I would like the discuss the following two questions. Who owns health? Why did Saskatchewan lead the way in universal health care in North America?
On a hiking trip yesterday, a companion and I had a thought-provoking discussion on the private ownership of our health care system, an idea which I strongly and passionately oppose. In his opinion, everything — I kid you not! — should be privatised, including rivers and the air. I wanted to see how far he would go with such a belief system, so I asked him about his thoughts on health care. The following passages contain a short summary of our heated discussion. I was frightened by its implications: I hope such firmly held beliefs of privatisation and deregulation are not reflective of significant portions of youths of my generation; I am hopeful that there is growing consciousness among us, the citizens of today and tomorrow.
My worthy opponent argued that our health care system should be completely privatised, which would lead to decreased costs and increased quality of patient care. I was completely baffled. I did not get his logic. Tell me more. How would costs go down? For whom would the quality of care increase?
He reasoned that costs would go down because the government would no longer hold a monopoly on health care, which would ensure market competition and reduced costs. I was confused. I still did not understand. Explain more, I asked, especially with regards to how this competitive process would occur. He elaborated by saying that the current system of medical education is excessive — again, I kid you not — and unnecessarily long. I was rather amused listening to such a statement, especially since the claim came from someone whose field of studies relates more closely to the dealings of Goldman Sachs than to genuine love for human kind. Please, continue and humour me. By deregulating medical education, he proceeded to argue, it would not take so long to train medical professionals and a free-market competition would emerge since better trained doctors would have the right to charge more while the not-so-well-trained ones would have to charge less . WHAT?!?! I don’t blame him for failing to understand how the system works. I then explained to him the rigours and purpose of post-graduate training such as residency.
Here comes the frightening part of the story. For whom would the quality of care increase, I asked. For everyone, he answered. That did not make sense to me, so I presented the following scenario him:
There are two people in this story: persons A and B. Person A is a white, male business executive who earns $100,000 per year. Person B is an Aboriginal single mother who raises two kids while carrying the burden of diabetes and working three part-time jobs. One day, both persons A and B get into a car accident and require life-saving surgery. My question to you is: would both person A and person B receive the same quality of care in a privatised health care system?
I did not get a satisfying answer. After pressuring him two more times with the same question, I was told that “charities serve an important function and can be effective if properly utilised”. I informed him that no, persons A and B would not get the same quality of care if the health care system were privatised, and that it would be the rich who would benefit from paying for more sophisticated and rapid medical services while the poor suffer. To my utter astonishment, he attempted to retort that because person A is making a greater contribution to society, person A deserves better care! How can one justify such a statement? The weak, poor, vulnerable, and most marginalised members of society deserve more support and attention than the political-economic elites. Had my worthy opponent read about the social determinants of health, he would have realised that addressing the root of the problem — improving subsidised housing, early childhood education, health literacy, just to name a few — and offering efficacious and timely health care services to disadvantaged populations would decrease inequity in our society, which would be beneficial for society as a whole.
Because my companion claimed that privatising the health care system would reduce costs and ultimately improve services, I proposed the following question:
Why then, don’t we also privatise the fire department and police force?
Contrary to his other beliefs, he said that we should not privatise these organisations. Why not, I asked. He thought about it for a minute or two. Then, he replied that these organisations should not be privatised because they protect our private property. I could hardly believe what I was hearing. Were you saying, sir, that protecting our private property is more important than protecting our health? Yes, he replied.
I recently finished a book titled Steps on the Road to Medicare: Why Saskatchewan Led the Way (2002) by C. Stuart Houston. The book concludes as follows:
Medicare got its start in Saskatchewan because, as in the biblical parable, the seeds fell on fertile ground. The thinly populated, relatively poor province of Saskatchewan consistently led all of Canada in public health innovations and legislation, including twenty-nine firsts. Many of these were firsts for North America, not merely Canada… But why Saskatchewan?
In a province without a large city, there were few rich people or powerful corporations. Rarely did people have surplus cash, but there was an abundance of good will, of trust in one another, of a willingness to help each other, and of a sense that lives could be improved through communal effort… Mutual co-operation among pioneer settlers was more the rule than exception; it was better to do things together than separately…
Saskatchewan residents had a strong sense of justice and fairness. Honesty was the rule. A high priority was given to health matters by the public, especially by farm women… the co-operative spirit of the predominately rural Saskatchewan people… had been developed to a higher and more practical degree than in any other jurisdiction in North America.
The advances made in Saskatchewan required two ingredients: the co-operative spirit, as described above, and the individuals whose passion and direction became the catalyst… The people of Saskatchewan were, to use today’s term, proactive. Whether bureaucrat, politician, or scientist, each leader saw a need, gathered the evidence necessary for an informed decision, and then acted expeditiously… Nearly immediate response by government was then more the rule than the exception… These were simple times, without red tape. The time was right.
Recent Comments