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?

Our twenty-year blind love affair with the private sector seems to be on the wane; but a number of Canadians still believe that you only have to replace the word ‘‘public’’ or ‘‘non-profit’’ with ‘‘for-profit’’ and you have automatically made something 15 per cent more efficient. Adam Smith knew this was a myth over two hundred years ago, but that doesn’t stop some modern-day economist wannabes from claiming that if we lift the regulatory shackles, the market’s invisible hand will erase all human woes.

Markets are the most efficient mechanism to provide most goods and services, but all markets require a court system to enforce contracts. And most businesses require some form of public-policy framework. Governments regulate capital acquisition through stock markets because otherwise charlatans will beat out honest financiers. Honourable manufacturers can’t compete with those that are willing to pollute the environment or reduce labour standards. Business needs government environmental and labour regulations to maintain a level playing field.

Furthermore, markets just don’t deal effectively with some goods and services. For example, we publicly fund and administer fire services. We don’t rely upon people to purchase firefighting insurance. What if everyone but one on the block had such insurance and his house caught on fire? Would we wait until the fire moved to someone else’s house before we called the firefighters? And would different fire services compete with each other? It sounds like a nightmare.

links to other presentations by Dr. Rachlis

• Privatized Health Care Won't Deliver