seeking surgical or therapeutic treatment will wait a median of 19 weeks
between an appointment with their physician and when they receive treatment.
According to physicians, this is nearly three weeks longer that what they
consider clinically reasonable. What’s worse is that wait times have increased
despite the billions of dollars in federal health transfers Ottawa has sent to
the provinces to tackle wait times. Under these circumstances, where nobody is
accountable, what options do Canadians have? They can get in line.
It should be
clear to most that the ‘Canadian way’ is not working. While this requires a
slice of humble pie for advocates of Canada’s single-payer health insurance
system – patients and taxpayers more generally would be much better off without
Canada’s health care hubris.
The first step
is recognizing that greater private involvement in the delivery and financing
of medical services does not mean an erosion of universal access to health
care. It also does not mean that the well-off will have access to high quality
health care at the expense of low-income families. But such fraudulent claims
pop up time and again whenever private involvement—which is how every Canadian
gets their food—is proposed in the health care sector.
Or there is this
other diversion—that any private involvement in health care will lead to
American-style health care. It can’t be repeated enough that every Canadian
should take a pledge to end American comparisons and instead focus on Europe.
There, in countries where universal health care is achieved, competition in the
private sector has led to increased quality and efficiencies, lower prices, and
virtually no wait times.
take the Netherlands, where 99 per cent of the population is insured and which
no reasonable Canadian thinks is a hotbed of supposedly radical anti-universal
sentiment. In contrast to Canada where almost the entire health care sector is
centrally planned by provincial and federal governments, the role of the Dutch
government is to ensure a properly functioning health care market.
Everyone in the
Netherlands must purchase a basic health insurance plan in the private market.
Those who cannot afford to purchase the basic package receive subsidies from
the state. That subsidy is then used to buy an insurance plan of their choice.
Children under the age of 18 are covered by the tax-financed Health Insurance
must be insured in the private sector and because individuals and families can
switch insurers without a financial penalty, private insurers are forced to
compete on price. At the same time, insurers negotiate prices with health care
providers for preferred services. Consequently, providers compete on both
prices and quality. That not only benefits patients but creates a system of
Compare that to
status quo Canada. Here, there are no incentives to ensure patients receive the
best medical care possible because there is no direct penalty to providers if
patients are unsatisfied. Canadians cannot switch insurers. Instead, they are
obligated to sit and wait for medical treatments for weeks or months without
the ability to shop around.
But not the
Dutch. Wait times for medical treatments in the Dutch system are nowhere near
the delays endured by Canadians.
One of the most
frequent Canadian criticisms of private health insurance is the notion that
sick people will not be insurable. However, in the Dutch system, insurers must
accept all applicants regardless of age or pre-existing medical conditions.
premiums are community-rated (as opposed to being risk-adjusted). That means
that the price of the basic insurance package is the same for everyone. To
compensate insurers, all working Dutch citizens contribute to a Health
Insurance Fund through their payroll deductions. Those deductions are then
pooled among health insurers based on a risk-adjustment system.
In other words,
the entire population has the exact same access to health insurance
irrespective of age, medical status, or ability to pay.
addition to achieving universality, choice has become one of the fundamental
characteristics of the Dutch system. By comparison, the notion of choice or
freedom is nowhere to be found in Canada’s health care context and is routinely
opposed by advocates of single-payer health insurance. Strangely, monopolies
are frowned upon everywhere else in Canadian society – but not when it comes to
current system, Canadian families cannot access insurance that best suits their
We can learn a
lot from countries like the Netherlands but we can’t afford to wait much