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The Globe and Mail

Quick fix for systems on the verge of a breakdown

Canadian health care costs have mushroomed by more than 260 per cent over the past 15 years to a whopping $130-billion in 2011, with an increasing portion financed by debt. Due largely to runaway health care costs, the provinces racked up a combined deficit of more than $30-billion in the 2010-2011 fiscal year. Health care already swallows more than half of revenues in Ontario and Quebec, and most other provinces will soon face the same debilitating prospect. And global fallout from the euro-zone crisis and U.S. economic lethargy is almost certain to reduce provincial and federal revenues.

What have Canadians been getting from this health care system that's slowly strangling public finances? The answer isn't pretty. The Fraser Institute's 2010 edition of "Waiting Your Turn" found the average waiting time between general practitioner referral and treatment from a specialist was 18.2 weeks. In a recent Macdonald Laurier Institute survey of 34 Organization for Economic Co-operation and Development countries, Canada ranked 26th in access to doctors and 24th in access to hospitals.

If ever there were a time for major surgery on our terminally ill health care system, it is now. Yet provincial premiers who gathered in Victoria recently focused mainly on how they could extract more money from Ottawa to try to keep their sinking systems afloat (though there was some discussion about being "more efficient").

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Systems on the verge of a breakdown exhibit telltale symptoms. One is that the system thwarts those needed to save it. Canadian doctors consistently rank lack of operating-room time as the biggest impediment to treatment. Specialists see little point in taking on more cases when their surgical time is limited to a few hours per week, making waiting times for non-life threatening, but frequently debilitating, surgery painfully long for patients.

Another symptom is that rationing becomes the only option. Many new doctors aren't able to obtain a residency due to what health care administrators call a "lack of resources." This, while physician retirements, combined with an aging population, portend a doctor supply crisis. Perhaps if all patients waiting for treatment were to line up at their local hospital, the parallels to Soviet-style rationing would strike home with those who perpetuate the myth that Canada has one of the world's best health care systems.

The 2010 edition of the peer reviewed Euro-Canada Health Consumer Index shows that, despite having the fourth-highest per capita spending, Canadian health care ranks 25th compared with 33 European countries. While Canadian laws make it a crime for doctors to deliver, and for patients to pay for, "medically necessary services," each of those 33 countries allows a mixture of public and private medical spending. They have found that dollars spent voluntarily for private care free up more money for the public system.

As for the alarmist view that private treatment reduces resources within the publicly financed system, how could that be true when new doctors can't even get into the system, and when surgeons wait for access to an operating room? Given these realities, it's understandable that those who can afford to escape the waiting lists and go elsewhere for private treatment – along with their money, which could be staying in Canada.

The Canadian system is expensive, but inaccessible. Our health care workers are high quality, but poorly utilized. Removing the Canada Health Act prohibition against private care would reverse the flow of money going to international hospitals, better utilize our excellent health care professionals, and foster job-creating investment in one of the world's fastest-growing sectors. The legal stipulation that all Canadians have access to government-financed health care would remain sacrosanct, while public system costs, along with waiting lists, would decline. It's time to move forward to a new, sustainable model for Canadian health care.

Gwyn Morgan is a Canadian business leader and a director of two global corporations.

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