Two articles in the March 2008
issue on health policy proposals in Quebec ("Couillard
flip-flops on pro-private report") and BC ("MDs
decry BC premier's vague reforms") accept without
scepticism the assertion that these provinces have "unsustainable"
healthcare systems. The BC Liberal government, you report,
warns of "out-of-control" costs. Such rhetoric sets
the stage for "cost-saving measures" such as "expanding
the role of the private sector" and permitting private
insurance.
Does anyone really believe that
cheaper healthcare is on the way from the private sector?
The point of private clinics and insurance is to generate
profit while delivering care. Costs will not decrease.
In fact, they will likely increase. The public system
will be left with fewer resources, as skilled professionals
will follow the money to the private sector.
Left unmentioned is the fact that
provincial health budgets are feeling the strain not
so much from hospital and doctor payments—those,
as a percent of GDP, have not changed. Drugs are the
fastest growing expense, and provincial governments
have not rationally addressed this problem. Moreover,
governments such as the BC Liberals have used any fiscal
discretion for tax cuts; hence, healthcare expenditures
as a proportion of the budget have risen.
Rather than offering the illusion
of a market-based fix, BC, Quebec and other provinces
should:
- Create a universal drug program
that will allow sole-source funding and other measures
to contain escalating drug costs;
- Stop handing out tax cuts like
political candy;
- Institute proven measures to
use existing public resources efficiently, such as
queue management, collaborative care programs and
incentives for effective primary care.
— Dr Randall
F White, psychiatrist, Vancouver, BC
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