CALLS to maintain and improve publicly funded Canadian health care have recently received two much-needed boosts: one from the Senate committee, headed by Michael Kirby, and the second, the Royal Commission report of former Saskatchewan premier Roy Romanow.
He observes, “Canadians consider equal and timely access to medically necessary health care services on the basis of need as a right of citizenship, not a privilege of status or wealth.”
Born in Saskatchewan, public health care was an example of co-operating to overcome problems. It was a response of people who feared losing everything so they could afford an operation or long-term care. Some had seen that happen in their communities; some had experienced it first hand.
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But medicare is facing major challenges that threaten the health of our nation.
One is a shortage of money, which has spawned the myth of a funding crisis.
There is no funding crisis. There is a crisis of political will to keep medicare well enough funded that it serves Canadians effectively.
As long as politicians convince taxpayers that the problem is money, they can expect us to fall for any excuse they provide. If anything, we Canadians need to remind our politicians what our real needs are, particularly better funding of what’s crucial for everyone.
That is not to say we should just throw money into medicare. Expenditures must be carefully considered and targeted; they also need to be well monitored, through agencies like Saskatchewan’s recently created Health Quality Council.
The other major threat is the call for private health care.
In the business world, you can set up your business to make a profit or you can set it up to provide a service, but you cannot do both because, when pressures come, responses differ. For-profit businesses normally limit service to keep profits up. Service-oriented, non-profit operations, like governments, sacrifice profits to keep service up.
Supporters of private health give various arguments for their positions. Those are illusions. You’ll hear privately operated health care cuts down waiting lists. That’s true. It does so by removing from the waiting list those who cannot pay, even if they have high need.
You may hear competition keeps prices down. Actually, competition raises prices through the unnecessary duplication of expensive administration.
As a compromise, some have suggested a dual system, where those who can pay extra push down those who cannot. Yet that is a one-way road; once the principle of universal care is broken, thorough privatization follows.
And it’s expensive. In the United States, annual costs often run in the range of $6,000 to $9,000 per family. Canadian equivalent: $12,000 to $18,000.
Who can afford private health care? Farmers struggling to live on break-even or negative incomes? Workers making minimum wage or even more, in small towns or big cities? Neither.
Canadian medicare is good and can be better. But we need to keep it working as an effectively funded public service so every Canadian can have good health care.
Rob Brown is a United Church minister now engaged in graduate studies on ethics. The opinions expressed in this column are not necessarily those of The Western Producer.
