Our health depends on it

By Walter Robinson
web posted September 13, 1999

A recent Compas poll suggests that 41 per cent of Canadians believe that they should have the right to privately purchase their own medical services. Even more interesting is the fact that this 41 per cent holds firm across gender lines and income groups.

It is a damning indictment of our state-run health care system, which, contrary to its fans, is not "the best in the world." Our system is, "at best," mediocre. Over 200 000 Canadians sit on surgical waiting lists, services are delisted each year, and unfunded health care liabilities now top $1.2 trillion. Demographic, technological, utilization and funding pressures over the next two decades will only serve to exacerbate this situation.

With a few exceptions, the Canadian political establishment does not dare to propose real solutions to allay public concern and actually fix our system. All of the federal parties, and their provincial cousins to boot, are still wedded to the inaccurate belief that more money into the system will automatically translate into better health care.

Recent elections in Ontario, New Brunswick, Nova Scotia and the current campaigns in Manitoba and Saskatchewan support this assertion. Commitment to health care is measured as an auction of spending promises (inputs) as opposed to dealing with real indicators (outputs) such as the health of the population, reduced waiting lists or surgeries prevented, just to name a few.

Collectively, our three levels of government spend over $59.3 billion (6.4 per cent of GDP) of our taxes each year on healthcare. Then we also spend $24.2 billion (2.7 per cent of GDP) billion of our own money on other medical procedures not covered by provincial insurance plans. Yet the waiting lists continue to grow and public confidence continues to wane.

Indeed, a May 1999 Angus Reid poll, commissioned by the Ontario Medical Association, found that 76 per cent of Canadians believe that the health care system is in crisis. In addition, this same poll noted that 71 per cent of Canadians want to change the Canada Health Act because it's five founding principles (accessibility, universality, comprehensiveness, portability, and public administration) do not meet the health care needs of today.

So what do we do? To begin, our politicians have to stop living in a binary world where the choice is a patriotic defence of all that is "Canadian" (remember, patriotism is the last refuge of a scoundrel) or a horrible slide into the abyss (can you say hyperbole?) of the American for-profit system.

We deserve, and must demand, more from our leaders. Every other industrialized nation on the face of the planet employs a true blend of public and private health care --including hospitals -- to meet the needs of its citizens. Politicians and policy engineers must seek out best practices from these countries and adapt them to the Canadian environment. Whether it be medical savings accounts in Singapore or internal market pressures in the UK and New Zealand, just to name a few, these approaches deserve serious study as opposed to the outright dismissal they've received to date.

We also need to carefully study countries like France, Italy and Japan.All three will face unprecedented demographic pressures (the greying of their populations) in the next decade whereas Canada won't reach this point until 2025. Their approaches to dealing with the strain that an ageing population places on a country's ability to care will prove very instructive.

There are many other issues to discuss including the brain drain of physicians, co-insurance options, capital and infrastructure financing, etc., but first, our politicians must open their eyes and minds to the world around them. Hopefully, recent opinion polls will have this effect...our health depends on it.

Walter Robinson is the Federal Director of the Canadian Taxpayers Federation.

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