Should Canadians be able to use after- tax dollars to purchase health services that are already covered under the provincial health plans schedule of benefits?
D espite the fact that 30% of Canadian healthcare is already privately funded, our public system is somewhat unique in that it provides first-dollar coverage of all physician and hospital services. For all its faults, this system ensures that healthcare in Canada is accessed based on need, not ability to pay. To allow some Canadians to pay their way in a parallel private system would be seriously detrimental to healthcare for the majority. Several key factors explain deterioration we would expect in publicly funded care were a parallel private system to exist:
- Scarce physicians, nurses and other personnel would leave the publicly funded system, a particularly Canadian concern given the current shortage of nurses and doctors in our country.
- Pressure from politically influential and wealthy Canadians to maintain the quality of publicly funded care would deteriorate.
- The private insurance system would treat patients at a higher doctor: patient ratio and “cream skim” the least sick patients from the public system. This would leave the public system with the most complex patients and fewer human resources to treat them.
In addition to promoting Canadian values of equity and fairness, our publicly funded model provides Canada with what the Canadian Council of Chief Executives has described as a “significant advantage in attracting the people and investment that companies need to stay competitive.” Former CEO of the Toronto - Dominion Bank Charles Baillie called Medicare “an economic asset, not a burden” because in “an era of globalization, we need every competitive and comparative advantage we have. And the fundamentals of our health care system are one of those advantages.”
Instead of moving to a parallel private insurance system, we need to capitalize on the built-in efficiencies inherent in our publicly funded system. A modern version of Medicare would keep Canadians healthy, out of hospital, and link their care providers to ensure a seamless transition into and out of the acute care system. We are making good progress – but the necessary changes take time. Private insurance would only introduce a barrier to access for most Canadians, and another layer of bureaucracy, while threatening our economic competitiveness.
Instead of knee-jerk reactions, we should base our decisions about our health care system on evidence and principle. On both counts, preserving and strengthening publicly funded Medicare is the way to meet the healthcare needs of all Canadians.
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