MEDICARE REFORM NEEDED

Reform key to fixing 'broken' medicare
By Rory Leishman
London Free Press
January 30, 2007

The Canadian health-care system has many problems, but at least it shelters all Canadians from catastrophic medical bills in the event of serious illness. The same, of course, cannot be said for the United States, where literally millions of people -- some estimates put the figure as high as 47 million -- have no health insurance.

Granted, several million of the uninsured in the U.S. are young people in good health who can well afford private medical insurance, but choose instead to spend their money on a fancy car or some other luxury. These people who gamble with their health deserve little sympathy if a serious illness drives them into bankruptcy.

Millions of other Americans want comprehensive medical insurance, but simply cannot afford it. Federal and state governments provide comprehensive medical care for the elderly, the disabled and poor children. Why, then, does the U.S. not follow the Canadian lead, by outlawing private medical care insurance in favour of a universal and comprehensive public system for all?

There is a good and sufficient answer to that question: The Canadian system is heading for bankruptcy.

British Columbia Finance Minister Carole Taylor has documented the problem in her province. In a report last September, she warned that if public spending on medicare in B.C. were to continue to increase at recent annual rates, it would absorb 71 per cent of the provincial budget by 2017. That's obviously out of the question.

In a paper published Jan. 11, Brett Skinner of the Fraser Institute noted that at least four other provincial government studies and a federal Senate report also have concluded that the rate of increase in Canadian health-care spending over the past several years is unsustainable.

Skinner has conducted his own study of the developing crisis. Based on figures going back to 1975, he concludes: "Government health spending in six of the 10 provinces is on pace to consume more than half of total revenue by the year 2020, two-thirds by the year 2035, and all of provincial revenue by 2050."

Canada's medicare system is fiscally broken. As costs grow, the provinces cut back services with the result that more and more Canadians have to put up with progressively longer wait times for ever fewer treatments.

There can be no solution without fundamental reforms. Skinner argues that Parliament and the provincial legislatures must, at the least, introduce affordable co-payments by patients to curb frivolous demands on the public system.

In this respect, Quebec is leading the way with a new law that will allow private hospitals that receive public funding to charge extra fees to patients for services covered by the province's public plan. In this way, the province hopes to increase both the number and quality of services available to all Quebecers.

In the U.S., President George W. Bush proposes to make private health insurance more affordable with a tax deduction of $15,000 for family coverage and $7,500 for single coverage through a qualifying health-insurance plan. It would not help millions with little or no taxable income. Several state governors have proposed making adequate private coverage available to all, regardless of income.

Switzerland already has such a plan: Thanks to government regulations and subsidies tied to income, every Swiss resident can afford to buy a mandatory health insurance plan from private firms.

A recent study by Britain's Civitas think-tank concluded: "Swiss attachment to universality guarantees an extremely good quality of care to all with little if any rationing."

Would that the same could be said about the Canadian medicare system. Is it any coincidence the Swiss system encourages vigorous competition among private medicare providers, while Canada is the world's only non-communist country with a public-sector medicare monopoly that forbids purchase and sale of competing private health insurance?