Does socialized medicine bring more accountability?

Whenever I'm in Canada I enjoy reading what the newspapers have to say about health care. Today's Montreal Gazette leads with Hip surgery wait times fail seniors and continues inside with Waits longest in cities for seniors' hip surgery.

Only 45 per cent of Montrealers over 65 have surgery to repair hip fractures within a day or two - the medically ideal wait time. In Laval, the figure is 32.6 per cent, the lowest in the province, while in Abitibi-Témiscamingue it is 94.2 per cent. The results contradict Health Minister Yves Bolduc's position that Montreal has better access to specialized medical services than rural or remote areas.

The Gazette's take is clearly that its readers are getting a raw deal. Yet from the standpoint of a visiting American there are a lot more interesting insights to be gleaned:

• It's amazing that rural and remote areas have better access to service than the big cities. That's due to how permits for specialists are allocated geographically
• There's no breakdown by payer, e.g., Medicare, Medicaid, commercial, uninsured because it's not relevant. Everyone has medicare (note the lowercase m, which somehow fits with the idea that universal coverage is taken for granted)
• The data come from a comprehensive look at all the hip surgeries around the country (and for that matter for a lot of other different procedures) rather than from a single-center study of a couple hundred people as would be typical in the US. They actually have comparable information on access across geographic areas and time for all patients
• The government is actually being held accountable for the results, and despite the sensationalistic headline the quality of the debate in the general media is a lot higher than the "rationing" and "death panel" noise one hears back home
• In the bigger picture, about 80 percent of Canadians are receiving "priority procedures" within the recommended time frames