Is the doctor in?

When it comes to the health care reform debate, Canada's single-payer system often is held up as an example of success by supporters -- and by opponents as a warning of the pitfalls.

Answering questions at the Summit of the Americas on Monday, President Obama seemed ambivalent about Canadian health care.

"I don't find Canadians particularly scary, but I guess some of the opponents of reform think that they make a good bogeyman," he said.

Obama went on to say the Canadian system wouldn't work in the U.S., but many American doctors believe it does some things better.

"Our health care system delivers probably the highest specialty quality care in the world but our primary care infrastructure is not good," said Dr. Joseph Ross of the Mt. Sinai School of Medicine.

Canadians have a longer life expectancy, lower infant mortality rates and lower rates of obesity and diabetes than people in the United States. Canadians' primary care doctors get paid more and spend more time with their patients than doctors across the border to the south.

But Canadians also wait twice as long for non-emergency care and sometimes come to the U.S. for specialized treatment.

Dr. Scott Gottlieb, a resident fellow at the conservative American Enterprise Institute, says the single-payer edifice is starting to crumble.

"What you're starting to see in Canada is that it is falling apart, and you're seeing the growth of a private market for a lot of essential services," he said.

That private market was born after a 2005 Canadian Supreme Court ruling ended the government's monopoly on some health care services.

But since people have to pay out of pocket for them, Canada's public system is still overloaded.

"The average wait time to get an appointment with a new primary care physician is 17 weeks and for specialty care it is even worse," he said.

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