I understand it correctly, does involve market pricing since the supply of medical professionals is impacted by what the government agrees to pay for services. Given the number of Asian doctors and healthcare providers who work in the U.S., I am assuming that Canadian healthcare workers would be able to immigrate if the wages/prices were unsatisfactory. It is a bit harder for a Cuban doctor dispatched to Venezuela in exchange for oil and foreign exchange to say "to hell with it" and hop the border into America (besides, medical training in Cuba appears to be so basic and substandard that few could get licensed).
By "doled by right" I simply mean that people in Canada (illegal immigrants and non-citizens too?) are entitled to most medical services with no direct payment. I am glad that you're satisfied with the system and feel well-served. I am doubtful that many Americans who up until recently pretty much had service on demand would be patient to wait in pain for the queue to work itself out, especially at the end of the budget year. A system which has the capacity to be adequately responsive to immediate life-threatening medical problems and ration remaining care may serve Canada's needs, but I am doubtful of its efficacy in the U.S.
As to medical tourism, caveat emptor. Cost is a big factor. Some people would rather drive an expensive car, have a second home, travel in style to exotic destination than be willing to pay for a procedure out of pocket. As a libertarian, for the most part, I respect the right of people to make their own choices with the caveat that they must be responsible for the consequences. If someone wishes to travel to Costa Rica or Poland for a back operation to save $20k, I guess it is a better choice than a much lower amount in Cuba or another similar country. I doubt that any would travel to Canada, even if your government allowed the already limited number of doctors to take on cash patients.
Regarding my use of the word "rationing", I don't know what you would call waiting several months for many elective procedures. The gall bladder example was only one of many I was made aware of. Perhaps I am guilty of confirmation bias. I can probably get my knee replaced during normal times in a week or so, the time largely a function of testing, scheduling with a specific ortho, and where I want it done. Some star doctors in high demand have longer lead times, a form of rationing I guess given how much they are willing to work and how many people demand their services, not a government budget or targeted type of service.
You know quite well my thoughts on "free" stuff. A country such as yours, huge in physical size relative to population, blessed in bountiful natural resources, beauty, and some of the kindest, most knowledgeable people anywhere, why is the cost of living so damned high? Of course, your health care is not free. And maybe you are getting an acceptable bang for the buck when it comes to health care and the quality of life. But your demographics, dominant culture, and expectations are quite different than ours.
As to NYC and the results from the pandemic, let's re-visit the subject this time next year. I've been pretty good at evaluating risk much of my life and my reading and gut feel are that we will fare better than many fear.
And thank you for your well wishes. Ditto to you and yours.