Privatizing Health Care - The Disease or the Cure?

Introduction

Healthcare services are essential to our well being at every stage of our life. Join us as Speak Up examines issues associated with our health care system. Is universal health care important? What constitutes universal health care? Can it be better provided through a single government-controlled model, a totally privatized model or a mix? What is the experience in other countries? How does Canada's health care system compare to others?

Panellists: Margaret McGregor, Robert G. Evans, and Don Copeman

Tuesday, October 24, 7:30 p.m. - Central Branch

Thursday, November 2, 7:30 p.m. - Oakridge Branch

Please arrive early as space is limited.

Panelists

Don Copeman

Dr. Don Copeman is an accomplished executive who has spent 25 years building businesses in the health care and information technology fields. He has been the CEO of five healthcare companies and a senior executive at some of the world's leading information technology firms. Don is an active supporter of the United Nation's Millennium Project to end extreme poverty and is actively organizing sustainable community development and healthcare infrastructure projects in association with the Copeman Healthcare Centre.

Robert G. Evans

Robert G. Evans is a Killam Professor in the Department of Economics and a member of the Centre for Health Services and Policy Research at UBC. An institute fellow of the Canadian Institute for Advanced Research, he was Founding Director of the Institute's Program in Population Health from 1987 to 1997. Major publications include Strained Mercy: The Economics of Canadian Health Care (1984), and Why Are Some People Healthy and Others Not? The Determinants of Health of Populations (1994).

Margaret McGregor

Dr. Margaret McGregor is a clinical assistant professor with the Department of Family Practice at the University of British Columbia and a family physician at the Mid-Main Community Health Centre in Vancouver, British Columbia. She is also a research associate with the Centre for Clinical Epidemiology and Evaluation at Vancouver General Hospital. Her research topics include the study of how nursing homes vary by facility ownership and organizational characteristics. She is a member of the Board of Directors of Canadian Doctors for Medicare.

Discussion Questions

  • Do you consider health care a public good or right that should be available to everyone?
  • Many experts believe that the forces squeezing our health care system are global in nature. Do you think Canada's crisis is isolated or part of a larger trend?
  • Do private health care providers have incentives to reduce costs for care or provide better care?
  • Both pro- and anti-privatization proponents argue that their system provides better care. How would you define better care?
  • Critics of health care privatization often appeal to our Canadian values. How does universal care fit into the wider context of Canadian values or culture?
  • Do you think Canada should strengthen its focus on illness prevention and organize its social structure to preserve health, or should it focus more on curing disease?
  • Almost all OECD countries except the US have some form of universal health care. Why do you think the US has chosen a different model?
  • Canada's system is often compared to the US's - how do you think the systems compare?
  • Do you think that initiating a two-tier system is inviting a "slippery slope" effect that will lead to further privatization or drain resources away from the public system?
  • Is a public system, funded by the government, the best way to meet health care needs?
  • Fees for private health insurance premiums in the US can cost $11,000 per family, per year, regardless of your socio-economic status. Would you be willing to pay that and/or could you afford it?

Quick Resources

Resources

Websites

Building on Values: The Future of Health Care in Canada

www.hc-sc.gc.ca/english/care/romanow/index1.html
The Romanow Report, the final product of the Commission on the Future of Health Care in Canada.

But What Does the Evidence Really Say? (Canadian Healthcare Association)

www.cha.ca/documents/CHA_OECD_Analysis.pdf
An analysis of the often quoted OECD statistics on healthcare spending.

Canadian and American Health Care Systems Compared (Wikipedia)

en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared
How do our two systems compare in Wikipedia, the online encyclopaedia that anyone can edit?

Canadian Doctors for Medicare

www.canadiandoctorsformedicare.ca/caseformedicare.html
Argues that publicly funded health care is better for patients and doctors. Links to additional articles and research reports.

Canadian Women's Health Network: Canadian Health Care Crisis Is About Values, Not Money

www.cwhn.ca/resources/kickers/crisis.html
Brief synopsis of ethicist and medical doctor Nuala Kenny's articulation about the underlying forces driving our health care crisis.

CBC News In Depth: Health Care

www.cbc.ca/news/background/healthcare/
Detailed articles covering the Canadian health care debate, and comparisons with other countries.

CBC News Inquiry: Problems and Cures: Romanow Report Released

www.cbc.ca/healthcare/
Extensive news coverage of the report and relevant health statistics.

Council of Canadians

www.canadians.org/browse_categories.htm?COC_token=&step=2&catid=218&iscat=1
Clear and concise fact sheets opposing health care privatization.

Fraser Institute

www.fraserinstitute.ca/health/index.asp?snav=he
Argues that applying market forces to Canada's health care system will reduce spending and improve care.

