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Musings on Health Care

Gary Mar – the perceived front-runner in the PC leadership race – caused a stir a few weeks ago with comments to the Edmonton Sun editorial board in support of private health care delivery.

Predictably, two things happened. First, media speculation focused less on whether this was a good idea from a policy and service delivery perspective; second, public health care advocates jumped all over him and any defenders for daring to bring up the prospect of private delivery.

Many recognize that our health care system faces challenges, which will only grow in the coming years. Health care already takes up more than 40% of Alberta’s operating budget, and that figures to grow as our population ages. Sustainability – financially-speaking – is only the second biggest challenge. The first is that we seem unable to have a serious, mature dialogue about health care in Canada. Without that dialogue, we’ll never get to solving the challenge of financial sustainability.

H1N1 Clinic
An H1N1 vaccination clinic in Edmonton, from 2009.

There is some truth in what Mar says. People with means, should they be interested, will find ways to get access to timely care if the public system in Alberta is not providing it. There are an increasing number of privatized (or elective) features of health care in this province. Capturing that cost is an economic opportunity. There is nothing inherently incompatible with having private delivery happening parallel to a robust, efficient public health care system.

Where defenders of public health care fall down for me is in demonizing private delivery. I support timely, quality access to health care for everyone. The conversation in my mind is not, ‘how do we stop private delivery?’, rather it is ‘how do we ensure timely, quality delivery for everyone?’

Part of me feels the same way about private health care use and cue-jumping as I do about marijuana use. It’s going to be happen anyways, so let’s regulate and tax the hell out of it. Let’s say a few changes were made to the health care system. There were more health professionals trained and practicing. Private delivery was allowed, but heavily regulated and taxed by government (with revenues going back into the public system). As long as everyone – from the millionaire business-owner to the single parent on income support was receiving timely, effective care, would it be such a calamity?

I recognize this is, and continues to be a controversial issue. It’s going to be an increasingly complex one to deal with as our population ages. I only hope we can have a mature, serious, open conversation about health care. Demonizing people who simply raise the prospect of private delivery is not the way to get there.

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