Every Canadian is covered by his provincial government’s health plan. So, doctors have only one plan with which to contract. Each doctor cannot decide how much he wants to charge his patients. Instead, he is dependent on a centrally bargained contract which determines fees for every procedure and practice from the skyscrapers of downtown Toronto to windswept hamlets on the frozen shores of Hudson’s Bay.
No wonder it takes more than two years to negotiate a contract. According to local media, the doctors’ demands were threatening to bust an already heavy-laden budget:
The hardline stand of Ontario’s doctors raises questions across the country about how to balance the labour rights of a well-organized profession with spiralling health costs that threaten to swamp provincial budgets as populations age and guaranteed federal health transfers grow at a slower rate.At least the doctors did not go on strike, like young doctors in Britain did recently. It is hard for Americans to imagine the entire profession of medicine walking off the job like U.S letter carriers did in 1970. However, labor strife among physicians appears to be common in countries where the government monopolizes payment for medical care.
The hostile relationship that develops between the medical profession and the state in countries with single-payer health systems makes a mockery of the so-called guaranteed “right” to health care that underpin single-payer proposals from politicians like Bernie Sanders.