Opening the Private Health Care Floodgate
commentary by Gabriel Yiu Global, Chinese Press column 17.8.2007

Those who advocate bringing in private health care often said, they don’t mind people paying to jump the queue because if such people get their treatment from private health care, the public health care waitlist would be reduced, thus benefiting citizens who can’t afford private medicine.

Let’s first put aside the issue of value and fairness. What I want to ask is, do they really not mind this? How about when they realize that it’s not just a handful of the wealthy who jump the queue but tens of thousands or even millions of people jumping the queue? Do they still support it?

What we’re talking here is not the wealthy who could afford private medicine. There’re also a great many residents who have the benefit of extended private medical insurance coverage. Civil servants, people who work for medium and large businesses, and union workers have extended medical coverage. So when the private gate is opened, they could all jump the queue. What’re left are low-income workers, the self-employed, unemployed and retired seniors. Many immigrant families belong to this category. Our citizens will be divided into two classes.

The private health industry will expand significantly. American companies will march in to grab their share of the new market. Our health care system will have added to it a massive new structure. Like what we’ve seen in the US, this new structure will suck in enormous financial resources for its administration, management, marketing, litigation, government lobbying and of course, profit. For its self-interest, the new private medical industry will aggressively lobby and influence the government’s health policy in order to create a very favorable environment for their business, for example, leaving the most expensive treatment to the pubic system, or using public medical facilities to conduct private surgery and treatment.

In the US, whether a patient can obtain treatment or surgery is not a decision made by a doctor or the patient; it’s determined by the insurance company.

Private health care would create immense pressure on the public system. First, it would absorb a great many medical workers, worsening the human resources shortage. Private companies would pay much more to attract medical workers to entice them to leave the public system. With public and private health care competing on top of the already tight workers’ shortage situation, the remuneration for health care workers would climb significantly. When there is only one public system, the government can control the remuneration of medical workers according to its priority and affordability, but in the public-private system (‘partnership,’as the government would say), the government would lose this capacity. When the expenditure on health care workers increases drastically, the government would have to either increase health care funding significantly or cut service. The latter would likely be the consequence. So when the public health sector experiences a brain drain, service cut, low morale and the chaos of yet another round of restructuring, it’s inevitable that quality would suffer.

Canada’s public health care is the foundation of equality and fairness. It’s also our basic right as well as the competitive edge for our business.

Thanks to our public health care system, our labour cost is much lower than that in the US. The average health care cost of a General Motors automobile produced in US is US$1600, whereas it is only a few hundred dollars in Canada. The US auto-worker labour cost is $4-5 per hour higher than that of Canadian workers.

The TIME magazine printed a special feature earlier, stating that the heavy burden of health care cost is dragging down the US auto industry. GM is the biggest purchaser of medical insurance. Currently, each of the company’s workers has to support three retired workers. The business value of GM is US$18 billion, but the company’s fund set aside to pay for employee pensions (including medical) is worth more than US$100 billion!

It is certain that private health care would increase BC’s business cost significantly.

Half a century ago, universal health care used to be a Canadian’s dream (it’s still the dream of the people in the US and China). When Tommy Douglas implemented universal health care in Saskatchewan, North American doctors fought against it fiercely. It was only after over a month of painful province-wide doctors’ strike that the public health care system became a reality in Saskatchewan, and the successful experience was later introduced across the country. And now, the Canadian Medical Association calls for the private health care to be brought back. From the doctors’ point of view, it certainly can boost their income. But for the general public, what’s the benefit?

In the US, 40% of individual bankruptcies were due to medical cost. In the world’s wealthiest country, 14% of the GDP is spent on health care but there’re 47 million Americans without medical coverage (Canada only 9% of its GDP). Do we really want to open the floodgate to bring in American-style medical service?