The Great Americanization Distraction
In the debate over health care reform in Canada, defenders of the status quo often resort to the tired old claim that a greater role for competition, private financing, or private provision of health care services in Canada would mean the Americanization of health care.
Indeed, the claim is often made that proponents of private financing and delivery of health care in Canada are recommending the U.S. approach to health care policy.
Its well time we put this misleading and false argument to rest.
First, no one arguing for a greater role for private financing and delivery of health care in Canada, that I am aware of, is recommending the adoption of the U.S. health care system. We all agree that Canadians should have a high quality universal access health care system.
The question Canadians must ask is how can we best organize health care policy in Canada to better deliver on the promise of high quality care provided in a timely fashion regardless of ability to pay at reasonable cost to the taxpayer? The question is an important one: The facts show clearly that Canadas governments break that promise on a daily basis despite asking Canadians to pay for the developed worlds second most expensive universal access health care system.
Notably, in spite of those relatively high expenditures, Canadians receive relatively poor access to physicians and medical technologies, are cared for using far too many old and outdated pieces of medical equipment, and endure some of the longest waiting lists for health care in the developed world.
In answering the question posed above, it is helpful to look at the developed worlds top performing universal access health insurance programs.
Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland all deliver health care services without queues for treatment regardless of ability to pay.
Australia, Japan, Sweden, Switzerland, and France all manage to outperform Canada in outcomes closely related to the performance of the health care system.
Notice that Japan, France, and Switzerland manage to be on both lists of top performers.
Critically, every one of these nine nations employs competition in the delivery and financing of health care and requires patients to share in the cost of the care consumed to the benefit of both patients and payers.
More specifically, each of these nations employs private providers in the delivery of publicly funded health care services; employs a private parallel health care sector that individuals can access when they desire to do so; and requires cost sharing or user fees for universally accessible health care services.
And none of these nations spends more on health care than Canada.
The claim that employing private financing and provision of health care in Canada would lead to the Americanization of health care is obviously not based in fact. The truth is that employing these policies would improve the state of health care in this country and make Canadas universal health care system much more like those in Sweden, Switzerland, or Japan.
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