We’ve said it here before: Albertans have no problems accepting private health care and for-profit surgical clinics — as long as they meet a few conditions. If private clinics accept all patients on an equal basis, and if they only charge what the publicly-funded system will cover, there should be no reason to deny clinics that do eye surgeries, joint replacements or other procedures.
In fact, it would be very interesting to see if private enterprise can indeed remedy the inefficiencies people talk about in public care. Meanwhile, space and time should be freed up in the public system for cases private clinics are not prepared to handle.
Where there is a problem — made evident in the Wildrose Party’s election plank on health care — is that those conditions will not be met.
These more-efficient privately-run clinics will indeed be allowed to pick and choose clients, and those clients will be people able (or desperate enough) to pay above what they have already purchased through their taxes in the public system.
The issue of wait lists is a red herring. Suppose the Wildrose plan worked 100 per cent, and treated every patient whose wait had exceeded provincial time standards. What then? Would these clinics close?
Of course not — there’s too much of an investment at stake, and it would be unfair to ask people who put up millions of dollars to just stand down and wait for excessive wait times to return.
So the standard regarding wait times will need to be altered to allow a continuous flow of patients. The province might also negotiate with other provinces, to allow patients here from out of province — at a profit.
Or, as seems likely, the law will be changed to make full two-tier health care legal in Alberta, and just remove the facade of relieving wait lists for surgeries in the public system.
The burgeoning cost of health care as a percentage of the provincial budget is well known.
What is less public is that Alberta spends the least of all the provinces on health care — as a percentage of GDP. Albertans are very efficient producers of goods and services, but we get no reward for that in the health care budget.
Is it true that people who work hard and earn enough to pay extra for their surgeries at private clinics should be allowed to do so? If you think that is true for individuals, why make it false for society as a whole?
We all work hard, we all produce our high GDP; there is plenty of financial gap between Alberta and the national average on health spending for us to have more public hospital beds and to do more surgeries.
But there is another hurdle to clear. As soon as there is choice in access, there must be choice in practice. If private clinics with extra-billing is allowed under the Wildrose plan, which option will attract the doctors? Maybe that is the plan. As fewer doctors choose to operate in the public system, there will always be excessive wait times to supply the private clinics with patients that can be billed above what the province will cover.
On the heels of that, comes private health insurance, and all the familiar problems Canadians see with that in the U.S. system. Denials of claims, taking premiums with no intention of paying claims (can you say “pre-existing conditions?”) — we’ve seen all that. Alberta business owners may also need to add private health care insurance premiums to their pay packets to keep staff. Eventually, that will pressure down your take-home pay.
Health care in Alberta is already largely free-enterprise. Albertans will accept — and even invest — in private clinics. But not at the expense of the system as a whole.
Greg Neiman is an Advocate editor.