On The Other Hand
Yet again our universal health care is under attack.
Dr. Brian Day owner of the for-profit Cambie surgery in Vancouver is taking the British Columbia Health Ministry to court. He is arguing that the Canadian Health Act is unconstitutional as it forces those with money to go on waitlists for surgery.
Dr. Day argues that countries with a blended private/public system have better health outcomes, spend less public dollars and have much shorter wait times. Specifically, his supporters speak to European nations such as Switzerland, the Netherlands, Sweden, Germany and Great Britain but nary a mention of the United States.
It’s easy to throw around a few well-chosen statistics to make your point for privatization.
But Canadians must be mindful that under the provisions of NAFTA, any move by the courts to allow the private sector to usurp our government’s power to choose how to deliver medically-necessary services, will swing the doors open to American-style health care.
If we’re being honest with ourselves, we really don’t want U.S.-style private health care. In our heart of hearts we know that unintended consequences come when profit takers become all powerful in health care delivery.
Snowbirds know it best. There are those who can no longer afford to go south because of the high cost of medical insurance premiums.
We’ve all heard the horror stories. A Canadian has a medical emergency south of the border only to learn a pre-existing condition voided the coverage and they are personally on the hook for a mega bill.
In fact, as much as snowbirds love the south, they return to Canada even in the dead of winter to access medical services.
Most Western European countries score must higher for quality of life and health outcomes.
It is also true most have a combination of private/public health care delivery.
But so does Canada.
Dentists and pharmacists are completely private and most doctors work within private professional corporations. Except for seniors, drug costs and specialty services such as chiropractors operate within the private insurance sphere.
In Canada only medically necessary services are universally insured.
A major difference between Canada and Western Europe is many corporations and governments do not provide health care benefits for their employees. Instead, countries such as Switzerland and the Netherlands make it mandatory that all citizens purchase health insurance, with government help for those on lower incomes.
Private insurance companies are also regulated. They must first be approved by government and then are required to offer standard insurance packages that include government-approved universal basics.
Better yet, these insurance companies cannot deny medical services because of pre-existing conditions.
Many Western European countries may have shorter wait times, but they too still struggle with wait times for non-emergency surgery because all citizens have equal access to services.
It’s really not the private/public mix of health care delivery that allows many Western European countries to be more efficient and cost effective in health care delivery. It’s also life style. Europeans are generally more active than North Americans as cycling and walking is a way of life.
Across the socio-economic strata, their citizens are better educated. They are also not afraid of high taxes. Those European countries that score highest on health outcomes have personal tax rates over 50 per cent. Universality has kept the economic spread between the top and the lowest earners much closer. Exercise, education and standard of living are all positive factors for healthier living.
Sweden will be the country to watch. It took a radical turn 14 years ago when it chose to follow neo-conservative policies and move towards privatizing health care, education and social services.
By 2015 private equity firms provided about 20 per cent of public hospital care and about 30 per cent of public primary care, all funded by the taxpayer. Unfortunately some of these private equity firms have already let the people down. The Swedish government launched a lawsuit against a major medical provider accusing them of tax avoidance and won.
Canada needs to study and take ideas from the European private/public models, but we can do without Dr. Day’s cherry picking, profit-taking, American model.
Dr. Day says “competition breeds excellence”! If that were the case, why did 40+ million Americans have no health insurance coverage before ObamaCare?
Excellence in health care is inclusive, not exclusive; humane not inhumane; people not profits, care not share prices.
Unfortunately, it appears the citizens of Sweden are already regretting their 14-year experiment with privatization. A 2014 survey by the Swedish SOM Institute found 69 per cent now oppose further privatization of public health, education and social services.
Little wonder when they see private, foreign-owned equity firms hired for health care delivery taking profits directly from tax dollars and then having the audacity to cheat on taxes owed.
Profit taking and good health care delivery are mutually exclusive because greed and empathy are incompatible!