Canadians shouldn’t be too smug about the wild and sometimes bitter debate raging in the United States about public versus private health care.
Those who object to public health care in the U.S. point to the rising costs and increased wait times for treatment of life-threatening conditions in Canada.
They point out that imposing a similar universal system in the U.S. will place a financial burden on future generations that will be impossible to absorb and promises no improvement and possible deterioration in overall health care.
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Certainly some of the descriptions of the Canadian system are exaggerated and amount to fear mongering, but some of the points are worth considering.
For instance, the use of that tricky word universal is problematic. Essentially, it means everyone has to pay into the public health system and is entitled to equal health care service.
The truth is Tommy Douglas didn’t suggest universal care when he proposed public health care in Saskatchewan. He was talking about only a safety net for those most in need who couldn’t otherwise be insured. But by 1960 he campaigned for public medical insurance for all citizens.
The concept became universal when the federal government got involved, which meant everyone had to chip in and everyone would be covered regardless of whether they could afford private insurance.
This generated a gigantic system that now has a life of its own and that government has little ability to control. Within the next four years, Ontario and New Brunswick will contribute half of their entire tax revenue to health care. In the following two decades other provinces will trip into the same condition.
Canada is fifth among Organization of Economic Co-operation and Development members in per capita total public and private health care spending.
The U.S. is the leader, with public and private spending on health care totalling $7,300 per person, compared to $3,900 in Canada.
The U.S. spends more public money on health care than Canada does – $3,300 per person compared to $2,000. These dollar amounts come from OEDC reports and are adjusted for purchasing power parity.
The problem in the U.S. is that 45 million people out of a population of more than 300 million have no access to health care, public or private.
However, the comparison of health care spending and performance should not be between Canada and the U.S.
Instead, it should be compared to other largely publicly funded systems.
Among a list of 23 such countries, Canada frequently ranks 19th to 21st on many of the most important health care performance measures.
Despite a four percent growth in health care spending in Canada in 2008, which exceeded inflation, wait times for surgical and therapeutic treatments still average 16.1 weeks, the same as in 2000.
Despite spending increases, the wait times for medically necessary treatment still averages 113 days. As care falls short, it is shown that medical costs will only rise.
The impact of demographic trends toward an aging society, the growing costs of new technology, the increasing rates of child and adult obesity and chronic diseases such as diabetes and asthma mean costs will continue to outstrip inflation in the future.
There are only two ways to support the Canadian system: demand more income through taxes or reduce services.
There is potential for intergenerational conflict as the large baby boom population expects the smaller X and Y generations to bear the tax burden of their care.
Larry Roche is a tax analyst with Farm Business Consultants Inc. Contact: fbc@fbc.ca or 800-860-7011.
