Public health-care solutions pay dividends

TimesColonist.com – news – Delisted services, private facilities undermining key B.C. advantages
January 13, 2011.   By Adrian Dix, Special To Times Colonist

British Columbia’s economic assets are often seen in terms of geography — its natural resources, proximity to markets in Asia and extraordinary natural beauty.

But according to international research, B.C. is a better choice for enterprise than Seattle, San Francisco, Los Angles and other commercial centres, in part because of its public health care system.

Vancouver and Prince George occupy the top spots in KPMG’s biannual Competitive Alternatives Survey, which ranks cities according to the cost advantage they provide companies. Our “competitive advantage” is less now than a decade ago, but still significant.

Vancouver and Prince George place No. 1 and 2 for the Pacific region, while Seattle, San Diego, Los Angeles and San Francisco rank 8 to 11. KPMG arrived at these rankings in part because public non-profit health care is a great deal for the private sector, as employers save considerably by not having to pay for most medical benefits.

Our public health-care system thus is a key asset B.C. should leverage to diversify its economic base.

For example, knowledge-based industries face higher labour costs because of the scientific and technical expertise of their workforce. Companies in fields like biomedical research and digital media need to provide health care insurance to recruit and retain skilled labour.

A provincial strategy targeting industries should underscore that in B.C. firms save on these costs. Sector-specific studies reiterate this — an analysis by IBM-PLI, a global consultancy firm, concluded that cities like Vancouver offer digital media firms a significant advantage thanks to the public health insurance plan.

Yet in the past decade, it has been B.C.’s chief rivals such as Ontario that have capitalized on medicare. Ontario’s economic development agency highlights how the province’s health care system reduces operating costs. According to Paul Krugman, New York Times columnist and a Nobel Prize-winning economist, Toyota’s decision to select Ontario over other North American locations was based in large part because of public health care.

In contrast, the B.C government has been diminishing our province’s competitive advantage by undermining public health care. It has adopted a “don’t ask, don’t tell” policy on private clinics illegally charging patients to earn a profit, alleged violations of the Medicare Protection Act that increase the overall cost of health care in B.C. They have delisted services and seen private health care costs — often paid by employers and employees through health plans — increase dramatically as compared to increase in public health care costs.

Even with its current challenges, “socialized medicine” proves to be far more cost-efficient and reliable and provides better quality care than private, for-profit health care. On average, the U.S. spends two-and-a-half times more per person for health care than other advanced countries, with profits to private insurance managers representing 20 per cent of total costs.

Arnold Reiman, former editor of the New England Journal of Medicine, recently wrote that “because of its overhead, as well as the expense of billing and collecting it imposes on doctors and hospitals, the investor-owned for-profit insurance industry probably adds at least $150 [billion to] $200 billion to the annual cost of providing health coverage to the American population.”

A coherent economic development strategy for B.C. would capitalize and strengthen, not diminish, the competitive advantage public health care affords us. The same public solutions that can reduce wait times, lower drug costs, improve patient outcomes and increase cost efficiency in our health care system also make B.C. a more attractive choice for private firms.

But the focus and energy required to establish the long-term care beds and network of specialized, efficient non-profit surgical clinics that would reduce and stabilize wait times, to set up nurse practitioner clinics to lower hospitalization rates and expand the Therapeutic Initiative’s independent assessment of drug treatments to protect patients and taxpayers has been diverted by the government’s questioning of a single-payer health system.

It accomplishes the opposite, weakening public health care at the expense of patients, health-care workers, social justice and even the business community.

Public health care remains a great deal for B.C. patients and businesses. It combines, as health economist Steven Lewis has said, “social justice with administrative efficiency.”

Adrian Dix is an MLA and the NDP health critic.

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