The U.S. is headed for a two-tiered healthcare system

Canadian doctors have already established private clinics to treat patients who are able to pay for their services in place of the socialized medical system in their country, as I have previously posted.


There are howls of outrage coming from the liberal community in Alberta,  Canada. It seems that some doctors, desperate to protect their patients from the  overcrowded and failing socialized medical system in their country, have set up private clinics to treat them. To circumvent Canadian laws,  which prohibit charging for medical care, they have set up private, membership  clinics where, for $2,000 a year, patients can access well staffed and equipped  clinics and avoid the long waits and compromised care of the public  system.

It does not seem to have occurred to defenders of socialized medicine that  the system itself is causing the doctor shortage. Cuts in medical fees,  overcrowding of facilities, shortages of equipment and space, and bureaucratic  oversight have all combined to drive men and women out of family medical  practice. Now, with a critical shortage looming, those who can afford to pay for  adequate care are opting out of the public system and, literally, taking their  lives into their own hands.

This is where the United States is headed. Socialism dries up the supply of  medical care and forces ever stricter rationing of the available resources. As  Margaret Thatcher famously said, “Eventually socialism runs out of other  peoples’ money.”

Can you believe that Canadian Law prohibits charging for medical care? Is that where the U.S. is headed under the Affordable Care Act? You bet it is. Socialized medicine, in which a doctor isn’t free to service a patient without government oversight – totalitarianism.

Not only will healthcare be rationed to maintain costs, but logic dictates there will eventually be only the one payer system. Someone has to pay the costs for the tens of millions of uninsured.

The U.S. will be moving toward a two-tiered medical healthcare system under the ACA if there remains any freedom in this country that would allow doctors to charge for services they provide in a private clinic to patients who can afford their services.

The government healthcare system will be a failure because you can’t add 30 million to 40 million uninsured people to the system without the plan also providing for more physicians to provide adequate care.


The evolution toward a two-tiered system was already under way before Barack Obama became president. But ironically, the Affordable Care Act (Obamacare) is accelerating the pace of change.

In one system, patients will be able to see doctors promptly. They will talk to physicians by phone and email. They will have no difficulty scheduling needed surgery. If they have to go into a hospital, a hospitalists (who reports to them and not to the hospital administration) will be there to make sure their interests are looked after. They may even have an independent agency that reviews their medical records, goes with them when they meet with specialists and gives them advice on every aspect of their care.

In the other system, waiting times will grow for almost everything ? to get appointments with physicians, to get tests, to obtain elective surgery, etc. Patients may find that they don’t have access to the best doctors or the best hospitals. They may find that the facility where they are treated does not have the latest technology. In terms of waiting times and bureaucratic hassles, health care for these patients may come to resemble the Canadian system.

The U.S. is about to see a huge increase in the demand for care and a major decrease in the supply.

In any other market, that would cause prices to soar. But government plans to control costs (even more so than in the past) by vigorously suppressing provider fees and the private insurers are likely to resist fee increases as well. That means we are going to have a rationing problem. Just as in Canada or Britain, we are going to experience rationing by waiting.

Because the two tiers of health care will compete with each other for resources, the growth of the first tier will make rationing by waiting even more pronounced in the second tier. As a result, waiting times in the second tier could easily exceed those in Canada.

The two-tiered healthcare system will happen as it has in other countries and it will happen in the U.S. faster than most people think!