COLUMN: Gunter – Time for health care choice in Canada

- August 8th, 2012

Choice won’t destroy system

by Lorne Gunter

There are now lawsuits in two provinces – British Columbia and Alberta – that seek to break the monopoly those provinces’ governments maintain over health care. In short, in both of Canada’s westernmost provinces it is illegal – as it is in nine of 10 provinces – to buy private health insurance for procedures supposedly covered by the public health system.

The only exception to this rule is Quebec where, in 2005, a successful lawsuit forced that province’s government to let citizens buy insurance for private procedures offered within Quebec.

Quebecers no longer have to go elsewhere (usually to the United States) and pay out of their own pockets if they get tired of Canada’s endless waiting lists for specialized care.

In Alberta, there are two legal actions against the province, both brought by men suffering horrible back pain that the provincial health care system was unable to treat in a reasonable amount of time. Both men were forced to go south of the line for surgeries that they had to pay for on their own.

In B.C., the Canadian Independent Medical Clinics Association and six private surgical centres have filed a constitutional challenge over the province’s authority to prohibit extra-billing.

If the health care monopoly is upset in either one or both of these provinces, the future of provincial health monopolies across the country will be at risk. One successful lawsuit, seven years ago in Quebec might be considered an anomaly, but three successful challenges would almost certainly trigger an irresistible tsunami of change – a change that would be a very good thing.

Before anyone gasps in horror and starts scaremongering about how this will lead to two-tiered American-style health care, here are a few things to keep in mind:

First, the American system isn’t our only alternative. Every Western European country also permits its citizens to spend their own after-tax dollars to buy private insurance and bypass the state hospital monopoly if they choose. That includes such paragons of democratic socialism as France, Sweden, the Netherlands and Germany.

Nowhere in Europe have more than 15% of the population opted out of the government-run system. And I imagine the same would hold true in Canada. Like most Europeans, the vast majority of Canadians would choose to stay wholly within our government health schemes.

Quebecers have had that right to opt out for the better part of a decade and still under 3% of them have moved to private plans.

In other words, if and when we Canadians finally get health care choice, that freedom is unlikely to destroy the public system or encourage an exodus of the best doctors into private clinics.

What it may well do is hive off just enough impatient patients that waiting lists in the public sector will get shorter. That’s what happened in Alberta in the 1990s when two private cataract clinics set up shop. They drained just enough fee-paying patients away that waiting times dropped from 24 months to three months for patients who remained behind in the public system.

Here’s something else to consider if you fear what might happen if the current legal challenges to our government health monopoly go through: Since 1997, the federal government has transferred more than $100 billion extra to the provinces for health care, yet wait times for surgery and specialist care are 60% longer than they were 15 years ago.

If all that was needed was more tax dollars, our health care problems would all have been solved years and years ago.

Our faith in government-run health care is misplaced. It’s time for a little health care freedom.

Categories: Contributor Columns

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