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On Fairness in Canadian Healthcare
I’m a week into my first trip to North America since 2011, and the first time I’ve been to Canada since my childhood. I’ve been visiting a famous Canadian healthcare complex and have been struck by a few things as an Aussie. I’m impressed by the professionalism of my colleagues and the standard of the technology being used to treat patients surgically. I am also struck by the fact that all the doctors I have spoken to are harshly critical of Canadian healthcare as it stands, and think that some kind of reform or change is needed.
Australia, like Canada, has universal healthcare but the similarity ends with this sentence. If you don’t like the waiting time, or the options presented to you, or your physician, or even just the decor of the public hospital in Australia, in most cases one can obtain the same service from a private doctor or hospital. In fact, once can choose to see the same surgeon from the public hospital in a private setting, if one wants. This usually comes at a price, but is always faster, and often in a “nicer” institution. None of that can happen if you are a patient in Canada, by law, because “fairness” and “equality.”
Fairness and equality as enshrined in the Canada Health Act make it illegal in that nation for a patient to be billed privately for medical treatment that is already covered by the public system. Physicians are also barred from providing both public and private health care. This was all very well thought out and designed by the left-leaning Liberal Party and enshrined into law by their majority government in 1984. (Message: Elections matter.)
As a result, a patient of limited income who requires a non-urgent operation was told by a surgeon today that he will go on the waiting list and is likely be seen in about a year. The same patient with money will most likely drive or fly to the US and get the same operation done privately at considerable cost, but with a better medical outcome and fewer risks than the poor counterpart.
The outcome is not “fair” or “equal.” Even left-leaning Canadian publications know it. However it feels fair to the Canadian people, and I have been told by medical colleagues here that changing the Canada Care Act to allow the existence of private care would be met with stiff public resistance. It seems like another case of Stalin’s Chicken.
With that sad tale, I bid farewell to Canadia and hello to Murica. Flyover country and the south await. Life is full of learning, I wonder what I shall see there?
Published in Healthcare
It’s all about union dues and Liberal Party election funding and support structure. Provinces like Ontario, with a population of approx 8million and annual deficit of $10billion, where health care is 50% of an approx $200billion budget, the possibility of breaking the government/union monopoly of health care is never raised by media. The Liberal Party has taken Canadians’ right to work freely in the health industry in many fields, must join union, must pay dues. So much for the freedom to innovate and the lower costs that that would bring to a desperate financial situation. US hhealthcare is headed the same way, imagine SEIU twice the size.
And as the original post points out, Canada already has a two-tier healthcare system, where the lower tier is the government/union monopoly, and the upper tier, for those with enough money, is otherwise known as the US healthcare system.
I don’t think anyone has yet mentioned the convoluted federalism of healthcare in Canada. Each province runs its own system, but the federal government provides transfer payments (of multiple types) towards paying for it. This also provides leverage to enforce uniformity across the country.