[Azure]

To expand on my comment about European countries and the two-tier system....

In Sweden in the late 1980s under a contracting system, private suppliers were performing 25% of coronary bypass surgery. In France, under fee-for-service, private clinics handle surgery for digestive diseases and eye surgery, and fully one third of hospital stays are in private facilities, and in Norway private clinics specialize in open-heart surgery and hip surgery, among others. None of these countries spend a significantly higher proportion of their GDP on health than we do, none has a higher private expenditure share, and all have life expectancies at birth on the same order as ours. In Japan, where both male and female life expectancy at birth are the highest in the OECD countries, and where expenditure on health takes up a mere 7.4% of GDP, a very large proportion of hospitals are in fact small, private clinics with facilities for overnight stays, and 54% of beds are classified as investor-owned.

There are countries with full-scale private hospital systems running in parallel to their private systems - Australia and the UK are probably the best known. In the UK the private hospital system is well established, and is regularly used by the NHS to pick up the excess demand when public sector waiting lists get too long, just as Canadian governments use the US private health care sector to relieve queuing times in Canada, as the Ontario government, for example, has done recently with cancer care.

But hey....what do I know?

When the WHO rated health systems around the world, Canada ranked 14th in “overall system performance” among industrialized countries, 4th in terms of overall system attainment and 5th in terms of responsiveness. Virtually every country that the UN ranked higher than Canada allows people to gain access to health services through private payment, and many of them have as good or better population health indicators and spend more per capita on health care.

A Harvard study comparing the UN health care system rankings with the opinions of the population of each country, found that Canadians’ level of satisfaction with their system was 12th in the industrialized countries, again lagging a long list of countries with more formalized multi-tier access and a broader range of services covered by public insurance. The poor and the elderly in this country both ranked Canada lower, at 14th.

http://www.aims.ca/healthcare.asp?typeID=3&id=333