Defending Universal Health Care - Just Look at the Alternative

Stephen Harper would like nothing better than to undo Canada's health care system. Here are a few quote from Stevie on the subject:

"Universality has been extremely reduced: it is dead as

a concept in most areas of public policy. ...These achievements

are due in part to the Reform Party."

"It's past time the feds scrapped the Canada Health Act."

"We also support the exploration of alternative ways to

deliver health care. Moving toward alternatives,

including those provided by the private sector, is

a natural development of our health care system."

"It is a call to action. We are going to reduce wait times,

we are going to hold governments accountable for their

commitments, we are going to do what it takes to protect

the public health-care system and respect the charter."

If that last quote doesn't seem to square with Harper's previous sentiments, it might be because it was delivered during the last election campaign.

The push to privatize health care in Canada, or adopt a two-tier system with a top tier for those who can afford it, is taking full advantage of problems we have allowed to set into the public system. We must weigh the actual costs and merits of fixing the public system before we debate privatized health care.

The United States stands alone as the bastion of for-profit health care. Why? There are two reasons: 1) there is a great deal of money to be made and 2) the idea of giving a hand up to the poorest hasn't really had much traction down there.

We think that privatizing health care is going to lead to a more efficient, more effective system. If you use the American model that's not the case. The health care system in the U.S. isn't really as privatized as you might expect. In fact, the U.S. government spends, on a per capita basis, an amount that equals a good hunk of what our governments spend in Canada. The private health care regime sits atop that. Together the private and public health care expenditures make America the biggest spender on health care services in the Western world and look at the accomplishments:

You can start with longevity, the age the average citizen can expect to live. America is way down the list. Some of that is Washington's fascination with getting its young people gainfully employed in war zones, some of it is America's gun culture, but a lot of it reflects the pretty miserable median standard of health care.

Other benchmarks include infant mortality. Again the U.S. leads the rest of the industrialized nations on this one.

Private sector health care has a couple of really fatal (pun intended) flaws. One of these is the amount of health care spending that gets siphoned off into administration costs. There are a considerable number of HMO's in the states. Their systems, such as accounting, vary according to each company's preferences. HMO's have to deal with hospitals and doctors. That means the health care providers have to have their own administrations to 'liase' with the HMO's and their various accounting systems. These administration costs eat 25-cents out of every healthcare dollar.

Private sector health care is another way of saying "for profit" health care. Out of the remaining 75-cents of every health care dollar, the companies have to find their reward. Think that's cheap? Think again.

How does a company generate profit? By keeping revenues up and expenses down, that's how. For-profit health insurers have a vested interest in keeping expenses down. There are two means of doing this: by finding any conceivable way to deny coverage to the insured and by negotiating with the health care provider to make treatment choices based on cost. Product X may be the latest and greatest, just what the patient really needs, but Product Y is a fraction of the cost and, well, it'll do.

What an enormous, and potentially deadly, conflict of interest. You're paying handsomely to have this HMO provide your health care needs and they're working their butts off to find ways not to have to deliver or to give you the cheapest treatment they can get away with. That's why the HMO administration costs are so high. They're funneling off a big hunk of your premiums to pay staffers to keep your health care costs to a bare minimum.

There are some of the advantages to the public health care system. Administration costs are minimal, more of every health care dollar is available to spend on your health. Doctors can give you the treatment you need, not just the best deal they can negotiate out of your HMO. Your health isn't being held hostage to some company's profit margins. That, to me, makes a lot of sense. You pay less and you get to live longer to boot.

This is not to say that we don't have serious problems besetting Canada's health care system. Obviously we do and we should always be looking for ways to improve it. We need to cut down waiting times, especially in critical areas such as cancer, heart disease and joint replacements. Remember, the Liberals actually wanted to implement that very reform. Hey, it was their idea.

You don't hear much about that from the new bunch.

We also need to accept the changing reality. We live longer than we ever expected when we created the health care model. Old people, on average, require more drugs and more treatments. When you increase longevity, it doesn't happen in youth. Wouldn't it be great if we could stay 20 for, say, 10-years? No, the extension comes at the last years and they're medically expensive years. There's no way around it, we have to adjust funding to the health care system to reflect this reality. Maybe we should go for a two-tier system. You can have the cheaper health care but we have to kill you when you hit 70. How attractive does that sound?