By Kristin Nelson
When it comes to health care, privatization is not the dirty word it once was.
In the 2004 election, Prime Minister Paul Martin tried to portray Stephen Harper as the enemy of health care and himself as the protector of the public system. But this campaign, editorialists and politicians of every stripe are musing about the unsustainable costs of the current system.
Ottawa Centre residents concerned about the future of the health system will find little difference between local candidates’ positions. All but one is willing to consider a blended private/public system.
Local NDP candidate, Paul Dewar, is the only holdout. “I wholeheartedly disagree with private delivery healthcare. We have been asleep at the wheel with health care.”
Dewar’s sentiments reflect those of NDP party leader Jack Layton, who helped to bring down the government in a vote of non-confidence after Martin rejected his health care ultimatum in November.
Private health care will be openly discussed in the election, says University of Ottawa management professor Douglas Angus.
“This time the emphasis should be on how the better features of the public and private sectors can be drawn together,” Angus says.
“Most people don’t realize that we’ve had a lot of private delivery for a long time. Doctors themselves are private pro-viders who bill OHIP,” he says. Eye doctors and physiotherapists are not covered in Ontario. And most Ontarians already get their blood tests and X-rays in private facilities, which bill OHIP for their services.
A report released by the Fraser Institute in October says health care is using a greater percentage of provincial revenues every year. Ontario’s costs are rising faster than any other province, and the think-tank expects public health spending to exceed 50 per cent of Ontario’s revenue by 2011.
Conservative candidate Keith Fountain says he supports universal coverage. He says health care is a “core function” of the federal government, but he’d like to see a mixed system of delivery. He says there’s a need for public hospitals, “but at the same time I’d like to see more private options for just about everything else.”
“Even if we went totally private it wouldn’t be such a bad thing,” says Fountain. “When you get private options you get competition and efficiency.”
Private delivery is also on the table for Green Party candidate David Chernushenko. “I have no problem with (private delivery). What is important is the universality of it,” he says.
Liberal candidate Richard Mahoney says a mixed public-private system already exists, and that it is working relatively well. He acknowledges that long waiting lists are an issue, but says the government has made progress in that area.
“I envisage a single payer system … where people cannot jump (the line),” says Mahoney. But he also empathizes with Centretown residents who are willing to pay for services.
“People who need treatment will do everything they can.”
It is illegal for Canadians to buy health care services provided by the public system. However, last June the Supreme Court ruled it was a violation of the Canadian Charter of Rights and Freedoms to prohibit Quebecers from seeking private health care. The court decision is only applicable in Quebec, but eventually it will affect the rest of Canada, Angus says.
Ottawa residents often use a private MRI clinic in Gatineau.
Mahoney says the government needs a better agreement with the provinces to reduce wait times so Ottawa Centre residents “no longer have an incentive to go to Hull.”
All this talk of a parallel private system and jurisdictional shuffling doesn’t sit well with some locals.
Centretown resident Wesley Clarke works for the government and enjoys skating on the canal – so much so that he developed “hockey groin syndrome” (a tear of the external oblique faschia) about four years ago.
The injury was misdiagnosed until Clarke finally found a physician who recognized the rare condition and recommended surgery. The doctor told him the only way to have the procedure done was to go to a private clinic in Montreal and pay for the surgery himself.
“It was all delivered to me as a fait accompli,” Clarke says.
Fortunately he was able to come up with the initial $2,300 to pay for the operation but he has been told OHIP will reimburse him $700 at most – less than one-third of what he paid.
“We pay a lot of taxes in the country and one of the reasons I don’t mind is that we get care when we’re sick,” he says. “I kind of feel like I have to pay twice.”
Politicians and pundits say health care is top of mind. But on a blustery day outside a private walk-in clinic on Elgin Street, most people seemed relatively unconcerned about the issue.
Health care is not a big concern for Gail Lill, 58. She says she’s happy with the current system and not so worried about increasing privatization. “It’ll eventually come anyway. You’ve got to take everything in stride,” she says.
Angus agrees. He says Canada should look to Western Europe, Australia or New Zealand. “If we don’t get beyond the rhetorical and ideological debates, we will end up, by default, with a U.S.-style solution.”