Consider that this week the Conference Board of Canada published the results of a survey of our attitudes towards the possibility of more private delivery of care. Only in Alberta were as many as half of residents in favour of more private options. Nationally, 60% were opposed.
Quebecers told EKOS Research they were the most opposed (65%) of any Canadians. At 64%, Atlantic Canadians were the next-most reluctant.
The irony in those numbers is that despite what Quebecers may like to think about the sanctity of public care, Quebec already has the most private options of any province. Indeed, the reason private care has been growing (very slowly) in Canada over the past 15 years is that the spark came from Quebec.
Montreal alone has more than 60 clinics providing private health care choices – some paid for by patients directly, others paid by the provincial health ministry under contract.
Had this blossoming of private care begun in any other province, Ottawa would almost certainly have shut it down. In the 1990s, the federal government withheld transfer money from Alberta, for instance, when the province refused to shutter two private eye surgery clinics that opened, one in Calgary and the other in Edmonton.
But because most of Montreal’s clinics opened when the Liberals were in power in Ottawa and because the Liberals were always fearful of confronting Quebec, the burgeoning of private options was permitted to go ahead.
Now that momentum has shifted to other provinces, notably B.C., Ottawa doesn’t feel it can step in because it didn’t initially halt the practice in Quebec. In the absence of provincial resistance, private choices will continue to expand.
Another irony is that while Quebecers express themselves most satisfied with public health in their province, it is in large part because of the significant number of private alternatives available.
Last week Vancouver’s Fraser Institute declared Quebec’s health system the best in the land. Fraser pointed out that Quebec has the most health resources available in the country and used them almost as efficiently as any other. But all that was because private alternatives were doing two things: prodding greater efficiency in the public system while also providing an outlet for patients unsatisfied with long waits for public treatment.
The Fraser Institute study may also offer a clue to why so many Albertans are unafraid of more private care. Despite spending more money per capita on care than any other province, Alberta ranked just seventh among the 10 provinces in the Fraser study. Despite spending more than $16 billion providing treatments for just 3.8 million residents, Alberta offered poor value relative to the amount of money its taxpayers spent.
Money does not buy better care. Free-spending Alberta, for instance, was one of the few provinces to see its waiting lists for specialized treatment grow last year. Nationally, average wait times dropped marginally, but they grew 3% in Alberta.
Ontario, which spends about a quarter less per capita than Alberta, offered almost twice as much value for money, according to Fraser.
It’s understandable Canadians would be leery of going to a public-private blend of health care, even to a system in which publicly paid-for services are provided by private clinics. Our system may not be perfect, but we have reassured ourselves at least it will be there whether we can afford it or not.
But the reality is we remain the only Western nation without significant private options and it is beginning to show.
Original Article
Source: edmonton sun
Author: Lorne Gunter
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