TRUE NORTH COLUMN: Health minister’s rant on private care out of touch, uninformed, and dangerous

Health care in Canada is in crisis. 

That’s a fact. But apparently, not one recognized by the Trudeau government. 

In response to a question about a recent Ipsos poll that showed 42 per cent of Canadians would go to the United States to pay for health care to avoid long waits, federal Health Minister Mark Holland went on a nonsensical rant. In fact, his remarks reveal a dangerous attitude at the very top of Canada’s federal government. 

Holland began his response with a clear denunciation of the idea that patients should have the right to pay to improve their health.

“I would say that, you know, health systems that have operated on this model, are an abject disaster,” he said.

Is that really so? Which countries would Minister Holland happen to be referring to? 

Sweden, for instance, operates a universal, government-run system, but allows patients to pay for private care if they so choose. A study from the progressive-leaning Commonwealth Fund showed that, despite spending roughly the same amount of money per capita on health care as Canada, Sweden’s system performed better. Same for the Netherlands, the U.K., Switzerland and France.

New Zealand and Australia both spent less than Canada and far outperformed our system.

All of these countries provide universal healthcare while allowing patients to pay for care if they so choose. Does Canada’s health minister not know this or is he deliberately trying to mislead Canadians? 

What’s even worse is Holland’s minimization of the suffering and death Canadian patients are facing in our health system.

“I would say to folks, most of the waiting that is occurring is for either elective procedures or for procedures that are non, not an emergency circumstance, that people be patient with those,” he said.

The disconnect from reality and disregard for patients is, frankly, shocking. One has to wonder if Holland would look someone like retired nurse Judy Anderson in the eye and tell her to be patient.

Both of the Ontario woman’s adult daughters died waiting months for heart surgeries that could have saved their lives. Ontario health data show that since 2013, there have been 931 patients who died while waiting for cardiac treatment in the province – 244 of whom waited longer than the maximum recommended wait time.

People like Kim Purdy, Jerry Agar and Sharon Kilkenny have suffered from chronic physical and emotional pain thanks to long waits for joint replacements. Would ‘patience’ have helped any of them out? They’re also far from alone. SecondStreet.org data show that over 17,000 Canadians died waiting for various surgeries and diagnostic scans just last year. 

The Fraser Institute has been tracking median wait times since 1993. Over the last 30 years, wait times have nearly tripled to 27.7 weeks. Over the same period, government spending in Canada – on a per person basis – has increased at nearly double the rate of inflation.

More money, longer wait times. Clearly, throwing money at the system hasn’t worked.

Perhaps the health minister would be wise to spend some more time looking at the data and hearing what patients are going through, instead of fear mongering about reform.

“We cannot have people begin spending money in private systems or private models. That’ll be the end of quality care for all of us,” he concluded.

As demonstrated, he’s clearly wrong that allowing patients the right to choose would somehow detract from the universal system. Perhaps sharing falsehoods like this is easier when you don’t have to rely on the Canadian system. If Holland was diagnosed with cancer or had chronic hip pain, he could afford care in the U.S. on his taxpayer-funded salary of nearly $300,000.

Though it’s possible a politician in his position may not face the same long waits as everyone else, given his influence on the system.

Years of pain and suffering, or maybe death, for many everyday Canadians, with the only real option for access to timely care coming from outside of the country.  It’s hard not to call a system like that an ‘abject disaster.’ 

Dom Lucyk is the Communications Director for SecondStreet.org, a Canadian think tank.

This column was originally published in True North on March 13, 2024.

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.