It's about Access (Canadian Medical Association)

www.cma.ca/index.cfm/ci_id/48620/la_id/1.htm
Report explores scenarios for expanding Medicare and involving private care.

Mending Medicare (Canadian Centre for Policy Alternatives)

www.policyalternatives.ca/Reports/2006/05/ReportsStudies1364/index.cfm?pa=BB736455
An accessible, magazine-style report that outlines the benefits of universal health care and provides background on other health care models

OECD Health at a Glance: Executive Summary

www.oecd.org/document/14/0,2340,en_2649_34631_16502667_1_1_1_1,00.html
Read the Executive Summary for an overview of the global health trends that are affecting Canadian health care.
Direct link to the executive summary: http://www.oecd.org/dataoecd/58/47/35624825.pdf

OECD Health Data 2005 - Country Notes

www.oecd.org/document/46/0,2340,en_2649_37407_34971438_1_1_1_37407,00.html
Descriptions of health care systems and statistics for OECD countries, including Canada and the US.

University of Alberta: Health Care Resources

www.augustana.ca/centres/ronningcentre/work/conferences/healthcare/resources.html
Fact sheets on key issues in the debate on public vs. private health care from the Ecumenical Health Care Network.

The US Health Care System: Best in the World or Just the Most Expensive?

dll.umaine.edu/ble/U.S.%20HCweb.pdf
An analysis by the University of Maine, detailing problems in the American system and exploring alternatives.

Wikipedia: Universal Health Care

en.wikipedia.org/wiki/Universal_health_care
Pro and con arguments for universal health care along with definitions and further links.

Blogs

Free Market Doctors

www.freemarketdoctors.blogspot.com/
Can free-market principles revitalize US health care? Medical student's blog highlights relevant reports and news stories.

The Health Care Blog

Large US blog dedicated to health policy issues. Search for Canada to find posts and comments.
www.thehealthcareblog.com/the_health_care_blog/2003/11/policy_oh_canad_1.html

Health Care For All California Blog

A recent post on Canadian health care with many comments.
www.healthcareforall.org/blog/?p=27

Vive le Canada - Privatization

www.vivelecanada.ca/index.php?topic=privatization
Dedicated to promoting Canadian sovereignty, this outspoken and sometimes controversial blog has a topic on privatization.

Papers or Articles

51% Say Private Care OK

National Post
A survey analyzes Canadians' opinions about private health care. Survey questions also available online.
www.canada.com/nationalpost/news/story.html?id=27b5eb83-d387-40a5-90a8-f7409d181490&k=75124

Canada Trumps U.S. in Healthcare, Study Says

Harvard Crimson (June 6, 2006)
www.thecrimson.com/article.aspx?ref=513741
An American study reveals that although Canadians are healthier and have greater access to health care, Americans are more satisfied with their care.

Europe's Health Reforms - Hard Lessons

The Tyee (March/April 2006)
thetyee.ca/Series/2006/03/08/EuropeHealthReforms/
A hard-hitting series providing information about private-public partnerships in the countries Gordon Campbell visited on his recent health care tour.

Health Reports Deemed Unhealthy: Even Romanow Got It Wrong (May 12, 2006)

Kingston Whig-Standard
Available through Canadian Newsstand
A medical and business professor team up to diagnose our health care system's woes. They conclude that Romanow's report only perpetuates the crisis.

In Health, Canada Tops US

Los Angeles Times (February 23, 2004)
A glowing review of the Canada's medical system from a number of US health experts.
www.commondreams.org/headlines04/0223-01.htm

Is There a Doctor in the House?

The Tyee (May 4, 2006)
thetyee.ca/News/2006/05/04/Doctorinthehouse/
Details the financial conditions of average general practitioners in BC and identifies how these affect quality of care.

MDs' Public-Private Opinions

www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/CMA_Bulletin/English/2006/bulletinfeb28.pdf
CMA Bulletin
How do Canadian doctors feel about allowing private health insurance?

Medical Bills Can Lead to Bankruptcy

WebMD (February 2, 2005)
www.webmd.com/content/Article/100/105540.htm
Summarizes a Harvard Medical School study claiming approximately 50% of personal bankruptcy claims in the US are due to medical expenses.

Medicare Critic Turns on Charm, Turns up Rhetoric

Toronto Star (June 3, 2006)
Available through Canadian Newsstand
Critic debates points made by Dr. Brian Day, a leading physician in the health privatization movement.

