At the Fraser Institute this last week the air has been thick with discussion, argument and counter-argument as a public forum was held to analyse the state of Canada’s health system. The Fraser Institute hosted as a guest speaker Dr. Brett Belchetz, a practicing emergency room physician from Toronto, to give his take on the problems that face the Canadian system. Dr. Belchetz’s presentation, named ‘We Need to Rethink the Canada Health Act, and Fast’ outlines what he believes is the best course of action to improve Canada’s health system based on an inside perspective.
I have learned that a “free” public health system is almost seen as a Canadian value, and the juxtaposition of the
Dr. Brett Belchetz, presenting at the Post-Secondary Seminar his talk : We Need to Rethink the Canada Health Act, and Fast
state of Canada’s almost-entirely public system with the almost-entirely private system of the US has resulted in a public (and hence political) reluctance of Canadians to take any steps in the direction of private funding. Misinformation and a lack of education have allowed this mawkish and naïve ideal to flourish while the Canadian system flounders. Despite public expenditure on Canada’s health care system exploding from 7% of inflation adjusted GDP in 1975 to greater than 11% today, health outcomes have steadily deteriorated, and Canada is now ranked 10th out of the 11 Commonwealth countries studied in Dr. Belchetz’s presentation.
The woeful performance of Canada’s health care system bears a striking contrast to its supposed objectives. The idea that the Canadian system is fair and equitable, even if you have to wait longer for care, does not stand up to reality – while approximately 50% of Canadians report that they are unable to access primary care within two days, 38% report they can easily get after hours care without going to the ER, and 31% of Canadians have to wait four hours or more when they go to the ER, Canadians with better means are reporting better access to, and quality of, health care.
Dr. Belchetz identifies the source of these innumerable problems to be the Canada Health Act (CHA), introduced by the Liberal Government of Pierre Trudeau in December 1983. This piece of legislation stipulates a $0 price for health care, no user fees allowed and no extra billing. Any first year economics student would realise that with a $0 price and a fixed supply, demand will go through the roof and overwhelm the system. The CHA makes it illegal to have private health care in tandem with the public system, which stifles innovative ways of expanding the supply of health care and leaves many people who are suffering without a health care option. Mr Belchetz gave an example of one of his friends who was recently diagnosed with MS, and who expressed that he would pay anything to see a doctor tomorrow, but was instead told that he would have to wait four months to see a specialist.
Dr. Belchetz is not arguing for a replication of the US system – in fact, he explicitly states that a public system is a necessary safety net for those with lesser means. Instead, Canada should be striving towards the approach of countries that have a two-tier health care system, with public and private health components, such as Australia, the UK and the Netherlands, which consistently achieve higher satisfaction and lower expenditure levels. To do this, Dr. Belchetz argues for the immediate scrapping of the CHA, and the pursuit of a capitalistic, market based approach to satisfying Canadian’s health care needs.
This last Saturday the Fraser Institute held a seminar in Vancouver for university students from across the country. Along with Dr. Belchetz, many other speakers made presentations regarding public policy issues, such as the Bitcoin movement, China’s one-child policy, and the importance of entrepreneurship from the perspective of small businesses in BC. A talk I found of particular interest was presented by Chief Karen Ogen, of the Wet’suwet’en First Nation, who spoke of her attempts to improve the standard of living for her struggling community by capitalising on LNG pipeline development. In the discussion groups afterwards many students were talking through the options that were available to best advance the standing of First Nations people in Canada, and a consensus was reached which echoed the thoughts of Ravina Bains, the Associate Director of the Centre for Aboriginal Policy Studies at the Fraser Institute – the promotion of property rights for First Nations peoples. This seminar was a great experience, and I was buoyed by the intelligence, interest and insight of the university students who attended.
Until next week…