Nation can afford quality health care
CANADA VOTES
The debate over the future of universal medicare took an extraordinary turn this weekend when New Democratic Party leader Jack Layton said he could not stop the growth of two- tier medicine and would not shut down private clinics. Was the leader of the party that brought universal health care to Canada in the 1960s giving up the fight to preserve medicare? Or was he suggesting efforts to ban two- tier medicine are counterproductive in that they do nothing to strengthen the public system? More important, Layton’s seeming shift raised a key question: Which party is the true defender of medicare? In an odd way, Layton’s remarks might actually help to focus the debate over health care along more productive lines. That’s because all the talk about two- tier health care and privatization over the past several years has been spawned, not by a bold new vision that health care can be delivered in a better way, but by a general concern over the evident cracks that have opened up in Canada’s publicly funded health- care system. As a result, too much time and effort have been spent exploring these alternatives instead of looking at how to repair the cracks in a system that served Canadians so well for so many years.
It wasn’t that long ago that Canadians were expressing both confidence and pride in the medicare system. In all of 1985, for example, there were only two stories in the about privatization of health care. The number of such stories rose dramatically in the mid- 1990s, a simple reaction to the decline in the quality of health care that followed the spending restraints employed by Ottawa and the provinces to reduce their deficits.
Clearly, there was virtually no demand for private clinics or private hospitals as long as Canadians felt their publicly run system was giving them timely, high- quality care. Private clinics did not spring up across the country, not because of legal bans on them but because few, if any, Canadians were prepared to pay out of their own pockets for services they could get for “ free” from a system in which they had full confidence. Can that confidence be restored?
Just as the deterioration in medicare, and the public confidence in it, can be traced directly to funding cuts in the 1990s, it would seem that timely, quality care now is largely a matter of adequate government funding. With Ottawa recording one hefty surplus after another, Canada can afford the kind of health care that people say they want. The question is whether Martin and his main challenger, Conservative leader Stephen Harper, are prepared to invest the money necessary to patch all the cracks. Harper has promised a “ patient wait times guarantee” to ensure patients get treatment in a timely fashion. He suggested such treatment could be provided by private clinics if not available in the public system. The $ 41 billion in new money that Martin committed to a health- care fix just 14 months ago will go a long way toward easing the bottlenecks in the system that show up in wait times for treatment that are just too long. There is nothing magical about that figure. More money may still be needed in the coming years to bring our health- care system up to the standard high enough to restore public confidence. In light of that uncertainty, it makes no sense for Martin and Harper to commit so much of Ottawa’s expected surpluses over the next five years to tax cuts before the future of our publicly funded, universal health- care system is assured. During the remaining weeks of this campaign, voters should demand that all party leaders outline how they intend to use a reasonable portion of future surpluses to finance the public health- care system. And if the leaders refuse to spell out their plans, voters should ask why they won’t.
If medicare were properly funded and efficiently run, there would be little need to debate two- tier medicine delivered by private clinics because they wouldn’t be able to attract enough patients to survive very long.