Consider these health-care quotes:

"Waiting times are a major source of public and private dissatisfaction."

"Over all, new technology is likely to continue to put upward pressure on health-care spending."

"Many parts of the service still experience significant difficulties recruiting and retaining the staff they need."

"The system makes very poor use of information technology."

"Care is too focused on the acute hospital setting."

Every one of these statements could be culled from the swelling number of reports about medicare. But they are actually taken from a formal review of Britain's National Health Service that was released last week with the U.K. budget.

That the British review's diagnosis and prescriptions were so similar to those offered for medicare is not surprising. After all, the NHS and medicare are both government-run, publicly financed schemes in advanced, industrial countries with aging populations, costly technologies, political demands and spiralling costs.

Once prescriptions in Britain and Canada rule out more private money, there's only one way to pay for health care's additional costs: higher taxes. That's what happened in the U.K. budget.

The British review concluded that "the U.K. must expect to devote a significantly larger share of its national income to health care over the next 20 years." The Blair government, hammered at home for the deterioration of the NHS, responded with whopping new sums.

Britain will increase health-care spending by 7.4 per cent after inflation in each of the next five years, more than double the rate for other spending. The tradeoff: a rise in the national insurance premium, a kind of tax on earnings imposed on employers and employees to pay for social programs. A big health-care spending increase paid for by higher taxes: That kind of British tradeoff is exactly the one sketched for Canadians last week by the Senate committee on health care under Michael Kirby.

The Senate did not provide estimates of future spending or tax increases. But the message was clear: If Canadians insist on a publicly funded system, then it will require much more money to meet future challenges and public demands and to fix existing problems. Hello, higher taxes.

The same tradeoff has already been made in British Columbia, where massive changes were announced yesterday. The Campbell government has already jacked up health-care premiums -- a tax by another name -- to pay for past commitments and higher salaries for health-care professionals.

The NHS, unlike medicare, had been underfunded for decades, leaving Britain well behind leading continental European countries, none of which use the NHS model to organize health care. Britain has too many old hospitals, too few doctors and nurses, bad food, and long waiting lists. In fairness, the NHS covers everyone, provides reasonable care to many and offers a wider range of public payment (eyeglasses, drugs) than medicare. Britain spends 7.7 per cent of the national income on health -- including 1 per cent for a small, private parallel health system -- compared to 9.6 per cent for Canada. If the British review's recommendations are fully followed, Britain will eventually be spending 10 per cent to 11 per cent on health care.

The British government, in establishing the review, ruled out any changes to the principles of the publicly financed NHS. The result was predictable to anyone who has read the studies recommending reforms to medicare: higher taxes and the rational planners' model for reform.

Rational planners believe productivity can be enhanced by imposed, administrative changes because market signals are ruled out. Therefore, they insist, as the British review did, the system needs better information, more sharing of "best practices" among doctors, more effective use of nurses and nurse practitioners, primary-care reform to cluster doctors and nurses together, better information for patients.

Every one of these changes has been recommended by Canadian reviews of medicare. Each will undoubtedly be hashed over again by the Romanow commission. None is inherently wrong. It's just that proponents exaggerate these changes' impacts on productivity and curtailing rising costs.

At least the British review was honest. While recommending the fully Monty of rational planners' solutions, it insisted that these solutions could not adequately constrain costs. These additional costs have to be paid for by higher taxes, which, in turn, depend on economic growth.

But even the British review ducked another inescapable tradeoff. Even if taxes rise, as long as health-care spending grows by 7.7 per cent a year -- as is forecast in Britain and as has been happening in recent years in Canada -- spending on other government programs will suffer.