Tuesday, January 8, 2008

Monopoly health care is not the answer

Jack Cembalisty wrote in “Privatized health care is not the answer”, (St. Catharines Standard, Jan.5, 2008):

“Every once in a while someone will write in saying how we should follow United States-style privatized service delivery as an example of how to improve our health-care system.
I'd like to add some context before someone else sends in a similar letter. The last World Health Organization report on the state of health-care systems worldwide ranked Canada 30th, and a country with a similar make up to our own, Australia, ranked 32nd.
The U.S.-privatized system however was ranked lower than our system at 37th.
The top health-care systems in the world were France at No. 1, Italy at No. 2, and Britain at No. 10.
If we really do want to reform our health-care system, then following the privatized model of the U.S. will decrease the efficiency of our system and ultimately make it worse.
The 2007 Organization for Economic Co-operation and Development health report has shown the Canadian system, for all its problems, is still a more efficient system than the U.S. model. Canada spends, per GDP and per capita, roughly half of what the U.S. spends on its private health care.
This despite the fact that all Canadians are covered by our system, and only about 45 per cent of Americans have health insurance coverage.
Our system of health care actually gives us a good bang for our buck. We spend slightly more per capita and per GDP than the average OECD country, but we're not too bad in comparison.
We can and should though, continue to seek improvements by looking to the leaders in health-care coverage (the French, Italians and British) and not a system which is ranked lower than our own.
It's been proven that privatizing the system lowers its equity and bogs it down in administrative costs. "

Cembalisty wrote “Every once in a while someone will write in saying how we should follow United States-style privatized service delivery as an example of how to improve our health system.”

Can Cembalisty provide a list of these letters he is referring to, going back to, say four years? Cembalisty does know (doesn’t he?) that a lot of Ontarians go to the States to obtain treatment, not because of malice, but because the Liberal-run health monopoly in Ontario failed them. The system that was ranked lower than our own, nevertheless was still the destination of choice for many ill Ontarians! 10% of Ontarians, about 1.3 million people, are "covered" by a single-payer government-run insurance plan, but do not have a doctor!

Cembalisty wrote that "only about 45% of Americans have health insurance" - which means that 55% don't. Is this even factual? The figures - questionable as they are - that I have read is that supposedly 45% aren't covered; not that 45% are covered.

It is a red-herring to purport that “privatized health care is not the answer”, when it should be patently obvious that “monopoly health care is not the answer” either.
Competition is the answer, which writers like Cembalisty skim over.
Market-oriented business principles, and payer/provider options, are sorely needed within Ontario’s health system, along with a good dose of fiscal, and medical, accountability.

When Cembalisty talks about the models we should look at, he mentions Britain, Italy and France – whose systems are not monopolies; privatization is part of the answer!

Look at the "outcry" here in St. Catharines since the Nov. 2007 CIHI report revealed that the NHS had the third-worst mortality rates in Canada, 35% higher than the national average - - - well, there was no outcry!!
The letters to the editor, the radio shows, the Standard Feedback column, were practically bereft of any response.
We are so browbeaten by second-best expectations to third-rate offerings that even shocking results such as this only warrant a shrug of the shoulders, a yawn, and a so-what attitude from the monopoly-defending locals.

Even the local single-payer-pushing MPP, Liberal Jim Bradley, glossed over the high death rate issue in his own riding’s hospital, when what he should have immediately done is call for the Ombudsman to investigate Ontario's entire Liberal-monopoly-run health system. In fact, the Ombudsman is investigating other hospital systems in Ontario, why should Niagara’s be excluded?

We should be able to do much better, but still, Ontario's monopoly-minded politicians - and their monopoly-enabling supporters - continue to pretend that privatization is not part of the solution.

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