Let's dream of the future, not the past

I read with some amusement, the opinion piece by Andre Picard in today’s Globe and Mail. Addressing the old as dinosaurs debate of multi delivery avenues (I refuse to use the biased term; two tier) in the Canadian health care system, he with ease glazes over many pertinent facts, as opponents of privatization often do.

The notion that more private care would "free up" resources in the public system is the subject of much rhetorical debate across the political spectrum.

Well, he couldn’t be more accurate there, but then things start to go off the rails with precisely the rhetoric that he speaks of.

The so-called Chaoulli decision has implications across the country, and nowhere more so than Alberta, which has mused about the "third way," an approach that, while ill-defined, would include a greater role for private insurers and private health-care providers.

Referring to Alberta’s current integration of private delivery health services as ill defined is frankly, ill-considered by Picard. As you can see here, on the government website there is much information about how this is to be handled, right down to the provisions of the Alberta's Health Care Protection Act.

If private insurance were introduced in Alberta (or any other province), the premiums would account for no more than 10 per cent of all health-care spending in the province -- meaning there won't be a lot of additional money to spend on health services.

Private premiums would also generate substantially less money than the current Alberta Health Insurance premiums of $528 for an individual and $1,056 for a family. In other words, forget about eliminating premiums in the public system -- unless the government is willing to sharply reduce spending in the public system. The alternative is much higher private-insurance premiums, in which case there will be few takers.

Here, the math does not makes sense. Less demand on the public system means less use of its resources. There is also an assumption that higher premiums will mean fewer takers, but that is impossible to determine unless you first state what benefits will be derived for your premium dollars. If the value is there, people will be there. Certainly if you got no better care than from a public institution, nobody would pay; however, if there is an established benefit then undoubtedly people will line up, regardless of cost. He addresses it somewhat here, but without its logical conclusion:

Mr. Emery and Mr. Gerrits argue that private care would have to be clearly superior to public care. Otherwise, you would have to be a fool to purchase private insurance. "The introduction of a private system would require the political will to institute a tiered health market," they write.

The political will exists NOW; the will to produce a system that works and covers everyone. Those that know how to ask can get better access to facilities currently because they are prepared to push until they get what they want. I live in a small town, but because I know how to talk nice to the lady at reception, I get an appointment almost at will. Am I favoured? Probably a little bit. Thus, already the system is skewed, tiered if you will in my favour. What’s universal about that?

My theory is the push for a pure public system is dictated by personal guilt. We all carry some, but today we are a wealthy society short on time. Rather than being a volunteer and making a difference on a personal level, many people want to be seen supporting this broad social program so they can feel they’re “making a difference”. Trouble is they’re willing to sell it out to get what they need quicker.

As an example, I’ll use my own mother. God bless her, she’s great. She’s middle class, financially quite comfortable and a supporter of status quo healthcare:

Giant Large: “OK, but let’s say you have a life threatening disease, and told you had to wait for treatment. Would you go to the U.S. if immediate treatment were available and pay out of pocket?"

Mother of Giant Large: “Yes. But…”

Giant Large” “Ah ha!”

Mother of Giant Large: “Where did I go wrong raising you?”

Do I blame her? No, of course I don’t. Anyone in their right mind would try and keep themselves alive rather than become a sacrificial lamb to universal health care on principle. It is basic human survival instinct.

The socialist dream of pure public delivery medicine is already dead. You have middle class members willing to announce their support on one hand, but slip out the back door on the other. How much support can you really expect when it comes down to taxation from someone who thinks like that?

I have no desire to see health access denied to any citizen, I just want it to be more efficient and Alberta is showing that this can happen. Their pilot project should be studied and considered in any further discussions. It will benefit us all. Supporters of the current system talk of its wonderful inclusiveness, yet so many health issues are left out of the debate its appalling. What about dental? Prescriptions? We’re already leaving people out in the cold, it’s awful. What about the integration of the private sector to help us do more, not less?

Tommy Douglas had a great vision, and kudos for it. But every idea needs tinkering, improvement and implementation of new methods available. Without that, we’re just livin’ in the past, man…livin’ in the past.

GL