We are doomed to pay high taxes forever, unless and until governments end their monopoly over the delivery of health care services.

If the production and sale of food in Canada were managed like health care, governments would have a monopoly on "foodcare." Politicians would declare that all Canadians, regardless of income, have a fundamental right to free food. After all, we need food even more than medicine, because without food a person will surely perish, whereas without medical care a person might live for weeks or months or even years.

If food were managed like health care, everyone would be given a "food-card," with which they could walk into any grocery store or restaurant, taking what they need, for free. People would take steaks before they took ground beef, thereby creating a permanent shortage of good steaks. Highly paid bureaucrats would be assigned the impossible task of deciding how billions of tax dollars should be spent on foodcare. Possessing both intelligence and sincerity, these bureaucrats would do their very best to spend our foodcare dollars wisely and efficiently. Nevertheless, demand for new, different and better foods would always exceed supply, creating chronic shortages and long waiting lists.

If food were managed like health care, access to free food would be considered the defining feature of what it means to be Canadian. It would be blasphemous to speak of food as a commodity, or to refer to foodcare users as consumers. It would be "obvious" that the private sector could not be trusted to do a good job with something as important as food. Those who wanted to introduce choice and accountability into the the food industry through market forces would be denounced as "trying to profit from someone else's hunger." People working in the food industry - on farms, in factories, and in stores - would be well-paid members of powerful public sector unions.

If food were managed like health care, wealthy Canadians would be prevented from spending their own money on better food; this would be considered as unfair to lower-income and middle-income people who had to rely on the public food system. Nevertheless, the wealthiest Canadians would always have the choice of going to the U.S. or elsewhere to spend their money on the food of their choosing. In spite of this fact, politicians would still pretend that two-tier foodcare did not exist.

If food were managed like health care, provinces who wanted to innovate with their public food service systems would be prevented from doing so by the Canada Food Act. The Friends of Foodcare would complain of "chronic underfunding." Even after spending on foodcare had doubled, some politicians would still claim that foodcare would work well if only more tax dollars were spent on it.

If it makes no sense to give government a monopoly over the production and distribution of food, why do some people expect good results from a government monopoly over health care

Many countries have parallel public and private health care systems. Health care services can be paid for by tax dollars but provided by private companies; this is already taking place in Canada today. We have a lot to learn about health care from Germany, Australia, the U.K., Singapore, the Netherlands, and other countries. It's dishonest to pretend that the only choice is between Canada's bureaucratic monopoly and health care in the U.S.

Finding taxpayer-friendly ways to improve health care is neither easy nor simple. But find them we must.