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Marni Soupcoff: Patients shouldn't be punished for the sake of health-care ideology

Offering government funding for everyone doesn’t have to entail barring anyone from paying for surgery themselves, especially if they are suffering

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On Tuesday, Alberta Health Minister Tyler Shandro introduced the province’s plan to reduce wait times by increasing the use of private facilities for publicly funded surgeries, and as expected, the very notion of the words “health care” and “private” existing in close proximity to each other has caused concern. The leader of the lobby group Friends of Medicare, Sandra Azocar, issued a press release complaining, “We don’t need private solutions to public problems like wait times.” And Alberta’s opposition leader, Rachel Notley, said Albertans “don’t need to be continuously relitigating the value of public health care.”

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All right, if I were to detail my personal bias on the issue, it would take half the column, but suffice it to say that when I worked as executive director of the Canadian Constitution Foundation several years ago, I was wholeheartedly supportive of a constitutional challenge of the B.C. health-care act (the trial of which finally wrapped up last month after a decade of litigation) because I truly believe patients should be permitted to pay for health care if they choose to — especially when the government cannot provide it.

Patients should be permitted to pay for health care if they choose to

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Or to put it another way, offering government funding for everyone doesn’t have to entail barring anyone from opting to pay for themselves, especially if they are suffering. It would be fantastic if our provinces could provide truly timely surgery for every patient who needs it, but until that happens, it strikes me as unconscionable to insist that a patient who’s waiting, in pain and with a diminishing capacity to live a full life, be legally compelled to suffer for the sake of an ideal of a purely public health-care system.

The automatic response tends to be — O.K., it’s greedy doctors and rich patients who stand to benefit from any privatization of health care. So clearly, these people champion such changes from a position of self-interest.

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And that’s not necessarily wrong, but it’s also irrelevant if the changes would also benefit other patients and the overall effectiveness of the system. Do we really have to put ourselves through a moral panic when a wealthy person pays to get his knee surgery next week at a private clinic, rather than in several months on the government’s dime at the hospital, if that choice then frees up hospital operating room time for the low-income patient who’s waiting for complex spine surgery?

It’s unconscionable to insist that a patient who’s waiting for surgery, in pain and with a diminishing capacity to live a full life, be legally compelled to suffer for the sake of an ideal of a purely public health-care system, writes Marni Soupcoff.
It’s unconscionable to insist that a patient who’s waiting for surgery, in pain and with a diminishing capacity to live a full life, be legally compelled to suffer for the sake of an ideal of a purely public health-care system, writes Marni Soupcoff. Photo by Postmedia News

There is something especially frustrating about the knee-jerk reaction to allowing any private component to health care when it’s characterized as the Americanization of our system. This is a feeling that ought to be more carefully examined, because it seems to be based in part on the delusion that Americans want to take over Canadian health care, when the reality is that we’re far too paltry a market for them to care much what we do one way or the other.

And, here’s the more important thing, no one is suggesting taking away the thing that distinguishes Canadian health care most decidedly from American health care: universal coverage. The B.C. constitutional challenge that has Friends of Medicare bursting with outrage. Alberta’s new plan to outsource more surgeries to private clinics, which Rachel Notley characterizes as “American-style health care.” Neither one of these suggests for a moment that the government stop offering funding for every single bit of necessary health care for every single Canadian. We’re not relitigating the value of public health care, we’re figuring out how to make it as effective as it can possibly be.

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No one is suggesting taking away universal coverage

Accordingly, the province of Alberta has zeroed in on an area of public health-care’s weakness in Canada: untenable wait lists for some surgical procedures. To fault them for daring to address this “public” problem with “private” solutions misses the point that there’s nothing more personal than an individual’s well-being, and there’s nothing better for people as a whole than creating an environment in which every individual has the space to seek and get the care they need.

We can’t know for sure if Alberta’s new plan will succeed in shortening surgical wait times in that province, but we do know that pouring more and more money into the system hasn’t been doing the trick there (or in B.C. or Ontario etc.), and generally private delivery of public care seems to be one of the more successful health-care models (and one which neither Canada nor the United States has embraced to this point). So, it’s certainly worth a try.

Anyone who truly cared about the health of Canadians would have to agree that what works matters more than what it’s called and which advocacy groups it represents.

• Email: soupcoff@gmail.com | Twitter:

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