July 5, 2005
Kamloops Daily News



I had to take a deep breath when the Supreme Court of Canada
ruled that Quebecers could buy private health insurance. 
Where waiting times are too long, the rights of patients to
timely treatment was denied - - health care delayed is
health care denied.

Was this the end of our treasured health care system?

Supporters of private health clinics could barely contain
their glee.  Dr. Outerbridge operates a private surgical
clinic in Kamloops where 22 doctors currently have
privileges.  "I can't see a downside too this," he said.

I can.

"What other thing in our lives can we not choose to spend
our money on?" asks Outerbridge.  That's not the question. 
What the consumers buy is of little importance to average
Canadians.  However,  public health care is.

The real question is "to what extent do the spending habits
of the rich affect our welfare?"   If private clinics rob
the public system of doctors, then that creates a two-tier
system.  The rich can spend their money as they please, but
not at the expense of the health of everyone else.

Oh no, say proponents of private health, it's not a
two-tier system like they have in the U.S. but a
parallel system as they have in Europe.  The semantics are
important.  Two-tier suggests a two-class system, one for
the rich and one for the poor.  "Parallel" suggests two
equal paths to health.

But comparisons with a parallel European system are moot as
long as we have a trade agreement with the U.S.

The Supreme Court heard evidence that Germany, the United
Kingdom and Sweden have parallel private insurance and they
coexist with a public system.  But because of NAFTA, these
examples do not apply says Maude Barlow of the Council of
Canadians.

"Once privatized, the system must give 'national treatment'
to hospitals and HMOs, which cannot be treated differently
than Canadian for-profit companies," says Barlow.  Once the
door is open to privatization, the door is open to predatory
tactics of U.S. corporations.  The options are either a
two-tiered system or no privatization.

It's not even clear that the rich would be better off buying
private health care insurance.  After all, insurance
companies are in the business to make money.  They are not
going to take unnecessary risks by insuring Canadians just
because they pay the premium.

To understand the economics of the proposed private health
insurance, compare it with private automobile insurance. 
Private auto insurers cherry pick, customers - - they
insure only those of low risk.   Because there is no money
to be made when they have to pay out claims, they insure
those who are least likely to need the insurance.

Private health insurance would do the same - -selectively
pick who they want to insure and carefully limit the
procedures covered.   Some Canadians may be able to buy
whatever they want, but only if it's for sale.  If an
insurance doesn't want to sell insurance to someone who is
sick, has bad genes, engages in risky work or lifestyle,
eats junk food, then they won't.

The same principle applies to the procedures done in private
clinics.  They only do procedures that are relatively
uncomplicated and low risk.  And where do patients go who
are seriously sick; those who require expensive treatment
for illnesses like cancer?  You guessed it.  They will be
sent to the public system.

If we are to have a truly parallel system, then public
clinics should be built to lower waiting lists.  Then there
would be a real choice for patients who could pay for added
private insurance, or get the same procedure covered in a
timely manner under medicare.

That won't happen in B.C. for ideological reasons.   The
B.C. government wants to starve the public system so that
the only options are private clinics and private insurance.

I don't like the Supreme Court decision but I defend it's
right to protect the constitutional rights of citizens.

In this case, the court has ruled that if Canadians can't
get timely delivery of public health care, they have the
right of optional insurance. 

But that's a big "if".  The ruling was based on conditions
in the past. The court made it's decision on evidence
originally presented in 1997.  Since then, the federal and
provincial governments have signed a deal, worth $41
billion.  That deal is already working to reduce waiting times.

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