Health-care policy doyenne Sally Pipes, president and CEO of the Pacific Research Institute, lived under the Canadian health care system — before moving to the United States in 1991 and becoming a citizen in 2006 — and she’s not excited about America’s health system heading in the same direction.

“Understanding health care is like unraveling an onion: There are many tearful moments,” Pipes said at a recent Heritage Lecture about the U.S. health-care reform debate. “When I look at [President Barack] Obama’s plan for health care, I see it leading America to rationed care,” said Pipes, author of The Top Ten Myths of American Health Care: A Citizen’s Guide.

Part of that concern has come from provisions within the recently enacted U.S. economic stimulus plan that creates the framework and funding for comparative effectiveness research and health information technology.

“It’s one thing to compare the effectiveness of treatments and procedures, and then disseminate the best information about what works,” Robert Moffit, the Heritage Foundation’s Center for Health Policy Studies, has said. “Taxpayers should watch very closely how these provisions are interpreted and implemented,” he warned, noting that health reform intentions from the Obama administration have called for greater government control in the health care system.

At the Heritage event, Pipes cited Canada’s health system as the best verification that government control leads to rationed care. Underneath the promise of “free” health care coverage, Canadian patients have experienced long waiting lists to see primary practitioners and specialists, rationed care and limited access to the newest versions of drugs and treatments that could more effectively help patients.

“In a country of 32 million, about 3.2 million are waiting to get a primary care physician,” Pipes said, pointing out that wage control on primary physicians in Canada has helped contribute to a doctor shortage, with more medical students choosing specialties that are more lucrative over primary care.

What’s needed, Pipes stressed, are changes in the U.S. tax code that encourage individual consumers to buy their health insurance — thus, giving them more control over their health care decisions and greater portability with their coverage. This would also lower costs in the long run, Pipes added.

“In the end, universal choice is key to achieving universal coverage in this country,” she said.