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Time to unmask the American health-care boogeyman

Author: Franco Terrazzano 2020/02/12

When anyone proposes tinkering with health care delivery in Canada they are usually met with a loud and incessant “Canadians don’t want American-style health care!”

Canada officially recognizes 195 countries, but Canadians continuously fixate on the United States when comparing health-care systems. This belief warrants its own Latin name: argumentum ad americanum. Definition: the fallacy that any change to the Canadian health-care system would result in a dystopian caricature of the American system.

This argumentum ad americanum was on full display when Ernst & Young’s review of Alberta Health Services was released publicly on Feb. 3. The report identified strategies to save taxpayers nearly $2 billion every year, including expanding publicly-funded and independently-operated surgical facilities.

Given the government’s $70 billion debt, savings should be welcomed. But the New Democrat opposition responded to the report with their best Chicken Little impersonation.

“It’s clear they want to move to more American style, private profit in our public health-care system,” stated opposition health critic David Shepherd.

While Canada ranks above the U.S. in many health-care metrics, our system isn’t the envy of the world.

The Commonwealth Fund, a New York Times panel of health policy experts and the prestigious medical journal The Lancet have all ranked Canada’s system relatively poorly when compared to other top industrialized countries.

Alberta’s median wait time from referral by general practitioner to treatment by a specialist is 28 weeks. And despite the Alberta government spending $1,000 per person more every year on health care than Ontario, Alberta’s wait times are 12 weeks longer. This conjures up the famous quote from former Chief Supreme Court judge Beverly McLachlin that “access to a waiting list is not access to health care.”

Fortunately, we can improve the health system by looking at places that outperform ours and by brushing off claims about the American health-care boogeyman.

Let’s look at the top three countries rated by the Commonwealth Fund: The United Kingdom, Australia and the Netherlands. All three are performing better than our system, all have universal coverage and all have business involvement in health care. Yet, we don’t hear horror stories from these countries about people having to remortgage their homes to pay their hospital bills.

The U.K.’s National Health Service involves universal taxpayer-funded coverage of health-care services provided in government hospitals. But it allows an independent insurance market and hospital network to operate and charge patients.

This allows patients to access treatments quicker through the independent facilities, helps lower wait times in the government system and reduces taxpayer burdens. Despite having lower spending levels than Canada, NHS patients and physicians reported having much easier access to MRIs and CT scans, and were much less likely to have waited over two hours in an emergency room.

In Australia, government and independent hospitals compete with each other for patients, providing the crucial incentive for both types of hospitals to reduce wait times and improve outcomes. The Commonwealth Funds’ study put Australia’s system six spots ahead of Canada’s in terms of access, eight spots ahead in terms of outcomes and seven spots ahead overall, ranking it as the second best health-care system in the world.

The Netherlands has a legal requirement for citizens to be insured, but there is no government-operated insurance plan. Despite its similarities to the American system, the Dutch regulatory framework has allowed its network of private hospitals and insurers to remain affordable for the average citizen and to ensure no one is left without proper coverage. Contrary to what the argumentum ad americanum would have us believe, the largely private financed Dutch system is ranked first by the Commonwealth Fund for accessibility and has better outcomes than ours.

These examples show business involvement can help improve health-care outcomes. And none of these examples resemble the appalling caricature of the American system we hear so much about. It’s time to take our blinders off and progress beyond the argumentum ad americanum.

 

Franco Terrazzano is the Alberta Director and Renaud Brossard is the Québec Director of the Canadian Taxpayers Federation

This column originally appeared in the Edmonton Journal on Feb. 12, 2020.


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