Canada inches toward private medicine...Interesting
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Posted on: 08-08-05 12:53:02
http://news.yahoo.com/s/csm/20050808/wl_csm/ocanadarx_1
TORONTO - Canadians have long prized their public healthcare system as a reflection of national values, and have looked askance at the inequities of private medical care in the United States.
But now that the Canadian Supreme Court has ruled private health insurers should be allowed to compete with the public system, the future of Canadian healthcare is a question mark.
In the short term, the decision may light a fire under provincial governments to improve chronic problems, especially long wait times for surgeries, tests, and treatments. Some experts believe the ruling could eventually spawn a parallel, private healthcare system here.
"For our government, it's a very strong indictment of the way they've handled the system," says Dr. Albert Schumacher, president of the Canadian Medical Association. "I hope it will move us forward in the debate. 'Private' has always been used by politicians as a very evil word, associated with America and for-profit. But it's not necessarily so."
It all started with a disgruntled doctor, Dr. Jacques Chaoulli, and his patient, George Zeliotis, a retired salesman from Quebec who waited nearly a year for a hip replacement.
In a split decision, the Supreme Court in June found that waiting lists for medical treatments were unacceptably long, causing some patients to suffer or die. The judges struck down a Quebec law banning private health insurance for procedures covered by Medicare. Patients like Mr. Zeliotis should be allowed to go outside the public system and pay for timely medical treatments through private insurance, the court said.
"There are tens of thousands of Mr. Zeliotis out there languishing on waiting lists," Dr. Schumacher says. His patients, for example, go to nearby Detroit and pay out-of-pocket to get CAT scans in six days instead of waiting six months in Canada.
By the end of this year, the federal government has promised to establish benchmarks for "medically acceptable wait times" for treatment of cancer, heart disease, and other ailments. The government is already spending billions to try to reduce waiting lists.
Technically, the court ruling applies only to Quebec, and the court on Thursday granted the government's request to delay its decision for a year. But Chaoulli v. Quebec will eventually ripple through the entire country.
"No minister of health can say, 'We're going to deny you a right that exists in the province of Quebec,' " Monahan says. "As a matter of political reality, it's applicable in all provinces."
The man who sparked this revolution was often dismissed as a gadfly during the years he spent fighting the system. Dr.
Chaoulli once went on a hunger strike to protest fines levied on him for charging fees. Chaoulli represented himself in court, and his rough yet impassioned arguments struck home with the court.
"I am so happy," Chaoulli says. "Sooner or later, the medical monopoly will be stopped."
He predicts the emergence of a private healthcare system existing alongside the public one, as in Australia or New Zealand. Meanwhile, he is busy lecturing conservative US groups about the dangers of socialized medicine.
"Libertarians and conservatives do regard him as a hero," says Michael Cannon, director of health policy studies at the Cato Institute in Washington, a libertarian think tank. "He's going to be a very influential figure moving forward in Canada, in the US, and abroad."
Cannon hopes Chaoulli's victory dampens the ardor for Canadian-style healthcare in the US.
For many Canadians, private healthcare wears the scarlet A - for America.
"There is no political support for American-style healthcare," says Michael McBane, coordinator of the Canadian Health Coalition, a healthcare advocacy group. He says he hopes provinces will toughen laws to prevent private insurers from entering the market.
Allowing people to buy private health insurance violates fundamental rights, McBane says, because not everyone will be able to afford it.
"You can't discriminate based on the size of your wallet on something as important as healthcare," McBane says. "I would say this is an aberration and the democratic process will correct it."
The public appears ambivalent about the ruling. A new poll conducted for the Canadian Medical Association finds that 52 percent of Canadians view the decision "favorably," and even more said it will reduce wait times. But when asked if the ruling would weaken the public system, 54 percent agreed, saying it was "a bad thing."
Allyson Lange, a federal government employee, says she would support a parallel, private health system but doesn't expect dramatic changes.
"There would be too much opposition," Ms. Lange says. "We see a lot of what goes on in the US - people go broke because they have a health issue."
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Competition is good....
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I once made a mistake, but I was wrong about it.
Interesting is correct! I am not quite sure how it will work in the Canadian healthcare context though. After all the Government provided Healthcare is free, so how will the private healthcare companies compete?
