It may have come to your attention that government never decreases in size or scope. When times are bad, more people need help; when times are good, we (i.e., the state) can afford to enact more programs.
Why is it that state spending works like a sphincterone way? Suppose that the government had a truly worthless program, even one that was counterproductive. The Monty Python players created the Bureau of Silly Walks. Lets say that the United States had a Department of Silly Walks. This department could be funded by 10 cents from each citizen, giving it a budget of $30,000,000 per year. Ten million dollars would be used to administer the program and the department would award $100,000 to the 200 people with the silliest walks.
Certainly, such a program would be cut from the U.S. budget. But wait. Not only would the beneficiaries and administrators have an interest in maintaining the department but potential honorees and administrators would share that interest. Add to them their families and the many people in communities with silly walkers, and you start building a voting bloc. Throw in silly walking aficionados and you are up several million interested citizens.
You might think that the millions of taxpayers would be outraged at this blatant, silly special interest group. However, these millions (maybe hundreds of millions) would receive very little from the abolition of the Department of Silly Walks. Yes, they would, in theory, be enriched by 10 cents, but no one cares about 10 cents. Its hard to sustain outrage over a dime.
On top of that, these millions of people would sense (correctly) that they wouldnt even receive their 10 cents back; the state would find another way to spend it. Hence, we have a system that works only to increase governmental spending, a one-way gate, the sphincterization of spending.
People in Canada approve of the governmental system of medical care. Polls show it. They feel that they might be net beneficiaries of the system. They also suspect that the state would find some other way to spend the taxes that currently fund the system. Another pressing need would certainly arise. Until something truly disastrous happens, they will not abandon that system.
How about the Department of Silly Walks? What if everyone received his dime back? Everyone would simply spend it or save it or give it away as he saw fit. What would the result be? Perhaps a streamlined means of subsidizing silly walkers would be created, one that delivered silly walking at half the price. Perhaps the money would be used to create a new fuel source or a more effective treatment for cancer. Maybe it would provide the seed money for an industry that generated tens of billions of dollars yearly. No one can say. We can say, though, that each 10 cents would be spent as its earner desired. That outcome, in itself, is reason enough to be outraged by a dime.