It’s time to talk about private health care

During the second presidential debate, Canada got name-checked for the first time. Donald Trump decried our healthcare system, as only he could so elegantly put it, as “so flawed” and downright “catastrophic.”

Not surprisingly, the comments gave rise to the usual hue and cry that appears any time our health-care system is criticized as anything less than first-in-class. Canada’s health-care system has become its political third rail — an issue so potent and explosive that it can be fatal to a political career to be perceived as even pondering the concept of making adjustments to it.

That our health-care system is untouchable is the received wisdom of politicians of every stripe. Candidates have long avoided anything other than bland praise or minor tinkering around the edges.

But on rare occasions, politicians acknowledge, with caveats of course, what Canadians know — that our system is not first-in-class. Last week saw one of those rare moments. Federal Health Minister Jane Philpott acknowledged that: “We know our health-care system is not doing as well as it could . . . We’re paying some of the highest costs in the world for health-care and we’ve got a middle-of-the-road health-care system.”

Provincial health ministers reacted predictably, insisting the system was perfect. But Philpott not only got it right, her comments ring true to many patients and their families who have experienced the system first-hand.

But while she discussed innovation and the need to challenge delivery methods, the minister tiptoed around the role of private delivery, promising only to uphold the universality of Canada’s healthcare system.

It has been more than a decade since any component of our system was challenged or questioned in any meaningful way. And yet all indications are that Canadians are clamouring for that very conversation.

Polls have consistently shown Canadians are ready to have a tough discussion about whether Canada’s current healthcare delivery model still makes sense.

Public opinion research has shown Canadians have reservations about the way the system performs, its sustainability and, most importantly, its ability to meet their needs.

What’s more, they have indicated an openness to exploring many kinds of change, including different methods of delivery.

Global rankings, such as the World Health Organization’s ranking of healthcare systems, have had an effect on the way Canadians perceive their system. Once the envy of the world, our system ranks a middling 30th in WHO’s estimation. Other rankings have reached similarly uninspiring conclusions about the competitiveness of our system compared to countries like France or Germany.

Those findings, widely covered in the media, reflect Canadians’ experiences with the health-care system, and this is largely why latent concern about the system has grown more tangible in the last several years.

Baby boomers don’t believe the system is sustainable. In a poll by the Canadian Medical Association, more than four-infive seniors fret about the quality of health care they will receive in the future.

My firm has conducted a significant amount of research on this issue. It underlined what other research firms had found: the political discourse surrounding the health-care system simply does not reflect what Canadians across the country think about it.

Philpott and her provincial counterparts met in Toronto last week to discuss the state of health care in Canada. Rather than discussing transforming delivery options or other sweeping changes, provincial ministers called for more federal dollars to be fed into the same inflexible system framework.

This lack of innovation is simply not what Canadians are looking for.

Our research has found Canadians are not afraid of talking about having a private component in our health-care system. Instead, they feel such a move is inevitable and makes sense, so long as the universality and equality of access remained in place.

More importantly for the country’s health ministers, Canadians do not care about the constitutional division of responsibility, or about the ins-and-outs of marginal change.

They simply want to see change occur so that, for once, the system delivers on their terms — a straightforward concept that seems to elude policy-makers the country over.

How often have we seen the sacred cows of political discourse remain that way until they arrive at the slaughterhouse door?

Canadians have begun to make it crystal clear to our politicians they are ready — in fact, beginning to demand — real change to our health-care system.

The rewards will go to the astute leader who takes up this challenge.

Jaime Watt is executive chairman of Navigator Ltd. and a Conservative strategist.