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public health care
Provincial governments remain incapable of providing access to care within a reasonable timeframe, yet continue to maintain their monopoly over the provision of medical care. It's time for policy makers to make the changes required for Canada to have a universal and efficient health-care system.
B.C. law prohibits residents from accessing private insurance to pay for medically necessary treatment in B.C. These prohibitions, together with the province's rationing of health-care services, has resulted in long waiting lists. Many residents in urgent need are forced to languish, suffering irreparable harm and risking death.
I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology. I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.
The evidence for the link between factors determined by social policy and health outcomes is crystal clear. Decades of studies have demonstrated that income and its distribution, education, employment, housing, food security and the wider environment have far greater impact than health care in influencing our health.
Along with failing to increase affordability and access, private MRIs pose a more insidious threat to publicly-funded health care. The more Canadians believe that they have to pay out of their own pocket for necessary care, the more we will see confidence in and commitment to medicare eroded. We need strategies to improve access to diagnostic technologies that strengthen medicare rather than undermining it.
Canada is the only country to limit the role of private health insurance exclusively to the coverage of services not insured by the public system. Canada is also alone in prohibiting doctors from practicing in both the public and the private sectors. Whereas 99 per cent of hospitals in Canada are public, in all other countries, private institutions have an important role to play in the provision of hospital services. Private, for-profit hospitals make up over one third of all hospitals in Germany (42 per cent), France (39 per cent) and Australia (36 per cent). Beyond any doubt, patients would be the first to benefit from such a pragmatic, evidence-based outcome.
What we need is a health care system that's based on need, not ability to pay. But we also need social policies that create the conditions for good health. The evidence also shows us that lifestyle choices such as decreasing smoking, exercise and good diet increase proportionally to an individual's social and economic status.
Three years ago, on a crisp November morning, my mother fell down a long flight of stairs in her home. I didn't know at the time that her life, and mine, were also about to descend into a dark and often agonizing journey through Canada's healthcare system. By the time this second hospital was through with my mother, her demise was said to be "imminent."
Healthcare in Canada is anything but free. The average Canadian family of two parents with two children (similar to Walt's family in the drama) pays approximately $11,320 in taxes for hospital and physician care through the country's tax system, in addition to the cost of private insurance for things like dental care and outpatient prescription drugs.