In the past, Canadas government-funded, universally accessible, health care system has been praised and admired both at home and abroad as one of the finest in the world. A great source of pride and comfort for many Canadians is that it is based on five fundamental principles. Principles that are a reflection of the values held by Canadian citizens since the formation of Medicare in 1966. These principles were reinforced in the Canada Health Act, (CHA), of 1984 and state that the Canadian system is universal, accessible, portable, comprehensive and non-profit.
With increasing concerns of debts and deficits, Canadas publicly funded health care system has recently become the target of fiscal attack. Efforts to reform and restructure the system have produced few results. Currently, some governments throughout the country are looking towards a more radical approach. An approach that would see not only the reform and restructuring of the method of operation of the current system, but that would change the system entirely. The proposed idea? In Alberta, it is to increase the role of the private sector in the current system.
On December 29th, 1999, Nancy MacBeth leader of the Albert...
a liberal party was cited in the Edmonton Journal as saying: Theres ample evidence that the Alberta governments plan to expand the role of private health-care will contravene the Canada Health Act. This is the strongest argument against privatization. It reflects the fears of many Albertans and Canadians; the fear that a two-tier system similar to that of the United States will develop. The fear that the system which was built upon values reflected in five principles will be eroded and replaced and that they will be the ones left to suffer the consequences. Privatization of health care would undermine the principles of the Canada Health Act and as such would undermine the integrity of the health care system.
The Evolution of Health Care
In 1966 one of Canadas most prided achievements to date was introduced to the Canadian Health Care system. Medicare was a daring and innovative concept pioneered by Canadians for Canadians. It revolutionized health care. Canadians overwhelmingly supported the new system as it reflected their values and the import they placed on universality and equal access to health.
Now, in the dawn of the millennium, the ideals of the same system are in jeopardy. Albertans are at present feeling the effects of restructuring. Accessibility and quality are being threatened due to cutbacks coupled with a lack of funding. There is a consensus now between medical professionals, the public, and the government that the health care system is deteriorating. It is failing to provide the quality of care promised in the CHA and prided by so many Canadians.
Yet the strings on the public purse continue to tighten. Transfer payments from the federal government continue to decrease as provincial debt loads increase. And, although the minister of health and the premier assured them that the costs of health care were doubling o
even tripling, Albertans have witnessed a steady decline in government spending on health care. The proportion of gross domestic product, (GDP), which Alberta allocates to health care is ranked last among the ten provinces, (Taft, 1997). Albertans now find themselves with a struggling health care system and a waiting list.
The proposed solution from current Alberta government would see the health care system incorporate the private sector. The government Most of all the government is looking to decrease cost, increase accessibility and efficiency.
Universality and Accessibility vs. Choice
Universality and accessibility go hand in hand. They are the principles that assure that each Canadian regardless of financial situation, will have equal opportunity to access the same level of care. The lack of a private market in the current system, some will argue, limits the individuals freedom of choice. Supporters of privatization maintain that these principles conflict with Canadians right to choose; the patients autonomy to choose to pay privately, and the physicians choice to provide preferential treatments to those payers ( Dirnfeld, 1996; Gordon, Mintz & Chen, 1998). Increasing choice in this manner would lead only to such detrimental practices as cream skimming, (Dirnfeld, 1996). Insurance companies would want only to provide coverage for those who meet certain low-risk physical criteria; physicians could care for those who could pay or for those who diagnosis proved to be the most profitable. This would be leading Canadians to take giant leaps backward in health care; moving towards the medical model of old that focused on disease and cure rather than health promotion and disease prevention.
With privatization comes private insurance, which can then delegate the what, whom, where and when health care services are accessed, in turn greatly limiting the individuals choice (Armstrong & Fegan, 1998). Utilization of a private for-profit system will be restricted to those who have adequate insurance coverage or the ability to pay out of pocket. Accessing services could also become dependent on hours of operation and rights to different facilities as dictated by private business owners and restrictions imposed by insurance plans.
Accessibility will also be affected when for-profit hospitals determine where to be established. Many Albertans live in rural areas too sparsely populated to encourage free-market competition. As more populated areas are bombarded with a barrage of health care competitors vying for their money, rural communities will be abandoned. Businesses and employees will be lured away by the prospect of fatter pocket books as profit is exchanged for people.
Decreasing Cost vs. Non-profit
One of the driving forces behind privatization is that it will cut and control increasing health care costs. There is a belief that a private for-profit market will create competition between health care providers. This would then reduce cost to the consumer as the different companies compete to obtain business. There have been however, many instances that have shown the effects of privatization to be just the opposite. For example, in order to remain competitive, money will have to be invested in advertising and marketing, a cost that is not present in the system as it stands, (Wilson, 1995).
Health care is not a place for the free-market competition.
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