If they offer healthcare \"step-up\" kind of options they will be high priced and no one would be able to buy coverage - unless they need the medical service desperately. Insurance companies work by mitigating the risk factors among several policyholders. So if the only policyholders are the people needing the service, then they will have a high degree of claims and payouts and the price of their policies will be correspondingly higher - making it even more unlikely that those who do not need the service will buy the policy.
If they offer employer-specific plans then again it would be based like in the US where larger employers have lower premiums and better medical plans than smaller employers.
Lets watch to see how the private sector enters into this market.
I wonder if the government will allow people to opt out of the social healthcare system (and its associated payments) and pay for a private medical system.
Straying off the topic...I have always wondered how socialist economies have survived, as I see them as a modified communist system. Capitalist economies, though not perfect, seem to provide more incentive to individuals to perform and not live off the fat of the land. Just a thought...
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Orginally posted by Canadian Dream
Interesting is correct! I am not quite sure how it will work in the Canadian healthcare context though. After all the Government provided Healthcare is free, so how will the private healthcare companies compete?
The private system would kick in where the wait time for a procedure is too high in the public system. In practice, this will likely be used primarily for procedures covered by insurance.
IMHO, there are too many people over-reacting to this. A dual public-private system certainly does not mean the ‘end of public healthcare’ – the two can certainly co-exist.
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Orginally posted by alexm
I wonder if the government will allow people to opt out of the social healthcare system (and its associated payments) and pay for a private medical system.
Thats what private healthcare providers hope.
But would that be like "I dont want it, so I wont pay for it".
Extend that to other areas where the govt provides services and you have problems....
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Straying off the topic...I have always wondered how socialist economies have survived, as I see them as a modified communist system. Capitalist economies, though not perfect, seem to provide more incentive to individuals to perform and not live off the fat of the land. Just a thought...
You are right and I wont argue that Capitalism is not a better system to enable growth. But as you said it is far from perfect.
In USA there is every incentive to work. But current figures on number of people not insured for health (whether working or not) is huge. 30 - 40 million if I am right. As per this article the figures over a period of 2 years is even higher. Much higher.
http://www.usatoday.com/news/washington/2004-06-15-uninsured-report_x.htm
Thats where public healthcare comes in or should have come in for the uninsured americans (which includes kids who may not be able to work or work only min/low wage jobs)..
So, capitalism does encourage growth, but it doesnt guarantee it.
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I once made a mistake, but I was wrong about it.
Quote:
Orginally posted by alexm
Straying off the topic...I have always wondered how socialist economies have survived, as I see them as a modified communist system. Capitalist economies, though not perfect, seem to provide more incentive to individuals to perform and not live off the fat of the land. Just a thought...
Actually - socialist economies have not just survived they have flourished. Several Western Europe countries have socialist models to some degree or other. In Denmark, France and Germany, for instance, the taxes are much higher but the degree of social security is also much higher (than in Canada). In France there are laws against having two jobs/ working more than xx hours a week.
I personally believe the socialist model is a much better overall development model than a pure capitalist. A capitalist model is much like a swimming pool - you sink or swim, there is no outside social support system. For the marginalised people of the country (the old, the poor, the disabled, the uneducated) a capitalist system usually becomes a very bad system to live in with no oppportunities for growth or social support system.
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Orginally posted by Canadian Dream
Actually - socialist economies have not just survived they have flourished. Several Western Europe countries have socialist models to some degree or other. In Denmark, France and Germany, for instance, the taxes are much higher but the degree of social security is also much higher (than in Canada). In France there are laws against having two jobs/ working more than xx hours a week.
This is exactly what I had discussed with a friend of mine the other day. He feels that European countries will have to move away from the socialist model when the competition from countries like India and China hots up.
Also, the term 'flourished' is somewhat misleading; that may have been the case 10 years back but they are sliding back now. Look at the problems Germany is having currently.
Already the richer (read complacent) EU coutrnies are starting to have problems with citizens of the poorer EU nations working harder for the same job. You might have heard of the recent controversy in France over plumbers coming in from Poland and giving competition.
That rule where people shouldn't work more than 35 (?) hours a week...that seems pretty dumb, IMO. Companies (and their employees) face an increasingly competitive world environment. If an American employee is going to put in 45 hours a week and their product out to market faster, guess what's going to happen.
Even in India we are moving away from the socialist model and privatizing industries. Why? The simple answer is that private industries are leaner and more competitive.
I feel the EU countries will be forced to change over the next few decades. It'd be interesting to see how it turns out....
