The Rants of Issachar

Thursday, February 04, 2010

Public health care and Danny Williams

It seems that Danny Williams, the Premier of Newfoundland went to the US for cardiac surgery. The Premier's office says that the procedure was not available in Newfoundland, but that's about all they're saying. They're pointedly not saying that the procedure wasn't available in Canada. This glaring ommission makes it rather obvious that the procedure was in fact available in Canada, but for his own reasons Mr. Williams chose to go to the United States rather than another province under Medicare.


I should begin by saying that I don't begrudge Mr. Williams' decision to forgo the Canadian option. Canadian health care is excellent, but if you've got the money for ultra-premium care it's possible to buy better or faster care in the US. That's the difference between the US and Canadian systems. The difference isn't in quality, it's the focus. Canada delivers excellent and universal coverage whereas the US delivers excellence and choice. Mr. Williams is apparently quite wealthy and if he chooses to spend his money on private health care that's up to him. I might well do the same, and I think that everyone should be allowed to choose to spend their own money on their care if they wish to. Some might choose it for convenience, some because while it might not be strictly necessary in their case, faster care would give them a peace of mind is worth more to them than a luxury car. The reasons aren't relevant.

The problem is that we can't do this. Not in Canada. In Canada it's illegal to provide any private health care for something the public system covers. So it's illegal to buy or sell "premium" health insurance and I think that's indefensible. Universal public health care is necessary due to our moral obligation to care for our fellow man, but it's no secret that if you've got millions of dollars to spend, superior care does exist. The catch is that we can't spend millions of dollars on every citizen. (Nor can an insurance company for that matter.) But making private care illegal does nothing to improve universal health care. It only denies premium health care to those who could afford it, and it does so on the indefensible premise that unless everyone can have something, everyone must be denied it.


So back to Mr. Williams. While his choices are his own, he's a provincial premier and an outspoken defender of Canada's single payer system. That's the same single-payer system that denies Canadians the legal right to buy extra insurance or care if they feel it's necessary. Mr. Williams' surgery clearly demonstrates this ban doesn't stop more fortunate Canadians from buying premium care. It only drives up the cost and unnecessarily denies it to some who could otherwise afford it.


This presents Mr. Williams with an opportunity. When he's recovered from his surgery he can tell Canadians that while he could have received excellent care in Canada, he's fortunate enough to be able to afford the private option and he choose it for his own reasons. So he's going to continue to support universal publicly funded health care as it changes to stay viable, but he will end the disgraceful ban on a parallel private system in his province and use his considerable influence to encourage other Premiers to do the same.


Excellent universal health care coverage is a moral obligation on any modern country. (As an aside, I think it's disgraceful that a country as great as the United States lacks it.) Unfortunately, Canadians fear that a parallel private health care would mean the end of universal coverage. Such a fear is small minded. The dual systems of modern democracies all over the world show this isn't true. We must stop letting the flaws in American health care stop us from improving our own.


:: posted by Issachar, 12:01 AM

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