Sarah Yuan
The Silhouette

The topic of two-tier healthcare systems has been a frequent subject of discussion since Dr. Jacques Chaoulli’s win against the Attorney General of Quebec and the Attorney General of Canada. Though the arguments for the privatization of healthcare are sensible, there are many underlining factors that must also be considered. Canada has the second most expensive health system in the world in terms of GDP, but we don’t have the second-best health outcomes in the world. Our beyond-expensive system offers us just mediocre outcomes. It is true that our capabilities should be much higher but moving towards the establishment of a two-tier healthcare system is not the answer.

Contrary to belief, having more private funding will not improve the sustainability of our healthcare system. Countries in which private spending is high actually spend more in total on healthcare. The U.S., for example, spends more public dollars per person than Canada does and yet 48 million Americans remain uninsured. It seems that Americans are not getting much more after paying all these extra expenses, but they do pay much higher prices for what we as Canadians take for granted.

On top of that, private clinics often “cherry-pick” the healthiest patients with minor or acute care needs (people who are the most profitable). More complicated and chronic patients are often denied services because they require more time and care, resulting in a decline of the clinic’s profit.

If Canadian physicians were permitted to give private care to patients, an equitable portion of people who make a reasonable living will be able to choose to spend a few hundred dollars to see a good physician or maybe even a couple thousand to have some cataract surgery done immediately. Sounds like a good plan, right?

Although a loan might be required for surgery, your medical expenses should be deductible from your taxes in April. This would satisfy almost everyone who is employed except the millions of poor people, pensioners, immigrants, people with disabilities, and people with large families who don’t have sufficient resources to experience such luxury.

Moreover in countries that have two-tier systems, typically only the wealthiest can afford such service. In the U.K. for example, only 11.4 per cent of the population holds a subscription to private health insurance. In other words, a majority of Canadians would not actually benefit from being able to purchase private health insurance as they will either not qualify for it, or they won’t be able to afford the premiums.

Ultimately it’s no secret that there isn’t really an equality of access in the Canadian medical system, as those with better education and better connections can more effectively find a way to receiving prompt treatment. A study that appeared in the Canadian Medical Association Journal found that wealthier patients were 50 percent more likely to be taken on as new patients by doctors than welfare recipients.

It is worrisome to find a conspicuous bias against poor patients within our healthcare system. Not only do they have fewer resources than wealthier patients, but they also face many more barriers to good health and are the ones who will benefit the most from the access to a physician.

Allowing the establishment of a two-tiered healthcare system is to allow the drawing of a thick and definitive border between the rich and the poor. Access to healthcare should be based on an individual’s need and not their ability to pay. If available resources are restricted we should revisit what is and is not essential. Healthcare should never turn into a competition for those earning the greatest profit.  Is this what you would want for the country we’ve all lived in and loved?


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