Canadian Supreme Court Weighs in on Private Healthcare
Prior to this ruling, only government healthcare was possible in Quebec and although it only applies to this province, new cases involving other parts of the country are expected soon.
Canada has a very "egalitarian" economic system characterized by extremely high taxes and a much greater government redistribution of wealth than is the case in the United States. One manifestation of this is Canada's so-called universal health insurance (the details of which vary from province to province). All medical costs must be paid through some version of this plan. This effectively renders any private healthcare funding sources illegal. The end result is an exclusively government-run healthcare system.
Private healthcare facilities are felt to contribute to a two-tiered system which itself is felt to be socially destabilizing.
Much has been written about the problems currently facing Canada as it comes to grips with some of the shortcomings of its healthcare system. Medical care there is troubled with very poor reimbursement rates, impossibly long waits for appointments with primary care providers, lack of availability of basic diagnostic testing, markedly delayed surgeries and a situation where countless Canadians seek healthcare in the United States. Canada has also experienced a significant exodus of physicians and nurses who seek employment in the United States as well.
It was in this setting that this recent ruling occurred. Although private clinics, providers, etc. are illegal, many exist clearly fulfilling a perceived need. Such facilities will now be legal at least in Quebec and it is obvious that many more will now open. It is also clear that private insurance will become much more readily available.
What is interesting to me is the legal argument upon which the Supreme Court relied on for its ruling. Their conclusion was based on a theory that the prohibition of private healthcare violated human rights in that this policy was responsible for results that, for most economists, are predictable.
"The evidence in this case shows that delays in the public health-care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care,"wrote the court's chief justice. She continues:
"The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital health care result in physical and psychological suffering."A lot of liberal-minded Canadians are not going to be happy about this. Although many will disagree with me, a bit more of a "free market" may go a long way towards increasing access through competition and by improving efficiency. This may also restore some of the profession's desirability which should increase the supply side. It is not inconceivable that some tax cuts may result reflecting less reliance on the government's insurance policy.
It is going to be very interesting to see how this plays out. I see a large number of healthcare policy PhD theses in the future comparing then vs. now in Quebec! Think tanks such as the Rand Corporation are going to have a lot to think about.