Canadians don't consider health-care status quo so sacred

"Will governments have the cash to meet the needs of our aging population without increasing debt to unsustainable levels?" This question, posed by Auditor-General Sheila Fraser to delegates at last month's general meeting of the Canadian Medical Association, is extremely important.

It doesn't take much detective work to discover that the answer is decisively "no." Statistics Canada reports that spending on health care grew at an average annual rate of 7.4 per cent over the past decade, driving the portion of government revenues spent on health care ever higher. Health costs are cannibalizing government programs, cutting ever deeper into financing for education, social programs and infrastructure.

As costs spiral upward, government tax revenues are in for a long, tough climb out of recession levels. Ontario and New Brunswick face the prospect of health care costs consuming half of provincial revenues, and other provinces are on track for the same debilitating fate. British Columbia's $16.5-billion health care budget is up 76 per cent since 2000, and the province's large and increasingly retired population means the "silver tsunami" will hit our Pacific shores the hardest.

Has such enormous spending growth made our health-care system better? Sadly, it continues to deteriorate. The latest physician survey conducted by the conservative Fraser Institute found that Canadians waited an average of 16.1 weeks to see a specialist after receiving a general practitioner referral, 73-per-cent longer than when the survey was first conducted in 1993.

According to Canadian Institute for Health Information statistics, the most dangerous place in Canada is a public hospital: One in every 152 acute care patients dies because of "preventable adverse events," while two in 10 patients contract a hospital-spread infection or are given the wrong medicine. No Canadian CEO could keep his job if his company's "defect rate" was even a small percentage of that in our government monopoly health-care system.

The 2010 edition of the peer-reviewed Euro-Canada Health Consumer Index shows that despite the fourth-highest per-capita spending, Canada's health-care system ranks 25th out of 34 compared with European countries.

Provincial and federal politicians treat the failing system like a sacred cow, but a recent Ipsos-Reid poll, commissioned by the Canadian Medical Association, found that Canadians don't consider the status quo so sacred. The survey found that 80 per cent worry that the quality of the health-care system will decline. It also found that they wonder how the country will pay for increasingly expensive health services, and they believe governments need to show leadership in bringing about change.

Imagine if governments owned and operated our farms and grocery stores and had the power to decide how much and what kinds of grains, fruits and vegetables should be grown, where they would be shipped, and how much we would pay for it. What do you think would happen to the availability, variety and quality of goods on store shelves?

I saw the answer during visits to Soviet-era Leningrad (now St. Petersburg): People lined up at stores in early-morning darkness and emptied the shelves within the first hour of opening. The food they bought would be repulsive to Canadians and some of it was downright dangerous, leading to a high rate of food poisonings. But because a government monopoly produced the food, consumers had nowhere to turn. Cases of food-borne illness are relatively rare in Canada's privately managed food system, and when they happen, the company responsible is held accountable, creating a huge incentive to supply safe products.

We've watched our health-care crisis grow for years, yet the bureaucratic "solutions" remind one of the proverbial rearranging of deck chairs on the Titanic. Just as doctors are not good at healing themselves, a government-run monopoly is incapable of reinventing itself.

Canada's health system requires major surgery. But what to do? Part of the answer is to separate the deliverer of health care from the regulator. There is no reason that publicly financed health care can't be delivered by private sector companies subject to strict quality, transparency and accountability obligations. The other part of the answer is to allow Canadians who are willing to pay for health care out of their own pocket to do so, rather than taking their dollars out of the country for medical care.

These suggestions will likely draw the usual protests from monopoly-loving union leaders and their left-wing sycophants. But when you hear their "no to for-profit medicine" rhetoric, ask why you're so much safer eating food that is produced "for profit" than when you're treated in a government-run hospital. If a two-tier user-pay option for medical care is so bad, why does it exist in every country that ranks above Canada in health-care system performance?

And there would be another advantage. Instead of being treated like those poor Russians lined up outside a grocery store, you would be seen as a valued customer rather than a problem.