A reader alerted me to a great piece in today’s Toronto Star. In “Patients just want quality care”, long-time Toronto-area physician Dr. Murray Waldman cuts through the left-wing lies and mainstream media scare-tactics to clearly portray the truth about our Ontario health care system:
There is a great deal of somewhat intentional confusion in the latest debate over private health care.
The Tories are advocating more private health care, while the Liberals and NDP are holding fast to the idea that two-tiered health care is an anathema to Ontarians.
No one is talking about the fact:
We have two-tier health care.
We have private health care.
After explaining that hair-replacement clinics and hernia-specialty hospitals constitute “private” health care, and that upgrading to a private room constitutes “2-tier” health care, he subtly advocates for Ontario PC leader John Tory’s position, to introduce more privately-owned health clinics into the system. In doing so, he identifies the simple reason why governments resist private health care so much: they don’t want to pay for more care! To wit:
…we can have hospitals that do hip replacements, for instance. If these hospitals were privately owned, but billed only OHIP and not the patient, the people of Ontario would have no problem with that. In fact, the Shouldice Hospital in Thornhill has been doing excellent hernia repairs for more than 60 years, and is a privately owned hospital.
The reason governments are reluctant to license private hospitals and often vilify the concept of “private-for-profit” hospitals is the same reason they are reluctant to license foreign doctors. They can’t afford it.
Governments have health budgets that set out how much they are prepared to spend on health in a given year.
If public and private hospitals were both doing hip replacements at the same cost to OHIP, then the number of annual operations would go way up – and so would the government’s costs.
The same holds true for actively encouraging more doctors. Doctors generate huge bills for the system. They are well paid, they order expensive lab tests, they order even more expensive X-rays, MRIs, etc. They also decide who is going to have those expensive treatments and they spend the government’s money with few cost constraints.
This makes for excellent but expensive medicine.
I am for private health care but firmly against two-tiered medicine – and I urge politicians to stop telling us they are the same thing.
This confusion helps them avoid talking about the fact cost constraints have to come from the supply side, as the demand is uncontrollable.
Waldman, in a roundabout way, eloquently exposes the philosophical rejection of public health care held by conservatives. Inevitably, government-run health care results in severe rationing of highly-demanded services. This works against positive health outcomes, and, most importantly, creates an even more unfair two-tiered result: the connected get preferrential treatment in-Province, while the wealthy get preferrential treatment by paying for services outside the country.
Waldman ends with an apt metaphor for the truth about our health care system: that it gives politicians a chance to pretend they are heroes for providing “free universal health care”, while avoiding the inconvenient truth that there are severe limits to what that “free” service will actually provide.
It’s somewhat like the joke about the man going back for his fourth helping at the all-you-can-eat for $10 buffet. The owner stops him from making another trip with the comment, “That’s all you can eat for $10.” Governments offer the illusion of free, unlimited health care on demand, but they can only provide what they can pay for.
This raises the basic question of whether government should be an insurer or a provider of health care?
Now, it’s a bit of both.
Perhaps the time has come to clarify the issue and have an open debate on what kind of health care we want from government – and what we are willing to pay for.
While The Star likely either edited his conclusion to tone it down, or told him that he can’t specifically endorse any politically-incorrect changes, the implication is clear: our government must open up the market to more privately-operated clinics, and our government must allow citizens more freedom to pay privately for services that the government can’t afford.
Thank you, Dr. Waldman. Without strong voices from within the medical profession, the politicians’ self-serving lies can never be properly challenged, and the health outcomes of individual human beings will never reach their potential in this miraculous world of modern medicine.