Canadian health care is no model

NationalPost.com – Opinions/Editorial: Canadian health care is no model
August 18, 2009.    Allen McInnis/Canwest News Service

The last two presidents of the Canadian Medical Association (CMA) have both been staunch advocates of increased private care. The incoming president, Anne Doig of Saskatoon, who will be installed this week, says our health-care system is “imploding.” While not as committed to private options as her predecessors, Dr. Doig acknowledges our current universal public system is “unsustainable.” She also argues we should not fear private options, but rather should implement whatever models from around the world — be they public or private — that produce the best results for patients. On the other hand, the physician who will replace Dr. Doig next summer, Ottawa’s Dr. Jeff Turnbull, promises to be a passionate defender of the government health monopoly during his one-year term.

Overall, then, three of the four most-recent CMA presidents and presidents-elect have argued to varying degrees that private options for patients are inevitable; just one believes our current government-administered system can be prolonged. Only a dogmatic left-wing outlet such as the Toronto Star editorial page would view this –as it argued in an editorial on Sunday — as proof that a “fresh [pro-medicare] approach may be taking hold” at the CMA, an approach that will “ensure the reactionary American debate over the future of its health care does not poison our own.”

Like most defenders of Canada’s health monopoly, the Star misses the point of what is going on Stateside. Contrary to what one might conclude from the clucking and preening exhibited by Canada’s friends of medicare, not even those Americans backing guaranteed care for all are holding out our system as their ideal.

No one in the United States, for example, is calling for a Canada Health Act-like ban on private insurance. Even Barack Obama, while allowing that our system may work for us, was emphatic that the Canadian system “would not work for the United States.” No mainstream U. S. politician is calling for the closure of private clinics.

Indeed, fewer and fewer countries believe, as medicare’s defenders do, that it should be illegal for ordinary citizens to use their own after-tax dollars to buy supplemental care. Even major countries with cradle-to-grave social benefits such as France, Germany, the Netherlands, Denmark and Britain, all permit their citizens private options. All allow user fees. Most also permit surgeons to charge thousands of dollars extra for non-emergency, non-life threatening operations, including hip replacements. Even Sweden, long the utopian ideal of the Canadian left, has recently permitted private clinics and hospitals to compete to provide publicly funded procedures. And the Scandinavian sky has not fallen.

Dr. Doig is neither categorically in favour of private options nor fundamentally opposed. She wants Canadians instead to debate what care they want and how they want it paid for. That strikes us as quite sensible. It is unfortunate her successor is not similarly enlightened.

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