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Jay Currie

One Damn Thing After Another

6/17/2004

Healthcare

The marvelous thing about the healthcare debate is it is not about health; it's about whether high cost public providers will be allowed to keep a monopoly on the provision of everything from surgery to clean sheets and which level of government will make that decision.

Andrew Coyne points to a Liberal Press release which quotes the scary Mr. Harper,
“I know this is a dangerous subject. My advisors say don't talk about it, but the fact is sometimes provinces have allowed in the past few years, they've brought in private services covered by public health insurance. Ordinary people can get them. Why do I care and why do we care as a federal government how they're managed? What we care about is whether people can access them. This is just an ideological agenda.”
liberal party of canada
So, private services covered by public insurance. Tommy Douglas is spinning in his grave - or is he? In fact the Canadian Healthcare system which Douglas began is a classic Canadian compromise. Unlike the British system in which doctors were effectively nationalized (leading to a significant wave of medical immigration from England) Canada has always had the primary caregivers, doctors, allowed to operate as private businesses. The actual principle at stake is a single payer model not the provision of services by private individuals and companies.

Moreover, the single payer model has never actually been true. The Workman's Compensation Boards, Aboriginals, and Canadians willing to go to the US have always been outside the single payer system.

So what is actually at stake comes down to whether or not individuals and companies are to be allowed to offer services which are publically paid for in competition with the public providers.

What this brings sharpely into focus is whether the public service unions which control the hospitals are to be allowed to keep their monopoly. Alberta and British Columbia are moving away from that model and are instead seeking lower cost providers. Which will likely result in more money reaching the end users of the system aka patients.

The Liberals and NDP do not want this to happen. Instead they want to put more money into the same, broken, system. The Conservatives are at least willing to look at fixing the system itself.