Thesis: Canada will benefit from a two-tier health care system because it will reduce waiting times, encourage doctors to return and stay in Canada, and control government spending.
Counter-Argument 1: Two-tier health care will not shorten waiting times
· “The introduction of private health insurance is no solution to the problem of long waiting lists,” Sharon Sholzberg-Gray, president of the Canadian Healthcare Association argued.[1] “Many Canadians couldn’t afford or qualify for private insurance and Canada’s publicly-funded health system offers a significant competitive advantage to businesses that don’t have to provide medical and drug coverage for their employees,” she said.[2]
· If Canada allows a private tier, only the rich will be able to use it, leaving the poor waiting in line for inferior quality public tier care.[3]
Argument 1: Two-tier health care will shorten waiting times
· In June 2005, the National Post reported the Supreme Court ruled that Sweden, Germany, and the UK all have two-tier systems which provide services much faster than in Canada. All of these countries provide a mix of private and public health care. In Sweden, the court found that the availability of private health care insurance appears not to have harmed the public health care system. It drew similar conclusions from its examination of the systems in Germany and the U.K.[4]
· The 2005 Health Care in Canada survey by the public opinion research firm POLLARA shows that 49% of the public said they would be willing to make out-of-pocket payments to purchase faster access to health care.[5] A majority also believes that expanding private insurance would result in shorter waiting times, 68%.[6]
· The public will be better served by offering private clinics to those who want to pay for quicker service. This would undoubtedly take a huge burden off the public system, as demand on the system will be lessened. While this occurs, waiting times will reduce substantially.
Counter-Argument 2: Two-tier health care will not bring doctors back to Canada
· If doctors can go private, then they are going to quit the public system.[7] If doctors can make more money working in the private system and on top of that have more freedom, why would one chose to remain in the public system?
Argument 2: Two-tier health care will bring doctors back to Canada
· When asked what incentives might entice doctors to return to Canada, respondents cited better remuneration and practice opportunities, proximity to family and workplace flexibility.[8]
· “As a general surgeon, I would prefer to live in Canada but I got tired of working in a resource-poor system with constant cutbacks and little O.R. time,” said one physician. And as stated by another respondent, “I love being Canadian and would love to live in Canada, but the remuneration and system constraints make it less attractive than my current U.S. practice.”[9]
Counter-Argument 3: Two-tier health care will not control government spending
· The United States private health system costs more than two times Canada’s cost per person. Americans pay more in taxes and insurance for health care than Canadians do. Even so, 43 million Americans have no health insurance. Costs are escalating at a rate that has thrown private industry into a crisis.[10]
· Ms. Yalnizyan argues that governments have created the crisis of sustainability in health care. Since 1996 $250 billion have been lost to tax cuts. Other government spending has decreased because of tax cuts so it appears that health care spending is more of the budget.[11]
Argument 3: Two-tier health care will control government spending
· A two-tier system would lower the cost of healthcare, as it would bring in competition, which results in lower prices. [12]
· In Ontario, for example, health care spending accounted for just over 30 percent of the provincial government's expenditures in 1981/82, but 45 percent in 2004/05. Assuming that current trends will continue, the Ontario government has projected that the share will increase to 55 percent by 2025.[13]
· “The key thing about health care is the rate of increase in health-care costs to government, because the cost of health care to government is increasing at all levels at a faster rate than the increase of any government's revenue. In the long term, if something is increasing at a faster rate than the increase in government revenue it's not sustainable. Eventually it will be 100 per cent of your budget, particularly if you have a downturn in the economy.”[14] This quote is stated by Janice McKinnon, a former Saskatchewan finance minister and a professor of public policy at the University of Saskatchewan
· “Medicare is a government-run health insurance monopoly. Its design is flawed because it is influenced by politics and not economics. It is not accountable to patients and is barely accountable to taxpayers. If we want to ensure we have a health-care system that's affordable and sustainable, Canadians need to start looking at private sector health-care policy alternatives.”[15] This is a quote by Brett Skinner, the Fraser Institute's director of health, pharmaceutical and insurance policy research
[1] Tracy Tyler, Beware Two-Tier Medical Care, http://osgoode.yorku.ca/media2.nsf/83303ffe5af03ed585256ae6005379c9/122cc9c25306a2fa852570a7006f5446!OpenDocument (October 27, 2005)
[2] Ibid
[3] Ibid
[4] R. Arnold, Should Canada Allow Two Tier Healthcare? http://iwarrior.uwaterloo.ca/?module=displaystory&story_id=2969&format=html&edition_id=78 (June 27, 2007)
[5] M. Soupcoff, Brian Day's Diagnosis: The President of the Canadian Medical Association Explains How to Fix Our Health-care System, http://communities.canada.com/nationalpost/blogs/fullcomment/archive/2007/10/22/brian-day-s-diagnosis-the-president-of-the-canadian-medical-association-explains-how-to-fix-our-health-care-system.aspx (October 22, 2007)
[6] Ibid
[7] CBC News, Public Vs. Private Health Care, http://72.14.205.104/search?q=cache:Kuw7un-YLd4J:www.cbc.ca/news/background/healthcare/public_vs_private.html+if+doctors+can+go+private,+then+they%27re+going+to+quit+the+public+system.&hl=en&ct=clnk&cd=1&gl=ca (December 1, 2006)
[8] CBC News, Canadian Doctor’s Would Come Home if Asked, http://www.cbc.ca/health/story/2007/10/09/canadiandoctors-return.html (October 10, 2007)
[9] CBC News, Canadian Doctor’s Would Come Home if Asked, http://www.cbc.ca/health/story/2007/10/09/canadiandoctors-return.html (October 10, 2007)
[10] The Pulse, Weighing the Evidence, http://web.net/~ohc/pulse/june%20pp1and2and3and4.pdf (June 2005)
[11] Ibid
[12] R. Arnold, “Should Canada Allow Two Tier Healthcare?” http://iwarrior.uwaterloo.ca/?module=displaystory&story_id=2969&format=html&edition_id=78 (June 27, 2007)
[13] Tom Sanborn, Canada’s Health Care Crisis, http://thetyee.ca/News/2006/04/11/CanadasHealthCareCrisis/ (April 11, 2006)
[14] Ibid
[15] Anne Kyle, Health Care costs Grow, http://www.canada.com/reginaleaderpost/news/story.html?id=517c3624-4fb4-43a6-83d0-9c36a86b2587&k=75064 (December 4, 2007)