Columns

Health: condition critical

Diane Francis November 27 2000
Columns

Health: condition critical

Diane Francis November 27 2000

Health: condition critical

Diane Francis

Columns

All the fuss by Prime Minister Jean Chrétien and his Liberals that the Canadian Alliance will create a two-tier health system is ridiculous. In fact, Canada currently has a four-tier system, which is very sick and urgently needs a fresh injection of ideas.

The first tier is basic care for all Canadians. The second tier consists of all the medical services that Canadians pay for out of pocket. Governments fork out roughly $70 billion for the first tier, while individuals in Canada pay another $25 billion for supplementary health insurance and dmgs. Then, there are the two other tiers that have been created because Ottawa forbids the current system to be revised for the better.

Tier three is enjoyed by persons involved in health care either as doctors, health-care employees or directors of hospital boards. These people and their families do not have to wait for treatment because their connections allow them to jump queues of wait-listed Canadians. Similarly, the fourth tier involves those Canadians wealthy enough to get topnotch medical treatment instantly south of the border or elsewhere outside Canada. Unfortunately, a series of federal governments have denied that such tiers exist or, more important, that anything can be done to change the system for the better. But the remedy is readily available, as anyone who is knowledgeable about European health-care systems can attest.

Canada needs only ape what the Dutch or Germans, for example, do. They provide a basic medical service for all residents, but also allow them to buy insurance in order to take part in a private, more expensive system that provides faster service in more pleasant surroundings. Such a system, by the way, is not about one system for the rich and one for the poor. In the Netherlands, 35 per cent of residents opt to pay for the extra service through payroll deductions or other measures; in Germany, the figure is 10 per cent. Those who don’t opt for insurance benefit from basic care, which is still more than adequate.

By contrast, Canadas current system is inadequate in spots and getting worse. Waiting lists are lengthening, even for needed treatments, and costs are rising. Resources are strained and doctors are trickling out of the country. All this could be reversed instandy. In fact, our health system could be converted from a nagging overhead to a huge profit centre through simple reforms.

Health care should operate exactly as our education system does. Foreign patients, like foreign students, should be encouraged to come here. If this were allowed, hordes of Americans might come north for treatments, and a new industry could be created earning foreign currency. But they

should be charged premium rates as a means of subsidizing care for Canadians and creating health-care jobs.

Private hospitals should also be allowed, just as the education system allows private schools. By permitting Canadians to pay extra for private, more luxurious care, pressure would be removed from the public system without reducing its revenues. This is how the education system works: private schools are supported by parents who pay private tuition, but who also pay taxes to support the public system. In other words, let people pay for both a private and public system in health care if they choose, as is allowed in education.

Put another way, if education was run like health care, there would be no private schools for basic education. Those who wanted schooling in a hurry or on a private basis would have to go south of the border or elsewhere. Instead of looking at reforms, the Liberals perpetuate the myth that their system delivers the same health care to all Canadians. They also perpetuate the myth that the official Opposition would create a two-tier system, one for the rich and one for the poor.

Europe has been able to provide better health care at dramatically lower costs by allowing people to buy insurance for the same services covered by their basic medical coverage. At the same time, the Europeans have devised a system that allows practitioners to earn more money in the private health field without cannibalizing the quality of the public system. One way these countries protect their health service is to insist doctors must put in a certain number of years in the public health sector before being allowed to spend any time in private practice.

But Ottawa has dug in its heels, playing politics with a system that is badly in need of help. Now, due to intransigence, it appears that a fifth tier is beginning to emerge. Recently, a man in Toronto who needed immediate radiation treatment for cancer could not get it soon enough in Ontario, so provincial health authorities sent him to Buffalo, N.Y., for several weeks’ treatment at huge expense to taxpayers. As more such incidents occur, we will find ourselves forking out even more tax dollars to purchase basic treatment from expensive American facilities because such basic treatment is unavailable here. This would be like Canada sending public high school students to private American educational institutions because there were insufficient schools, school buses or teachers available here.

The politics involving health care in this election campaign are disgraceful. Ail parties must seek solutions and stop merely playing around trying to win cheap debating points. Canadas health-care system is ill and without major surgery the patient’s prognosis is exceedingly grim.