Canada must abandon its health-care monopoly

Posted on May 14, 2011 in Health Delivery System

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NationalPost.com – Full Comment/editorial
May 14, 2011.    National Post editorial board

The non-partisan Conference Board of Canada has released a new study enumerating the weaknesses in Canada’s public health-care system. In short, the report says that while Canada spends a lot on public health care, our health outcomes are middling compared to other developed nations. Many countries — such as Australia and Sweden — spend less but with better results.

Why the difference? The Conference Board offers no easy answers. The North American lifestyle, it contends, plays a significant role. A grossly overweight person consumes about 42% more health dollars per year than a person with the proper body weight. Japan, for instance, spends relatively little on health care, but because of its skinnier population (and perhaps its focus on high-tech diagnostic equipment), Japanese have significantly longer, healthier lives than Americans and Canadians.

Looking beyond lifestyle factors, creating better health outcomes for Canadians will mean finding the right balance between private and public care. An over-reliance on private care drives down the health outcomes of poorer citizens who are dependent on government care, which skews downward the averages for the citizenry as a whole. But a dogmatic commitment to publicly funded and publicly run health care, such as we now have in Canada, prevents competition that can increase efficiency, improve delivery and hasten the adoption of new technologies and new drugs.

Every country above us on the Conference Board’s list permits a better mixture of public and private spending on health. None of them outlaw private insurance for treatment in private clinics, as we (wrongly) do here in Canada. Indeed, policy makers in countries such as France, Germany and the Netherlands would likely be baffled by Canada’s rigid insistence that private options somehow sully health care. Even in Sweden — once the standard bearer for public-only health care — private companies provide nearly a quarter of the care, even though most care is still paid for by the government.

The focus of any health-care system should be the best-possible outcomes for the greatest number of people — not abstract questions of “national identity.” Now that Stephen Harper has his majority, we would urge him to bring our health system into line with the more successful mixed public-private models that have long been the norm on the other side of the Atlantic.

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