Time for an adult conversation about health-care reform

Pundits on all sides of the debate about health-care reform in Ontario tend to speak in absolutes. The system is broken and we will fix it, says Doug Ford. The government plans to privatize large chunks of the system and that’s absolutely wrong says NDP Leader Andrea Horwath. Health-care unions warn of absolute disaster. Health Minister Christine Elliott is on the record promising, absolutely, that no “Ontarians will fall through the cracks” of the reformed system.

Why this absolutism, this refusal to acknowledge shades of grey? It’s because the discussion and debate has become so politicized, there’s no room for anything other than black or white.

But the truth is, as anyone with even a basic knowledge of the system knows very well, speaking in absolutes risks simplistic solutions to complex problems.

The reality is more like this: The system isn’t broken. It works remarkably well for thousands of Ontarians every day. But, from a financial and infrastructure perspective, it is not sustainable. Health care is only beginning to feel the weight of an aging population, and already cracks and fissures are causing problems for too many health-care consumers as well as the people who work in the system.

We would agree with Horwath and other critics who worry about the extent to which the Ford government’s free market leanings will drive reform down a road toward two-tier health care. We’re already seeing signs of centralization — the province’s planned “super agency” to oversee most aspects of the system, including primary and hospital care, is just one example.

But let’s keep this in mind, too. The previous Liberal government had 15 years to make measurable progress in major health-care challenges — hospital overcrowding, inadequate community-based care and insufficient long-term care infrastructure are examples — and while it had some success, we’re far from there yet.

We need to see what the current government’s solutions look like, and we should not get bogged down in partisan hyperbole. Let’s take privatization, for example.

The NDP and others insist more privatization will be the end of universal health care. But the reality is significant aspects of the system are already private and, in some cases, are working as well or better than the public aspects of the system. Have you used a lab for blood or other testing? Chances are it was private. Your dental work? Physiotherapy? Some ultrasound testing?

The truth is that complete public universality hasn’t been the reality for many years now. That doesn’t mean we should endorse radical privatization holus bolus. But nor does it mean the private sector cannot be an important, perhaps the most important, partner in reform.

Consider the example of a fully-integrated, secure, real-time online system for medical record portability. The Liberals largely failed at this. Is it so hard to envision private sector innovation and agility being key ingredients to finally getting a system we should have had years ago?

Here’s an absolute: Reforming health care breeds anxiety. It’s that important. The opposition and media, but especially citizens, have a crucial rule to play as the government rolls out its plans.

One thing we know for sure about the Ford government is that while it doesn’t always listen, it sometimes does — think about successive attempts to open the Greenbelt for development stymied by solid public opposition.

We have to remain alert, to listen, set aside preconceived and partisan notions. What other choice is there?