Public Health Care - Canada's Frankenstein

"Time and health are two precious assets that we don't recognize and appreciate until they have been depleted."

~ Denis Waitley

I was born and raised in the province of Ontario. I am average, I am in good health and I pay taxes.  I use the health care system as necessary but I wouldn't want to rely on it to save my life.

Public health care is a noble idea.  When it was first introduced it was intended to provide its residents with emergency medical services and preventative care at no charge. (Well, no additional charge -- the "system" after all is financed through taxation.) It meant that the impoverished or the uninsured/uninsurable could access basic health care. Honourable.

Some forty years later, Ontario introduced an additional health care premium on personal tax returns based on annual earnings.   The same year the new levy was introduced, the provincial government began to de-list services that had, until then, been made available through OHIP.  Residents were now being asked to pay more for less. Those of us paying attention noticed that certain health care coverage was now offered to individuals under the age of 19, over the age of 65, or to individuals on social assistance.  Wage earners -- those funding the program through taxation -- were being asked to pay out of pocket for services available free of charge to the unemployed.

The fact is, our medical insurance program lost sight of its original purpose -- to provide emergency health care and preventative care at no cost.  It has grown over time to fund diagnoses and treatment across multiple modalities from birth until death on an inpatient and outpatient basis.  It became and unwieldy beast.  Our Canadian Frankenstein.  It was a good idea at the time...but it soon grew out of control.

How could an idea conceived 50 years ago integrate contingencies to reflect decades worth of medical advances and their financial implications much less anticipate swings in the economic landscape and changes to the the nation's demographics?  It cannot.  And, as with every other government program, failure to manage the program has resulted in a crisis.  That, in my opinion, is the single biggest flaw with government health care -- it is not managed.  It is budgeted, it is regulated, but it is not managed. 

So now what?  So now we have a system that is built to fail.  It is unsustainable. Worse still, Canadians feel it is their birthright and they become outraged when insurance drops another service.  Our health care program has become a political playground used to launch platforms and criticize government spending.   Now, doctors and bureaucrats are playing tug-o-war with our health insurance as the latest cuts focus on a "wage freeze" for physicians.  That's right...our government currently maintains that the health care crisis is partly due to medical professionals who have benefited from a 75% increase in earnings over the past 10 years.

Canadians need to read between the lines.  Politicians will not freely endorse or work towards a two-tiered system until it has the support of the Canadian public.  There is too much unease around any inequities that may follow.  We all agree that class should not dictate the level of care one receives...but it does.  It always did.  It always will.  If you have money, you can spend it on your health.  It is as simple as that.  Let's not be naive. 

Private health care options already exist in Canada, however they are few and far between.  The Canada Health Act penalizes provinces who, among other things, make private health care an option for their residents by reducing federal transfer payments.  Some view the penalty as an acceptable loss in exchange for alternative health care solutions that would alleviate a program in crisis.  Clearly it's a financial win for some provinces. 

Canada needs a strategy that would provide health care solutions for individuals covered by private insurance plans or who may be willing to pay out-of-pocket for health care services; a two-tiered system that alleviates a straining health care system without diminishing services to those that rely on a public health care.  A system that keeps health care dollars in Canada to promote research and development and create jobs for health care professionals that are being lured south of the border.

There has been no health care reform in Canada.  If anything, Canadians should not be upset because services are being de-listed, they should be outraged that their government is not planning a strategy that will outlast its term of office.