Private care systems that have succeeded in European countries may not work in the Canadian context, say University of Ottawa academics
In a groundbreaking legal challenge to the Canadian healthcare system, Dr. Brian Day of Cambie Surgery Centre, along with other plaintiffs, is essentially proposing to remedy long patient wait times through enhanced participation and payment for private care. This is disputed by a duo of academics, however, who penned a recent article in the The Huffington Post Canada debunking the merits of privatization of the healthcare system.
“If the Cambie case succeeds, scores of private buyers will join the bargaining table, driving up prices for physician services and diverting resources to the highest bidder irrespective of medical need,” said Colleen M. Flood, director of the Centre for Health Law, Policy and Ethics in the University of Ottawa, and Bryan Thomas, a research associate for the same institution.
While the plaintiffs have pointed to European nations with successful systems combining private and public healthcare, Flood and Thomas argue that this is a false equivalency.
“In England, for example, specialists working in the public system are salaried and contractually bound to a full-time, 40-hour work schedule… It is not a viable option in Canada, where physicians have grown accustomed over a half-century to a much higher level of independence,” the authors wrote, saying that any move to force physicians from fee-based to salary-based income will face strikes and further constitutional challenges.
In the Netherlands, meanwhile, private insurers are a major participant in health care because there is no separate public system: there’s just a system with heavily regulated private health insurance, wherein all Dutch citizens over 18 must get health insurance policies, with their employers contributing to the cost. “The rub is that private health insurers must offer coverage to everybody and cover almost everything… [Cambie challengers insist on] a free public health-care system left behind with just a small private tier on the top. That is clearly not the Dutch model.”
The authors said it’s “purposefully naive” to expect Canada’s Medicare system to be fixed by splicing in certain features of European health systems. Rather than privatization, they recommended tougher regulation.
“A Patient Ombudsman in each province – with real teeth – would be an important start to help patients that fall through the cracks get timely, quality care.”
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“If the Cambie case succeeds, scores of private buyers will join the bargaining table, driving up prices for physician services and diverting resources to the highest bidder irrespective of medical need,” said Colleen M. Flood, director of the Centre for Health Law, Policy and Ethics in the University of Ottawa, and Bryan Thomas, a research associate for the same institution.
While the plaintiffs have pointed to European nations with successful systems combining private and public healthcare, Flood and Thomas argue that this is a false equivalency.
“In England, for example, specialists working in the public system are salaried and contractually bound to a full-time, 40-hour work schedule… It is not a viable option in Canada, where physicians have grown accustomed over a half-century to a much higher level of independence,” the authors wrote, saying that any move to force physicians from fee-based to salary-based income will face strikes and further constitutional challenges.
In the Netherlands, meanwhile, private insurers are a major participant in health care because there is no separate public system: there’s just a system with heavily regulated private health insurance, wherein all Dutch citizens over 18 must get health insurance policies, with their employers contributing to the cost. “The rub is that private health insurers must offer coverage to everybody and cover almost everything… [Cambie challengers insist on] a free public health-care system left behind with just a small private tier on the top. That is clearly not the Dutch model.”
The authors said it’s “purposefully naive” to expect Canada’s Medicare system to be fixed by splicing in certain features of European health systems. Rather than privatization, they recommended tougher regulation.
“A Patient Ombudsman in each province – with real teeth – would be an important start to help patients that fall through the cracks get timely, quality care.”
Related stories:
More than 45,000 Canadians sought healthcare outside the country last year
Push for private health puts profit over patients, says lawyer
