As I mentioned in Part I, health care proponents for either public or private delivery should first be focusing on what the product is to be delivered. This is the critical missing element and fundamental flaw in the current debate.
There first needs to be a consensus on what is to be delivered.
Currently I estimate that Canada in total spends 40% of every tax dollar on health care. The sum has grown and will continue to grow annually much faster than the cost of living rate. We have been able to get away with that since we do not spend a similar per capita cost on our military as does the United States. But even in Canada we are coming to the breaking point.
How the USA can expect to adopt a system similar to ours with its huge and growing health care costs, in addition to its mammoth military expense, is beyond me. Indeed, from my perspective, with its trillions of dollars in bailout payments, I think our neighbour to the south is teetering on bankruptcy right now. (Something for another Blog)
Here is what I believe needs to be done:
- Develop a list of core services - starting from basics;
- This list needs to focus solely on protecting the citizen from illnesses that have potential to threaten one's life and to protect against economic catastrophe - illnesses such as cancer, heart, alzheimer's, etc., etc;
- Health care in relation to the items on this list would be available to all citizens - i.e. universal coverage, and would be paid for by the government directly to the service provider;
- Everything else would be left to the individual to decide whether to pay for his / her own private coverage - for things such as cosmetic surgery, birth control (abortions), knee / hip replacements, broken bones, day surgery and the like;
- Co-payment for visits to a Doctor (e.g. if a visit cost $50, patient would pay 20% or $10 and the taxpayer would pay the remaining $40).
Many will see this approach as being draconian but the fact is we as a society can no longer afford to pay the cost of entire universal care. In fact, we haven't been, since we have 2-tier health care now in many respects plus more and more items are being dropped from the list of insured care by the financially challenged provincial governments.
And, it will only get worse as our societies continue to age.
Simply stated, there is no other choice.
So we end up now with 2 glasses:
- Glass number one contains water representing the core services paid for by government and from which everyone drinks. Users give it a 10;
- Glass number two contains water representing the extra services paid for by the user him or herself which they too allocate a 10.
Once this is determined, society can get on with deciding how the above services are to be delivered. As you might guess, I believe fervently that they should be delivered by the private sector with government oversight. My main reason for saying this is due to the fact that dispensing Health Care is no different from dispensing Dish Detergent or motor vehicles - only through true competition can the consumer expect to receive a quality product at a reasonable price. Just ask General Motors.
More on the delivery aspect of Health Care later...
"Galagher"
