Time for a healthcare revolution

With family doctor wait lists getting longer and emergency room beds getting scarcer, perhaps it’s time for Canadians to take the cue from Europe’s social democratic countries and allow private care into hospitals, says David Descôteaux.

For every dollar I pay in income and other taxes, 40¢ goes to fund the healthcare system. But if I’m unfortunate enough to require surgery on my leg (as is currently the case), I have to pay — again — to have surgery in a private clinic to avoid the year-and-a-half-long wait time in my province’s public hospitals. And if my four-year-old son falls ill, I have to line up at my neighbourhood clinic at 5:30 in the morning and cross my fingers that I get an appointment before the end of the day.

I’m clearly not getting my money’s worth. And I’m not alone.

According to Statistics Canada, more than 20% of Canadians in six territories and provinces, including Alberta, Saskatchewan and Quebec, are unable to find a family doctor. In many places, wait times for some surgeries are downright inhumane, and if you have to go to a hospital emergency room, be sure to bring a week’s worth of sandwiches and underwear.

It’s therefore no surprise that Dr. Brian Day, former head of the Canadian Medical Association, has filed a lawsuit against the government of British Columbia on behalf of five victims of the system, patients who contend their health suffered due to long wait times. A sixth patient has died while waiting for the trial, and another has joined the lawsuit after becoming a paraplegic. The plaintiffs want to be able to pay — with cash or through private insurance — for care in private clinics if the public system can’t provide timely care. The trial is scheduled for September.

Day will no doubt rely on the 2005 Supreme Court of Canada decision in the Chaoulli v. Quebec case, in which the court ruled in favour of Dr. Jacques Chaoulli, who claimed that the province’s ban on private health insurance violated Quebec’s Charter of Human Rights and Freedoms.

What’s there to be afraid of?

I’ve never understood our collective phobia of the private sector’s involvement in healthcare. We rely on the private sector for food, laser eye surgery and dental care. And yet we prefer to let our fellow citizens languish on waiting lists instead of allowing private care into our hospitals.

The public system can surely be made more efficient. But far from being a cure-all, the private system can also play an important role. I’m not saying we should imitate the United States, but rather Europe’s social democratic countries.

In Denmark, anyone who waits more than a month for surgery is sent to a private hospital. In the Netherlands, citizens can take out private insurance and insurers do not have the right to turn down clients. Access to healthcare remains universal and the Dutch government pays an allowance to households whose premiums exceed 5% of their income. In Sweden, Stockholm’s most respected hospital, Saint Göran, is listed on the stock exchange and offers free care to both the wealthy and the poor. In France, 40% of the country’s hospitals are private, for-profit institutions. Yet, anyone can have surgery there, paid for by the state.

European countries realize the private sector can play a useful role in the health system. They also understand that the state’s role is to ensure all citizens have medical coverage and that entrepreneurs can provide health services in a competitive market.

Canada’s aging population will only exacerbate wait times in the coming years. The healthcare system is crumbling. It’s time to stop losing sleep over the private-sector bogeyman. Let’s take our cue from Europe and make way for our entrepreneurs to offer quality health services to Canadians with wait times that are worthy of a civilized country.

About the Author

David Descôteaux


David Descôteaux is a Montreal-based business columnist.

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