a, Opinion

Commentary: The American health care distraction

In the debate over health care reform in Canada, defenders of the status quo often resort to the tired claim that a greater role for competition, private financing, or private provision of health care services in Canada would mean the ‘Americanization’ of health care. Indeed, the claim is often made that proponents of private financing and delivery with the universal Medicare system are recommending the United States’ approach to health care policy in which only the rich can have access to top quality care, a highly deceptive and misleading argument.

Most people arguing for a greater role for private financing and delivery of health care in Canada are not recommending the adoption of a U.S. style health care system. All Canadians should agree that it is in the national interest to have a high- quality universal access health care system regardless of ability to pay.

The U.S. is a straw man comparison and is not a model for any country to reform its own nation’s health care system on. In addition to its high costs, the U.S. also fails to deliver coverage to millions of its citizens. However, while Canadian health care is better than the system (or lack thereof) that exists in the U.S., it actually performs relatively poorly compared to other developed nations that provide universal health care.

The question Canadians must ask is how to best organize health care policy in Canada to better deliver on the promise of high quality care provided in a timely fashion regardless of ability to pay at reasonable cost to the taxpayer. The facts show clearly that Canada’s government breaks that promise on a daily basis despite asking Canadians to pay for the developed world’s second most expensive universal access health care system.

Notably, in spite of those comparatively high expenditures, Canadians receive relatively poor access to physicians and medical technologies, and are cared for using far too many old and outdated pieces of medical equipment. Canadians also have to live through the agony of some of the longest waiting times in the developed world.

The question Canadians must ask is how to best organize health care policy in Canada to better deliver on the promise of high quality care provided in a timely fashion

Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland all deliver health care services without waiting lists that are excessively long, while still providing treatment regardless of ability to pay.

Australia, Japan, Sweden, Switzerland, and France all manage to outperform Canada in outcomes closely related to the performance of the health care system. According to the Fraser Institute, a Vancouver-based market-oriented think tank, Canada performs worse than these other nations on indicators that range from infant mortality to breast cancer survival rates.

Critically, every one of these nine nations employs competition in the delivery and financing of health care and requires patients to share in the cost of the care consumed to the benefit of both patients and the public treasury.

More specifically, each of these nations employs private providers in the delivery of publicly funded health care services, employs a private parallel health care sector that individuals can access easily, and requires cost sharing or user fees for universally accessible health care services.

According to organizations like the World Health Organization and the respected health policy think tank the Commonwealth Foundation, all the above-mentioned nations achieve better health care outcomes at a lower cost than Canada.

The claim that employing private financing and provision of health care in Canada would lead to the ‘Americanization’ of health care is not based on facts. The truth is that employing these policies would improve the state of health care in this country and make Canada’s universal health care system much more like those in Sweden, Switzerland, or Japan. Universal health care is rightly a Canadian value. Yet this does not mean the system is perfect. The failure of the Canadian model to deliver a quality of service on par to other developed nations means that we must move away from our obsession with comparing ourselves to the U.S. and learn from our global peers who seem better able to balance the twin goals of equity and efficiency in health care.

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