Rejecting the Canadian Way

Ottawa Citizen (May 18, 2006)
A Canadian living in the US argues that government control over drug choice and medical care is harmful.
www.pacificresearch.org/press/opd/2006/opd_06-05-18sp.html

So Many Patients and Too Few Dollars

Globe and Mail (June 5, 2006)
Available through Canadian Newsstand
Brings the challenges of balancing a hospital's budget to life.
Also available here: www.theglobeandmail.com/servlet/story/RTGAM.20060605.wxhospital05/BNStory/National/home

US Health Care Costs Double Canada's

National Public Radio (August 22, 2003)
www.npr.org/templates/story/story.php?storyId=1404971
New England Journal of Medicine research suggests that Canada's system costs less because it is a single-insurer system.

Who Will Start a Frank Debate on Health Care?

Globe and Mail (April 1, 2004)
Available through Canadian Newsstand
Health care costs are rising and the money has to come from somewhere. Argues that we need to debate increasing taxes or allowing private care.

Books

Better Medicine: Reforming Canadian Health Care

Dr. David Gratzer (ed.) (2002)
Thoughtful essays detail other health care models with more private-sector involvement.

Bottom Line: The Truth Behind Private Health Insurance in Canada

Diana Gibson and Colleen Fuller (2006)
Debates seven beliefs cited as reasons for privatizing healthcare.

Broken Promises: Why Canadian Medicare is in Trouble and What Can Be Done to Save It

Les Vertesi, MD (2003)
Argues that Canada should institute an internal market for health care and pay hospitals for their services, instead of funding global budgets.

Clear Answers: The Economics and Politics of For-Profit Medicine

Kevin Taft & Gillian Steward (2000)
Clearly details the economics of privatization, explaining for-profit health care's economic and social costs.

Code Blue: Reviving Canada's Health Care System

David Gratzer (1999)
Careful argument that universal health care is fundamentally flawed - if people don't have to pay for services, they will overuse health care. Suggests medical savings accounts as an alternative.

First Do No Harm: Making Sense of Canadian Health Reform

Terrence Sullivan and Patricia M. Baranek (2002)
A clear, concise picture of Canada's healthcare system, along with a breakdown of the economics of privatization.

Four Strong Winds: Understanding the Growing Challenges to Health Care

Michael B. Decter (2000)
Argues that four global trends are pressuring our health care system.

The Health Care Mess: How We Got into It and What It Will Take to Get Out

Julius B. Richmond, MD, & Rashi Fein, PhD. (2005)
A former US Surgeon-General and a professor of medical economics argues that the "Canadian-like" system is the most effective, efficient, and equitable health care insurance system.

Kill or Cure? How Canadians can Remake Their Health Care System

Dr. Carolyn Bennett with Rick Archbold (2000)
Argues that privatization is actually more costly and provides clear, practical solutions for problems in our current system.

Life Before Medicare: Canadian Experiences

Helen Heeney (1995)
Heartbreaking stories illustrating Canada's previous medical system.

Medicare Myths: 50 Myths We've Endured about the Canadian Health Care System

Dennis J. Furlong, MD (2004)
Is there really a health care crisis? Not yet, but Furlong, former New Brunswick Minister of Health, advocates some fee-for-service reforms.

Prescription for Excellence: How Innovation is Saving Canada's Health Care System

Michael Rachlis, MD (2004)
Argues that universal care was and remains the best model and that better management and innovation is what Medicare needs.

Profit is not the Cure: A Citizen's Guide to Saving Medicare

Maude Barlow (2002)
Details the management of private health care in other countries and the motives and tactics of the pro-privatization movement.

Squandering Billions: Health Care in Canada

Gary Bannerman and Don Nixdorf, DC (2005)
A journalist and chiropractor analyze our system's paradoxes and inefficiencies, such as its reliance on gatekeeper doctors, "big pharma," and highly paid administrators.

Uninsured in America: Life & Death in the Land of Opportunity

Susan Satt Sered and Rushika Fernandopulle (2005)
Stories of those who have slipped through the cracks in the US health care system.

Universal Health Care: What the United States can Learn from the Canadian Experience

Pat and Hugh Armstrong (1998)
How did we first get universal health care? What are its benefits compared to other systems?

Wasting Away: The Undermining of Canadian Health Care (2nd ed)

Pat and Hugh Armstrong (2003)
Argues that privatization schemes and a steady but largely invisible undermining of the universal health care system is the real cause of the health care crisis.

What Good Is Health Care?

Dr. Nuala P. Kenny (2003)
Examines the global forces shaping our health care debate and asks, "What are our values as Canadians and how should we respond?"

Privatizing Health Care Discussion Guide PDF 390KB

This guide was created to enhance your understanding of this issue. We hope it provides you many useful resources to enrich your experience of Speak Up.