A7

CHARLES MOORE
AT LARGE

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I'm delighted that the incoming president of the Canadian Medical Association is carrying on his predecessor's sensible advocacy of a mixed public and private health-care system for Canada.

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In his inaugural address on Aug.t 20, Dr. Robert Ouellet told the CMA convention at Montreal that "The fact is that the private system exists, and like it or not, it is here to stay. We need to accommodate it in order for the public system to prosper."

Dr. Ouellet, a Longueuil, Que. native who himself operates private radiology clinics in Quebec, told CTV's Question Period that Canada's health care system is not sustainable, will need the help of the private sector to get back on track, and that Canadians must stop being "dogmatic about public and private" and acknowledge that private health care exists almost everywhere in the world.

That's similar line to the line taken by outgoing CMA president, Vancouver orthopedic surgeon Dr. Brian Day, who some public health care absolutists liked to characterize as the "Darth Vader" of privatization. Dr. Ouellet observed that by electing Day and himself in succession as CMA presidents, a majority of Canada's 67,000 Canadian physicians have registered their support for a more public-private mix of health care delivery.

And they're right. In a supposedly free society, citizens should not be coerced clients of a monopoly. Heck, even socialist Sweden and public health pioneer Great Britain have mixed public/private health care delivery. No other Western developed country places the extreme constraints on private health care delivery Canada does, in dubious company with totalitarian states like North Korea and Cuba, doggedly insisting that all funding for insured services must come from government.

In July, 2007, the CMA under the presidency of Dr. Day's predecessor, P.E.I. cardiologist Dr. Colin McMillan, issued a policy document recommending that provincial governments hire private-sector firms to deliver publicly funded health services to prevent delays for medically necessary treatment. Dr. McMillan observing at the time that Canadians need timely access to medical services and the private sector could act as a "safety valve," ensuring that wait-time guarantees are met.

Sounds perfectly sensible and commendable to me. Allowing consumers some choice and discretion regarding health care options won't threaten Medicare's survival. Rather, it's the obstinate refusal by too many Canadians to revise their irrational, stop-thought phobia for "two-tiered health care" that is killing the health care system, as well as many people - literally - while they wait for timely treatment.

In my estimation, both the Canadian and American health care delivery models are flawed, and could respectively be improved upon by adopting the sort of European-style public/private hybrid the CMA is calling for.

"But two-tier health care means one level of care for the poor and another for the rich," goes the reactionary boilerplate protest. Yes, those with comfortable financial means will always be able to jump queues and obtain access to a higher standard of care. That's reality. Deal with it. We already have two-tiered health care; those who need and can afford to, go to the a U.S. or Far East for treatment. Money Canadian consumers spend on services they couldn't find or wait for in Canada helps fuel the U.S. economy and benefits Canada's GDP not a whit.

Another problem is that with medical technology advancing much more rapidly than our ability to pay for often astronomically expensive new treatments and therapies, we have to face the hard truth that because a treatment is technically possible doesn't mean we can necessarily afford to provide it universally. Sooner or later we will have to accept that two-tier or multi-tier health care is inevitable, and shouldn't be a political taboo. Both the U.K. and France, cradles of socialized medicine, have relatively smoothly-functioning, efficient, and effective blended public/private health care systems.

Denying domestic access to medical services that financial reality has rendered publicly unaffordable is cramped and mean-spirited.

Allowing people to pay for alternate care should decrease pressure on the public system, and facilitate quicker access for those who continue to use it.

Charles W. Moore is a Nova Scotia based freelance writer and editor. He can be reached by e-mail at cwmoore@gmx.net. His column appears each Thursday.