In a public health care system, the doctors, nurses, janitors and administrators all need to be paid every Friday so the only point at which costs can be controlled is through the patient, by restricting access.
And how does the system restrict access? Why, through the dreaded waiting list, of course. In a socialized system–whether it is in Canada, England, New Zealand, or Pluto–the incentives always work against the customer:
If you go to an American doctor with a monstrous lump on your shoulder, it’s in his economic interest to find out what it is and get it whipped off as soon as possible. If you go to a British or Canadian doctor, it’s in the system’s economic interest to postpone it as long as possible.
Steyn is not, of course, a health care policy type. Nonetheless, I think he has pretty much captured the crucial difference between socialized medicine and free market health care.