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Ever so many years ago when the world and I were
young in rural Saskatchewan some people were able to afford to go to the doctor
and get whatever treatment they needed. Others took chickens and pigs
with them because they had no money. Then along came Tommy Douglas and
universal single tier public health care.
Now the Supreme Court of Canada has rendered a
decision that opens the way for a two tier system, a private one for those who
can afford to pay, and a public one for those who can't. Many people,
including doctors and private insurers who are bound to benefit from the private
tier are jubilant. You can already hear them laughing on their way to the
bank. Many people will be able to get off the long public waiting lines
for various tests and surgeries and go directly to their private clinic and have
their needs met.
But for ever so many others, the large majority,
the lines will lengthen. The reason the lines are so long now is because
there isn't enough capacity in the system. They will lengthen for those
who cannot afford to be in the private tier because many doctors and part
of the diagnostic capacity will have moved over to where the money is.
I suspect that it's diagnostic capacity and
specialized surgery that's the real problem. I can get an appointment to
see my doctor anytime, but if we then decide that I need MRI or a CTScan, we may
have to wait a couple of months. Waiting times for specialized surgery is
much longer. A friend of mine recently had her knees replaced.
Because she runs a stable, she uses her legs most of the day everyday.
Even so, she had to wait for more than a year.
For years now, everybody has been after the
federal government to fix up the public system. We've had a Royal
Commission and a major report from the Senate of Canada. Not much has
happened. The provinces have asked the federal government for more money
and the federal government has been unable to provide it. I suspect costs
are the big issue. Training good doctors is expensive, training
specialized doctors is even more expensive, but providing the kind of
diagnostic equipment that has now come into standard use is hugely
expensive. Paul Krugman, an American economist, recently noted that a
considerable proportion of the large cost increases encountered in Medicare over
the past couple of decades was due to the costs of the technology now in
standard use in the US. Canada uses the same technology.
So, where will we be in a few years? For
some, the lines will greatly shorten. For most, they will become very much
longer, so long that their pain and suffering will make a good case for assisted
suicide, perhaps with government picking up some of the costs.
Ed
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