Opinion
Trudeau’s Unreasonable Approach to Private Healthcare.
On Friday, March 10th, Canada’s Health Minister, Jean-Yves Duclos, signaled the Trudeau government’s latest intention of clamping down on for-profit healthcare in Canada. This signal came in the form of a threat: if a province allows for for-profit care, that province will experience a reduction in the amount of healthcare funding that it receives from the federal government. Additionally, Duclos indicated his intentions of putting restrictions on virtual care, and ending the practice of patients traveling to other provinces to pay for surgeries. In a time of a health-care disaster, this approach is ridiculous.
First, let's clarify the healthcare context Canada currently finds itself in. Such a context is one of overstressed and overcrowded emergency rooms, burnt-out healthcare staff, 20% of Canadians being without a family doctor, and excessively long wait times-median wait of 27.4 weeks between referral to a specialist by a general practitioner and receipt of treatment. In addition, provincial healthcare budgets are experiencing considerable stress. This state of disaster is reflected in the fact that Canada’s healthcare system ranks as one of the costliest and worst performing out of all the developed democracies. Contrary to how some explain these problems, they are not simply attributable to the COVID-19 pandemic; the pandemic merely exacerbated and exposed pre-existing issues. For example, in 2019 half of all wait times exceeded 20.9 weeks.
In response to this troubling situation, some provinces have turned to for-profit services in hopes of saving money and relieving some of the pressure from the public system. The most prominent example has been the Ontario government’s plan to expand private healthcare by funding clinics to perform more cataract surgeries, MRI and CT scans, colonoscopies, hip and knee replacements and other procedures.
This is a perfectly reasonable response on the part of provinces. Introducing for-profit elements of care allows those who can and want to pay for care to avoid terrible wait times, while at the same time freeing up the public system to better serve those who cannot pay for private care.
This is a particularly reasonable response considering that a mix of private and public healthcare is the norm; Canada is essentially the only developed democracy that offers universal healthcare but does not allow for the option of private care. Most of these countries pay less for healthcare than Canada and all of them have better performing healthcare systems than Canada. This demonstrates that not only does allowing for private care not necessarily lead to American-style healthcare, but that it is completely consistent with a better system.
Moreover, restricting private care in the face of extreme wait times is likely unconstitutional. In 2005 the Supreme Court ruled (Chaoulli ruling) that a Quebec law preventing people from paying to avoid burdensome wait times was a violation of Quebecers’ right to life, liberty, and personal security and thus unconstitutional. As Chief Justice Beverley McLachlin said at the time “access to a waiting list is not access to health care.” The court also noted evidence indicating that “private contributions and insurance improve the breadth and quality of health care for all citizens.” Since, however, one of the four majority-ruling judges ruled that prohibitions against private care violated Quebec’s charter instead of Canada’s, the case has only applied in Quebec. Nevertheless, many legal authorities believe that the ruling should apply to provinces with restrictions similar to those that existed in Quebec.
In fact, the Supreme Court may rule in this way soon. A case is currently heading to the Supreme Court in which British Columbia laws prohibiting private care are being accused of violating Canadians’ section seven charter rights. Seeing as the court has already deemed similar laws unconstitutional in the past, it is very much possible that they will rule similarly in this case, and thus align with the Chaoulli ruling. Even the B.C court of appeal-the court which ruled in favor of bans on private care-said that prohibiting private care violates Canadians’ right to “life, liberty, and personal security”, and causes “real hardship and suffering to many for whom the public system is failing to provide timely necessary care.”
Moreover, most Canadians are okay with more for-profit elements being introduced into the healthcare system. Polls indicate that a majority of Canadians are open to private delivery of publicly-funded health services, and private healthcare for those who can afford it-especially when wait times are excessive.
However, universal single-payer healthcare is part of Canada’s national ethos; all Canadians grow up learning that one of the-if not the- greatest things about Canada is its healthcare system. Seeing as, out of all developed democracies, Canada’s healthcare is only clearly better than the United-States’, healthcare is clearly only important for Canadian identity because it differentiates us from the United-States. This explains some Canadians' strong aversion to any amount of for-cost care. It is thought that any adoption of private healthcare would bring Canada down a slippery slope that ends with American-style healthcare. However, as the example of other developed democracies prove, this myth is unfounded.
Unfortunately, attachment to this myth seems to be the best explanation for the Trudeau government’s recent stance. Why else would they so adamantly refuse to even consider private care as a solution to Canada’s healthcare fiasco? For instance, in minister Duclos’ statements announcing the government’s hardline towards private care, he gives absolutely zero reasons as to why it would not help deal with our current healthcare disaster, but nevertheless says that it “is not acceptable and will not be tolerated.”
Thus, the Trudeau government's approach to private healthcare is unreasonable. No one would dispute the point that Canada’s healthcare system is deeply flawed-and has been even since before the pandemic. And instead of open-mindedly considering whether private elements would solve some of these problems, the government is blindly clinging to universal single-payer healthcare simply because it is part of Canada’s ethos-even though all developed democracies with better healthcare systems have for-profit care. They are so irrationally attached to this ethos that they are willing to withhold healthcare funds unless provinces pass laws that have been deemed unconstitutional by the Supreme Court. Finally, their approach to private care does not even align with the view of most Canadians.