Greed fuels fight for private health care

Posted on September 17, 2020 in Health Policy Context

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TheStar.com – Opinion/Star Columnists

I have a bad feeling about the future of Canada’s publicly funded health-care system.

That’s because despite a major court ruling last week that upheld the basic principles of public medicare, the rich and powerful forces that favour profit-driven health care are gearing up for more legal challenges aimed at opening doors wider for private medicine.

Indeed, the coming fight for increased privately funded health care could lead to a dark hole of unprecedented greed on the part of some doctors, insurance companies, financial institutions and senior business executives.

Importantly, if they win this fight, medical service for most Canadians won’t be any better, although it may be faster for the rich, who can pay to jump the queue for medical attention.

Advocates of private health care aren’t deterred by the B.C. Supreme Court ruling that upheld the view that access to health care should be based on need, not ability to pay. They dismissed the ruling as “no big deal” and are now vowing to take the fight all the way to the Supreme Court of Canada.

Dr. Brian Day, a B.C. orthopedic surgeon, who founded the private Cambie Surgery Centre, had challenged a provincial law that bans extra billing and private insurance for medically necessary procedures.

But Justice John Steeves ruled that Day failed to show patients rights were being violated because of long wait times, noting the law was based on equitable access to care, not on a patient’s ability to pay.

No question, though, that the B.C. ruling is a big deal.

If the judge had ruled in Day’s favour, it would have been a nail in the coffin for public medicare. It would do so by opening the door for insurance companies and financial institutions to make a ton of money — the very people who will financially support Day and others fighting for private health care.

Here’s how the math works for the big-money people, as outlined to me by one of Canada’s leading health experts.

Let’s say the B.C. court ruling had allowed patients to pay for access, either out of their own pockets or more likely through new, private insurance. Now assume Canada becomes like the U.K., where 10 per cent of people have private health insurance on the basis of paying for quick access to care.

In Ontario alone about 10 per cent of the provincial health budget amounts to $6.4 billion. Then assume the premium quick-access cost is doubled to $12.8 billion. Upgrade that to all of Canada at about $32 billion. Figuring that profit margins would be about 12 per cent, that results in about $4 billion in new profit for private insurers.

More than 10 per cent of Canadians might get this private health insurance through company benefit plans.

“Not only would insurers create an important new recurring annual revenue line,” the health expert explained, “they would also get all the loans needed to build new private hospitals and clinics — which would be immediately profitable based on the availability of private insurance.

“So it would be a huge windfall for big banks and health insurance companies,” he said.

In his decision, Justice Steeves said he found that physicians preferred the more lucrative private practice over the public system.

But he found little evidence during the trial to back claims that private health care and private insurance reduced wait times in public systems in countries such as Australia and the U.K.

And in a direct slap at the Fraser Institute, a right-wing think tank heavily financed by rich U.S. donors, Justice Steeves said he “seriously question(s)” the idea that the institute’s wait-time surveys can be “relied upon as providing reliable data.” He added the institute’s “expert” who testified in the case was “minimally qualified as an expert.”

For years Fraser Institute “experts” have railed against medicare and medical wait times. Sadly, their “dire-warning” press releases are often treated as gospel by right-leaning news outlets and conservative politicians without any serious scrutiny.

Ultimately, with billions of dollars are stake and greedy forces at play, the struggle to preserve medicare is far from over. The B.C. ruling was a step in the right direction, but there is still a long way to go.

https://www.thestar.com/opinion/star-columnists/2020/09/16/greed-fuels-fight-for-private-health-care.html

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