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Two health care decisions followed instructively one
after another this month.
The first, by US corporate giant General Motors,
identified skyrocketing private health insurance and delivery costs as sources of
unsupportable multi-billion dollar loses requiring layoffs of 25,000 GM workers,
mainly in the US. The second, by the Supreme Court of Canada, opens the door
to private health insurance and delivery, citing unsupportable wait-times for single-payer
publicly insured services.
GM US employees will lose their jobs and health care
access for their families while Canadian plants will be spared by the GM decision,
perhaps because of their reputation for high productivity and very likely, although
surprisingly no one is saying it directly, because our comprehensive public health
care system is part of our national infrastructure and industrial strategy. The Supreme
Court decision offers Canadians the chance to revisit our arrangements and to
adapt the public context in order to avoid the fate of those abandoned by private
systems and to sustain the Canadian advantage.
Yet Health Care is another pillar of our society
subject to criticism whenever adaption and innovation are needed or proposed. Sustainability
has for some time been the buzz word. The costs of the baby boom demographic bulge
and increasing costs of new technology are frequent points of reference. Too often
they have been the excuse to abnegate responsibility and to abandon established social
responsibilities.
But to say let the "marketplace" decide is not good enough. Doctors, not stockbrokers or investors,
should be empowered to make medical decisions. Private sector participation in delivery
of diagnostic services under strict public sector control of costs and distribution
is one thing. Privatization, even through so-called Public Private Partnerships,
is something else; after all, private providers are free to leave the field when
the going gets rough, while public responsibility remains. And privatization may
actually make the problem worse.
I recently learned from an interested party that private
clinics in Vancouver have recruited Operating Room nursing staff from
area hospitals, promising less work for the same or more money to overworked nurses,
increasing wait times for available surgeries in public hospitals. Procedures can
then be obtained, for those with the money to pay, in private clinics which do not
have the obligation to provide nursing and beds for postoperative care; instead,
patients are transferred to public hospitals which must accept them, again increasing
wait times for those who cannot afford private clinics. This is anecdotal and based
on personal experience and disturbing. It seems PPP might also stand for Private
Profit at Public expense.
Long term, stable, predictable funding and improved input
into diagnostic services, which might include a private contribution, is not the
whole solution by any means, but it is a good place to start, I suggest. The model
advocated by Mr. Justice Emmett Hall needs to be revisited, I think, mindful
of the principled mission on this file of Tommy Douglas and without consideration
for mere political opinion.
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Editor : Timothy W. Shire
Faster Than Light Communication
Box 1776, Tisdale, Saskatchewan, Canada, S0E 1T0
306 873 2004
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