You leave the line, maybe not with what you were craving, maybe you paid a bit more, but you get lunch. And you've shortened the waiting list for the person who just had to have pizza. Everyone's happy, no?

So why can't we do that with health care?

Here's why not:

Food vendors are not doctors

Or MRI technicians, or care assistants for that matter. Canada has a huge doctor shortage and it's getting worse. The same shortages exist for nurses, technologists and other health care professions. Allowing the private system to expand will make the public system shrink. Overall no more people will be served, but those who get served will pay more for the privilege in the private line up, while those in the public line up will wait even longer.

Healthcare is not a food court

If chinese takeout is too expensive for your taste, you can do without it. You cannot get by without your health. This is not something we should leave to the vagaries of the market.

Actual solutions exist

There are solutions that will work for health care:

1. Keep the solutions public. Evidence from Canada and around the world demonstrates that private health care lengthens wait lists and drives up costs.
2. Streamline wait lists. Combine doctors' individual wait lists, and use queuing theory and case management to improve care.
3. Create public surgical clinics. These clinics provide the efficiencies that private clinics have capitalized on, without siphoning public dollars to shareholders.
4. Fully utilize hospital ORs. Schedule operations and invest resources to maximize OR time for patients in the public queue.
5. Expand team work. A North Vancouver joint replacement clinic reduced waits from 50 weeks to under four through collaboration between five orthopaedic surgeons.
6. Combine different steps. The Sault Ste. Marie breast health centre reduced the wait for diagnosis by 75 per cent with one-stop assessments, offering mammograms, ultrasounds and sometimes biopsies on the same day.
7. Expand continuing care. Under-funding of home care and residential long-term care has increased pressure on emergency rooms and in-patient wards.
8. Improve primary care. Community health centres offer public health, chronic disease care, 24-7 access, and a range of programs that ease reliance on hospitals.
9. Invest in equipment, facilities and staffing to clear backlogs. While many of the solutions involve making smarter use of existing resources, some areas need new resources to meet pent-up demand.
10. Invest in healthcare workers. Governments should implement health human resources strategies that improve working conditions and support professional development.

Our list of solutions is long because people in the public sector are working to improve the system and we have a wealth of ideas for doing it. But treating health as a commodity and health care as a marketable service is a betrayal of our values as a society.

written by Paul Moist on behalf of CUPE - The Canadian Union of Public Employees