Canada’s Health Care System

Perhaps the only acceptable way to solve our health insurance crisis is by adopting a two-tier system. One form of insurance covers cost for basic health care, another a more comprehensive one. In the basic coverage, heroic measures such as neonatal care and organ transplantation will be totally excluded or only 50% covered.

Today there is no great incentive for either the patients or the physicians to conserve our medical resources. I know of a case wherein an 84-year-old woman’s relatives insisted on a coronary bypass procedure after having been advised that there was a zero chance for recovery. Unfortunately, were the physician to refuse to perform the procedure, he would face a lawsuit as certainly as the sun rises from the east.

Thus, major legal reform will also be necessary to reduce both the direct and indirect cost on medical care. Under the Canadian system, a common procedure such as coronary bypass often requires months of waiting. I doubt that this is acceptable to most Americans.

JOHN T. CHIU, M.D.

Anaheim