by Klaus Rohrich
May 13, 2004
The recent study released by the Fraser Institute showing Canada is #1 in spending among 28 countries with universal guaranteed health care, yet near the bottom in the quality of care delivered, will do nothing to motivate Canadians to demand their money’s worth. There are two reasons why this is so. The first is that we have an inherent mistrust of anyone seeking to make a profit and this is particularly true in the field of healthcare.
Never mind that privately owned and publicly funded healthcare components such as clinics, labs, and even physicians have always been part of our national healthcare system. Never mind that everyone bleating the same mantra about the evils of ‘for profit’ healthcare will do absolutely nothing to actually improve the quality of public healthcare currently being delivered. Never mind that any amount of money we add to the current system in support of the status quo will be the equivalent of flushing it down the toilet. There’s already too much money being spent on publicly funded, i.e. "free", healthcare.
While surfing the Internet recently, I came across a blog that asked if anyone could remember the time when there were user fees for healthcare in Canada. This took me slightly aback, as I remember well the time when there were user fees in the system. First of all, everyone who made use of the system actually paid into it through direct payment or through source deductions from their paycheque. Some physicians even billed an additional amount to what was covered through the provincial healthcare program. It was always some token amount, never more than about $2.00 per visit. Coincidentally, the quality of care available at that time was outstanding, with little or no waiting for any procedures. Truly, we had the best healthcare system in the world.
However, when the Liberal Government decided that universal healthcare was a basic human right and that it should be FREE, it was in effect setting up an open bar that one could use as often as one wanted- no questions asked. Naturally, what followed was predictable in that the waste and excesses of the system soon forced governments to de-list coverage of some procedures, and limit others to once annually or bi-annually. It’s interesting to note that among the procedures not covered are items pertaining to mens’ health, such as PSa testing, yet abortions are covered.
It did not take long for the system to degrade to the point where it is barely a shadow of its former self. I believe it will continue to degrade to the point that we truly will have a two-tiered healthcare system. One for those few fortunate enough to be able to make use of and pay for american healthcare, while the rest of us are stuck with a Soviet Gosplan system.
What’s needed to fix our system is a new window through which to look at healthcare. This means a massive re-writing or even total scrapping of The Canada Health act, which currently forbids private healthcare concerns to provide publicly funded services. The 2002 Romanow Report on the future of healthcare in Canada was a bad joke; well scripted, perhaps, but still a joke. The Millions of dollars the government spent paying the former socialist Premier of Saskatchewan and his commissioners was money wasted, much in the same vein as the sponsorship monies blown in Quebec or the Gun Registry.
The reason that it was money wasted is that the Commission itself was biased in favour of the status quo, so logically the conclusions the report drew were essentially in favour of the status quo. What’s the point of having a commission examine an issue that can only be viewed through certain parameters? I can see that this approach might work in situations such as shipwrecks, for instance, where the options are sinking or swimming. However approaching the future of healthcare based on the premise that effective healthcare can only be provided on a non-profit basis is absurd.
It is a total myth that effective, high-quality healthcare can only be provided through a unionized, not for profit vehicle. In fact, I would say that exactly the opposite is true as eventually the system becomes so top-heavy with bureaucracy and waste that it literally smothers under its own inertia. That’s what we are seeing in Canada today.
If we want to fix our healthcare system there are certain paradigms we must embrace. We need to recognize that user fees are a good thing, in that they serve to remind those making use of the system that it has some value. It’s always easier to spend other peoples’ money than it is to spend your own. ask any politician.
We need to recognize that for profit healthcare can be just as effective as non-profit healthcare. The unions want to frighten you with dire warnings that beancounters will make those life and death medical decisions about your health instead of doctors. It’s a specious argument that won’t survive the light of day under close scrutiny. In fact, having a few beancounters looking out for the bottom line can be helpful in eliminating waste, of which we currently have a lot. Strictly speaking, if a private company can deliver a high-quality procedure at a lower cost than a not for profit organization, why not make use of it? The money that’s saved could go into acquiring more diagnostic equipment such as MRIs or CT Scanners.
Until we are ready to put everything on the table when we examine how to fix our system, we’ll never fix it.
Oh, and the second reason that Canadians won’t demand a better healthcare system is that they just don’t care enough to make the effort. The single most debilitating disease plaguing Canada today is apathy. While I am not a medical practitioner, It’s not difficult to diagnose this condition. Just go to any lineup at a bank, beer store or government office and look around you. Then look at the percentage of people that actually vote in this country. We are a people who are essentially defeated- by our own government no less. It also belies the old adage that "you get what you pay for".