Public health care has a long and vibrant history in Canada. From Tommy Douglas’ initial push to make health care available to all Canadians to the federal government’s recent promise of massive cash injections, health care has become as much a part of our identity as has the maple leaf. In fact, public health care is probably the single largest symbol in Canadian society. However, private health care is quickly becoming big business in Canada, making up nearly a fifth of government expenditures on health care.
Privatization of the health care system might actually bring a number of tangible benefits and visibly better service for all Canadians. Shorter wait times, superior practitioners, and modern facilities associated with for-profit organizations mean an increase in the quality of care provided and more expeditious service overall. That is, if the system has provisions for private delivery using public funding (what some unaffectionately call “passive privatization”), and does not differentiate between people based on the size of their bank accounts.
With a deteriorating public health care system and increasing waits for diagnostic tests, appointments with specialists, and many elective surgeries, privatization of at least a portion of the system can lead only to reduced pressure on the public system and improvements in the quality of service offered across the board. Privatization also means a greater ability to attract and retain physicians that are currently being lost to the United States. This said, Canada cannot be caught in the trap faced by the United States, where there is a complete absence of public health care. If non-subsidized private health care is allowed it operate in Canada, the quality of health services for many groups will suffer. Those Canadians—and those living in less prosperous regions—who cannot afford the service fees and insurance premiums associated with private health care will be forced to turn to a public system (being pushed to the margins by a market-driven, private one) filled with increasingly long backlogs, inferior technology and less qualified, more overworked physicians. If private health care is to have a positive impact, it must be heavily subsidized by the federal government.
Clearly, a more efficiently managed private health sector may bring an expansion in the breadth, quality, and availability of services that are offered to the public. However, if this sector is mishandled and medicine is turned into a full-fledged commodity, then the accessibility of health care to large segments of the population will be reduced significantly.