Medicare is safe after all

Looks like I wrote too soon about the demise of the Canada Health Act in Vancouver.

The new False Creek Urgent Care Centre will apparently operate just like any other free public clinic in Canada. No word yet on whether their first patient from Friday will be getting a refund.

I’ve heard from both sides by now on this issue and I think one’s view ultimately comes down to: if you got hurt in an accident, would you be willing to pay a few hundred dollars to get faster service? Would you be willing to pay a few thousand to ensure you didn’t have to wait months for an operation (during which your health could deteriorate to the point where a more invasive operation was needed?)

Obviously, I don’t support a private system that cannibalizes resources from the public system. But if private interests are willing to put more clinics, doctors and health technicians to work that otherwise would have more limited venues and operating hours for their needed skills, I don’t see a problem with that.

Basically, I don’t see why Canadians should have to wait longer, or indefinitely, for services that you can actually get in other countries.

2 Comments so far

  1. Matt (unregistered) on December 3rd, 2006 @ 2:41 pm

    “I don’t support a private system that cannibalizes resources from the public system.”

    Neither do most people. The problem is that when you have a divided system, it’s very difficult to confirm that resources given only to one wouldn’t have gone further if invested in the combined plan.

    Not to mention, there’s the bigger problem (which I experienced growing up in the states) of the “eating your own dog food” effect: if the people in power are subject to the same health care system as everyone else, they’re inherently incented to continue to refine, evolve, and improve it — otherwise they’re suffering from lacklustre care themselves. But as soon as the upper socioeconomic levels have a back door, the only way the mass populus system is improved is if someone rememebrs to care about them.

    People’s hearts may be in the best of places, but they still instinctively take care of their own needs first.

    Is the BC public health care system perfect? No. But if we jump ship, what are we leaving as a legacy for the 90% of the population who can’t afford to go to paid care on a regular basis?

    One last point: surgery and premium care wait times are often held as the greatest deficiency of the BC system, and a reason to look at other alternatives. The wait times for 99% of the people in the US private system are little better (I can’t say much for others), so looking at privatization as a solution for wait times:
    1) offers reduced wait times only for the people who can afford to bid on it
    2) is a bit like buying a new car in response to congested freeways — it’s an answer to the wrong question. Wait times are caused by capacity problems, and capacity problems are improved by increased supply of resources overall, not increased diversity of existing resources.


  2. Jonathon Narvey (unregistered) on December 3rd, 2006 @ 4:38 pm

    “Wait times are caused by capacity problems, and capacity problems are improved by increased supply of resources overall, not increased diversity of existing resources.”

    I agree with you somewhat, but capacity can also be increased by increasing efficiency within the system. Ask doctors or nurses in the public system what the things they use cost – blood tests, X-rays, doing an MRI scan – or the price of the equipment they’re using, from syringes to X-rays – and there’s a good chance they don’t know.

    In a private system, the cost of alternative treatments is a primary consideration, whereas in a public system, the people who are allocating resources have no idea what things cost. Because they lack that data, they are in a poor position to increase efficiencies.

    Introducing a bit of privatization to the mix could increase efficiency for both systems as they share data on costs – thus improving the health system’s capacity without pumping any more money into the system.



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