“The Madness of Medicare in Canada” – Webinar by Dr. Brian Day

On Wednesday November 28, Dr. Brian Day, the 2007-2008 president of the Canadian Medical Association, presented a webinar entitled “The Madness of Medicare in Canada” for the Fraser Institute.

Dr. Day argued that Canadians should be able to pay for private insurance and private care. He also addressed a lawsuit his facility, the Cambie Surgery Centre, and other plaintiffs have launched against BC’s Medical Services Commission to try to get a ruling similar to Chaoulli, which held that Québec’s prohibition on private insurance violated the Québec Charter of Human Rights and Freedoms.

Dr. Day explained the title of his webinar saying that “in years to come” he thought we would come to think that today’s health care system was “madness”. “There is only one country that has a law that prevents citizens from spending their money on health care for themselves or a loved one,” he said, “Canada.”

However, he was quick to point out that Canada does not have a single payer system. Instead he called the system a hybrid, composed of, among others:

• Public funding
• Workers’ compensation
• Prisoners treatment regimes
• Politicians’ treatment regimes
• Foreign travellers’ insurance

According to Dr. Day, 70% of Canadians have private insurance for medically necessary things like prescriptions, ambulances, and the like. “The real challenge is lack of access to care for those who need it,” he said. “The individuals with the worst access are the poor and the soci-economically disadvantaged.”

So how would allowing private insurance and care improve access for these groups?

According to Dr. Day, it would lead to greater efficiency and thus to greater availability of healthcare providers.

Comparing it to Air Koryo, North Korea’s state owned airline (and the “World’s Only 1-Star Airline”), Dr. Day described the Canadian health care system as extremely inefficient and unresponsive to the real needs of patients. Some of the problems he outline with our health care system include:

• In his view, the system is extraordinarily bureaucratic. For example, in Canada, there is a public health administrator for every 1 415 people, while in Germany, there is a public health administrator for every 15 545 people.
• Provinces are forced to cut doctors’ operating hours, trying to balance the budget. Dr. Day saw his weekly operating hours drop from 22 to 5 under the cuts made in BC in the 1990s.
• Some patients suffer irreparable harm or die waiting for care.

According to Dr. Day, 200 children were waiting for spinal surgery at BC Children’s Hospital. One of those children, Walid Khalfallah, is now permanently paralyzed because his turn did not come soon enough.

He proposed the following strategy to address inefficiencies in the Canadian Healthcare regime:

1. REDUCE PUBLIC SPENDING

• Allow private insurance and care
• Encourage healthy competition and incentives
• Discuss what services should be covered
• Empower individuals to take responsibility for their health choices
• Reduce wait times
• Reduce bureaucracy

2. INCREASE REVENUE

• Encourage Canada to become a destination for health tourism

We should look to Europe for inspiration, especially to France, Germany and Switzerland, which have a public/private mix. According to him, even Communist countries like China and Cuba are warming to a private element in their health care systems.

Dr. Day thought Chaoulli would shake up health care in Québec, but the decision’s impact has fallen short of his expectations. He hopes, however, that the lawsuit the Cambie Surgery Centre is bringing will allow him and others to trail blaze where his colleagues in Québec did not dare go.

A recording of the webinar is available here.