|
Canada Should Be Having
Its Own Healthcare Debate
- by Andy Radia
About a year ago, President Barack Obama embarked on an ambitious effort to overhaul the U.S. healthcare system. Since then, our neighbours to the south have been embroiled in a contentious debate.
It is obvious, from our vantage point in Canada at least, that the current U.S. healthcare delivery model is in dire need of reform. Out of all the industrialized nations in the world, the United States spends more on healthcare than any other country — both in terms of GDP and per-capita spending. Even with the huge expenditures, however, some 45 million Americans are uninsured and hundreds of thousands go bankrupt every year because of costly medical bills. The question now facing Americans is how to get the uninsured insured. The potential policy solutions are divisive and polarizing. It is, however, a debate that must happen.
The United States is not alone in its struggles to develop a sustainable and affordable healthcare system. Every country in the world, including Canada, is facing an aging population and overwhelming healthcare costs.
But while the Americans are facing the challenge head on, it seems that we in Canada are avoiding the healthcare debate.
Canada, unlike the United States, has a one-payer Universal Healthcare system: Every citizen has access to medically necessary procedures that are paid for by the “public.”
I don’t think there is a Canadian among us who could argue against the universality component of our healthcare plan. Every citizen should be entitled to a high quality of medical attention regardless of their ability to pay.
Unfortunately, our one-payer component, where the government outlaws most private insurance and service providers, has made our “Medicare” system unsustainable and, frankly, unimpressive. International think-tanks consistently place Canada’s healthcare system between 25th and 30th in worldwide rankings, citing long wait lists and ballooning costs.
In 2007-08, the Province of British Columbia spent $14.2 billion on health care. If historical trends continue, health care will consume 50 per cent of the province’s budget by 2040, leaving little for other critical services such as education, policing, etc. This rate of growth simply cannot be sustained; we have got to find other ways of providing health services in this country.
The suggestion of introducing a privatization component into our healthcare model is scary for many Canadians. When we think of private healthcare we often think of the US system, which is fraught with disparities in service levels between the rich and poor. Uppermost in many minds are images of a young mother of an infant who is refused healthcare service because she doesn’t have insurance.
The reality, however, is that many developed nations have chosen a pluralistic healthcare system that involves a mix of public- and private-sector involvement. And, in most of these countries, patients who choose public instead of private care are at no medical disadvantage and receive the same standard of care as those who enrol in private plans.
Italy, whose healthcare system was ranked as No.2 in the world, has a national insurance program which, like Canada’s Medicare program, is designed to ensure that everyone in the country has free access to the healthcare that they need.
But Italians also have the option of visiting a private hospital, for a fee, if they wish to avoid surgery wait times. The result, in Italy and in other countries around the world, has been lower costs and smaller waiting lists for the public system.
Along with improving upon our insurance and delivery schemes, healthcare reformers in this country should aggressively tackle the issue of “incentifying” our doctors. Under our current system, we pay doctors per patient visit. Real reform needs to address preventative measures such as providing incentives to doctors to motivate their patients to follow better diets and get more exercise.
As Canadians, we’re told that our healthcare system is the envy of the world. We stick our chests out with pride, trumpeting its universality, its affordability and its availability. The truth of the matter is that our system is unsustainable, overwhelmed, and even meagre compared to other developed countries.
As we have seen in the United States, a healthcare debate can become difficult and unwieldy. These are uncomfortable, difficult and even emotional topics. But the time for Canada’s healthcare debate is now. p
Andy Radia is political columnist based in Vancouver, B.C. His articles have been published in the Vancouver Sun, Winnipeg Free Press and Vancouver Metro. He can be contacted through his website at www.radia.ca
|
