There has been a lot of talk the last few years in Alberta about introducing some aspects of “privatized health care.” This prospect has made some people afraid.
This is how our system currently works: The public health care system is funded partly by taxes and partly by the health insurance premiums we pay to the Alberta government. Some aspects of essential health care, such as eye care and dentistry, are covered either by user fees or by private health insurance, or both. The government hires all the doctors for the public system, but not for the privately run chiropractors, dentists and pedorthists, among other specialists.
Private health proposals are calling for a parallel system, not just for chiropractors and other privately-funded doctors, but for other services as well, such as MRI scans.
Those who are afraid of changes to the public health care system have a certain logic to their arguments. They point to a future where the wealthy can afford good health care, but poor people are stuck with the left-overs, or with high cost health insurance. The theory goes that the Alberta government wants to create a system where private corporations are invited to set up shop in Alberta, bypassing the public system, and charging their clients full cost for medical procedures. The profits from this system would allow these corporations to attract doctors at higher rates of pay, thus depleting the public system of professionals. The public system would begin to starve to death, leaving the poor without health care, while the rich can access health care any time they want, for the appropriate fee, which they can afford. And the Law of Supply and Demand means that increased demand for doctors will lead to higher costs for everyone, including the public system.
But critics of private health care also acknowledge that the public system is not currently adequate, either. They argue that we should inject more funding into the public system to make it more viable, rather than relying on a private system to take up the slack. More funding would therefore attract more doctors and other health care workers.
In essence, I see this solution as a demand for higher tax on everyone, rich and poor, to pay for better health care. This is the socialist method. And it does nothing to alleviate the problem of increased demand leading to increased cost.
Now, here is how I see private health care working: Continue current funding of the public system, while also allowing private clinics to begin setting up shop, within certain specialized boundaries. Instead of just privatized dentists, chiropractors and pedorthists (etc) – which no one is opposing because we are used to them by now – extend the reach to privatized elective surgery. Allow those with cash to go to a private clinic that will give them what they need. This gives everyone choice.
Now do the math: The “wealthy” are continuing to fund the public system through taxation (and now that I’m making more money, I’m paying 1000% more taxes). Also, those with cash have a choice to go and spend additional money with a private clinic to get better service. Meanwhile, by not going to the public facility, they are taking the burden off the public system. By paying for what they are not using, they are essentially paying for the needs of those who do use the public system. The wealthy are not “jumping the queue” – they are enabling other people to “jump the queue” by walking away from the queue.
In Toronto about 15 years ago, when traffic on Highway 401 became unbearable, the Ontario government decided to build another highway around the city (Highway 407). But this “ETR” (Electronic Toll Route) would not be entirely publicly funded – it would, at least in part, be funded by user fees. So, those with cash could skip the line-up on the 401. In theory, traffic on 401 has gone down as a result (or not gotten as bad), and so everyone benefits – even those who are not paying for 407.
So, what if the private system draws doctors away from the public system, leaving it with lower levels of service? The funding levels in the public system do not have to drop. We can continue to fund public hospitals. And we would have to hire more doctors. And this is exactly what the critics of private care are saying we should do – hire more doctors. So, if we have to hire more doctors anyway, why not enable private clinics to alleviate some of the burden on the public system?
I feel that I have a logical basis for my arguments. But then, everyone always feels they have a logical basis. About the only way we are going to see if this works is to look at other countries where parallel systems are already working (or failing). And no fair pointing to the United States as an example of private system failure – they do not have the same public system funding that we have in Canada. And, many Canadians are forced to leave the Canadian health care system and go to the United States to get health care that they would not otherwise get. A friend of mine (from a few years ago) is one example of a person who might have died in the Canadian health care system if she had not gone to Texas to get the private health care she needed.
I think we need to try a few changes. Just try it.
Oh, and one more thing: If we really want to reduce the burden on the health care system, let’s all try and live healthier lifestyles. People who drink heavily, smoke, drive recklessly, and refuse to let go of stress and anger, have no business criticizing the health care system, because they are the ones putting undue burden on it.
Well written article.