Brad Wall is a former premier of Saskatchewan. Gordon Campbell is a former premier of British Columbia.
Discussing health care in Canada is like Americans trying to discuss gun laws.
We raise our voices to one another. We put empirically demonstrable facts aside and make personal attacks questioning the care and compassion and patriotism of anyone who dares to question Canada’s health-care orthodoxy.
Health services are important to everyone and Canada has a framework that could provide the foundation for one of the world’s best health-care systems. But we are falling far short today.
The World Health Organization rates Canada’s health-care system at No. 30 in the world. If we are unable to use innovation and investment to focus on patients and their care, our global health-care ranking will fall even further.
Make no mistake − your right to decide what is best for you has been taken out of your hands. That is not what the Royal Commission on Health Services had in mind when it set the foundation for today’s health services back in 1964. In fact, it was hoping “to make all the fruits of the health sciences available to all our residents without hindrance of any kind.” It explicitly recognized, “the individual’s responsibility for his personal health and that of the members of his or her family is paramount to the extent of the individual’s capacities.” Tommy Douglas made it very clear in a speech to Saskatchewan’s legislature: “I think there is a value in having every family and every individual make some individual contribution. I think it has psychological value. I think it keeps the public aware of the cost and gives the people a sense of personal responsibility.”
A lot has changed since then that might further strengthen Mr. Douglas’s assertion. In the early sixties in British Columbia, there were no cardiac bypass procedures, no cataract replacements, no hip replacements and no kidney transplants. Now, we have more than 2,500 bypass procedures, 31,000 cataract replacements, almost 2,900 hip replacements and more than 160 kidney transplants each year.
Health costs relentlessly escalate faster than population growth and far faster than economic growth.
Today, the notion that every Canadian is treated the same way when it comes to health-care services, a principle of our system, is folly. Every province and territory’s health-care system differs. British Columbians injured at work are provided with expedited comprehensive care and rehabilitation services that far exceed those offered to those suffering from exactly the same injury sustained outside of work. A Canadian living in Quebec has different rights from Canadians living elsewhere. If patients in Quebec do not get the timely care they need from Quebec’s public health services, they can use private care to meet their needs.
If flexibility and innovation in the name of a patients-first approach were being treated the same by the federal government in other provinces as it is in Quebec, there might be more room for optimism about the future.
Sadly, that is not the case. The federal government is threatening to reduce health transfers if Saskatchewan does not end its innovative approach to diagnostic clinics that increases services for people and adds resources that reduce waiting times and put patient needs first.
The federal government is threatening to withhold funds if B.C. doesn’t punish doctors who are following their professional obligations to meet patients’ needs when the public system cannot − by using the private clinics that have been serving B.C. patients for more than two decades.
Despite the Chaoulli decision, which restored patients' rights in Quebec, the federal government continues to insist that those rights do not exist elsewhere in Canada. Today’s B.C. government is spending millions in a court case to stop British Columbians from having the same right to access timely care as Quebeckers.
And last week, the B.C. government took steps to eliminate patients’ ability to access timely medical care when the public system cannot or will not provide it. That can have dire consequences, longer waiting times, fewer doctors and poorer care that fails to meet people’s personal needs.
It is time to put health-care dogma and old fights behind us. It is time for a new Canadian partnership that brings people together − individuals, health-care professionals, governments, scientists and the private sector.
It is time to give patients back their rights and doctors back the ability to do the best thing for their patients. It is time to encourage private investment into new diagnostics, pharmaceuticals, capital plant and training initiatives to complement governments efforts to meet the needs of Canadians. It’s time to allow patients to plan financially for the future health needs that governments cannot or will not provide.
Fifty years ago, Justice Emmett Hall and Tommy Douglas encouraged private contributions and private participation in the funding and delivery of health care, as well as patient choice.
It would not at all seem a radical proposition to return this country’s approach to health care back to the much more patient-first pragmatic one envisioned by Justice Hall and Mr. Douglas.
For us to do that, we need to be able to have a reasoned, fact-informed discussion and avoid the ad hominem and the hyperbole from both sides. One hopes we are all up to the challenge.