The question this conference has been asked to consider is: “Should Canadians be able to use after-tax dollars to purchase health services that are already covered under the provincial health plan schedule of benefits?”. This question about health care privatization raises a larger and more fundamental question with which Canadians must first come to terms.

But let us take the starting question posed at face value. And let us take it from the view of one facing a life threatening or severe quality-of-life threatening situation, and with the assumption that the publicly-funded, publicly-delivered system may not necessarily at all times and in all places be able to address dire needs in a timely or satisfactory fashion. This is a situation to which many Canadians today may personally face or sympathize.

With these rather black and white conditions, the answer to the question can only be “yes”: someone in dire need should be able to purchase health services as an option for meeting that need. The right of a person to save her life through purchase of health services trumps the sanctity of the notion that all such services must only be delivered through the public realm. Indeed, it is impossible to morally defend the premise that someone should not be able to use her financial resources to address a dire health need. It cannot be presumed that the public sector, in all cases, will have the ability or a superior means to meet this need.

But the question raises the emerging and larger issue of steadily growing socio-economic inequity – and thus the broader and more important question of the kind of country Canada is becoming and the kind of Canada we, the people, want. For the truth is Canada is becoming ever more polarized between those with the means (in some cases unlimited) to purchase health services already largely or heavily privatized (e.g., dental care, pharmacare), and those without the means. And unless we deal with this advancing polarization, we will find ourselves at a morally repugnant moment in time where some literally save their lives by virtue of fat wallets, whereas others lose theirs by virtue of empty purses. We may not be quite there now, but we are getting close: as example, a man in Toronto recently lost his eyesight due to a dental crisis that he could not afford to have treated (the dental problem led to an infection that resulted in blindness).

The Canadian Centre for Policy Alternatives (CCPA) is doing stellar research into Canada’s “growing gap” in incomes and wealth, and by extension therefore opportunity and, indeed, human freedom. As an example, according to the CCPA, “ in 2004, the richest 10% of families raising children earned 82 times more than the poorest 10% – almost triple the ratio of 1976, when they earned 31 times more.” Many other data points illustrate an issue becoming a defining one for Canada’s future – rapidly advancing economic inequality among our citizenry, and what that means for our common future.

So imagine a more fundamental question for public dialogue: “How can it be ensured that all Canadians, as a matter of human right, have access to health services whether delivered by the private or public sector?”

In answering this more fundamental question, we would consider Canada’s growing gap, our notions of moral obligation towards one another, and the rights of all to security of the person. In choosing the proper (i.e., morally correct) way forward, we would effect an income and wealth redistribution system so that everyone has the means to access the health services they require, no matter how delivered. We would not tolerate someone dying or suffering for lack of means of such access. This is the more critical question we must come to terms with.