Barack Obama has a high opinion of the Canadian single-payer health-care system.  In March, he lamented that the only thing separating us from Canada’s system was our “legacy” of employer-based health care, and of course free markets and private contracting, neither of which have been allowed in Canada.  That may account for why Canada’s system, in an effort to reduce wait times, now contracts with American providers across the border:

Hospitals in border cities, including Detroit, are forging lucrative arrangements with Canadian health agencies to provide care not widely available across the border.

Agreements between Detroit hospitals and the Ontario Ministry of Health and Long-Term Care for heart, imaging tests, bariatric and other services provide access to some services not immediately available in the province, said ministry spokesman David Jensen.

The agreements show how a country with a national care system — a proposal not part of the health care changes under discussion in Congress — copes with demand for care with U.S. partnerships, rather than building new facilities.

The Detroit Free Press hasn’t paid much attention to the debate here in the US if it thinks single-payer isn’t part of the changes under discussion in Congress.  Rep. Anthony Weiner (D-NY) has gone on television twice to push the idea of “Medicare for all Americans.”  Rep. Eric Massa (D-NY) says he’ll vote against his constituents’ wishes to get single-payer.  Reps. Barney Frank, Jan Schakowsy, Carol Shea-Porter, and more have made on-camera public statements in support of single-payer.

For that matter, so has Barack Obama.

And we see what happens in a single-payer system.  The system does not expand to meet the need, for a couple of reasons.  First, the payer doesn’t want to spend the money necessary to meet the demand, because it would mean admitting that single-payer does not actually control costs; in fact, it sets in place an entitlement mentality, which increases demand and costs.  Second, because of artificial price controls, the system does not generate enough supply to meet the demand, which increases rationing and shortages.  All of this is Econ 101.

In this case, Canada has decided to contract with private services across the border to shunt off its excess demand.  This costs more than reverting back to a private-market system, but it costs less politically.  In the meantime, the ability to shorten wait times helps keep Canada from seriously addressing its problems, although probably not for very much longer.

And that’s good, too.  Because when we adopt Canada’s system, we hope they’re smart enough to adopt ours, and those of us close enough to the border can slip across to get our health-care needs met.