The debate over private health care often seems lopsided.
On one side are abstract notions about equality; on the other are compellinganecdotes about people in pain waiting for treatment.
It’s hard not to side with the people in pain. Why shouldn’t they go to aprivate clinic and get that new hip now?
They’re allowed to spend all they want on clothes, wine or any otherindulgence.
Why do we stop them from spending on worthy projects like pain relief orbody-part replacement?
Denying someone this opportunity does seem like an infringement of thatperson’s rights.
But that person isn’t the only one with rights.
The real question is whether allowing that person access to a privatesystem — allowing him or her to jump to the head of the line — wouldultimately hurt the health care of millions of other Canadians.
A majority of judges on the Supreme Court concluded last week that itwouldn’t.
Their decision is at odds with the findings of two lower courts and numerousstudies, including the exhaustive inquiry into health care headed by RoyRomanow.
The judges note that other countries allow private health care and also havegood public health-care systems.
But in a powerful dissent, three Supreme Court judges questioned suchcomparisons: “(I)t is particularly dangerous to venture selectively intoaspects of foreign health-care systems.”
The Supreme Court majority relied heavily on a survey of foreign health-caresystems prepared by Michael Kirby, who headed a 2002 Senate investigationinto health care.
But Kirby’s foreign survey actually points to some problems in othercountries where the wealthy are allowed to buy their way to fastertreatment.
In his final report, Kirby rejected the idea of allowing this in Canada,arguing that it would violate the principle of equal access.
Certainly, evidence from countries like Australia is not encouraging.
Dr. Joel Lexchin, an emergency room doctor who teaches health-care policy atYork University, spent six months working at a hospital in Australia.
He says that Australian doctors have gravitated toward the more lucrativeprivate system and in some specialties — particularly surgical ones — manydoctors no longer take patients who can’t pay extra.
This is an all-too-familiar problem.
Once the rich start buying their services outside the public system, theyresent paying taxes to support it.
They press for, and usually win, tax reductions, leaving inadequate fundsfor the public system.
As the public system deteriorates, it ends up serving only the poor — whohave little clout with governments.
Politicians don’t mind letting the poor sleep on the street, so they aren’tlikely to mind if the poor lack timely access to hip replacements.
The Supreme Court has breathed new life into the privatization campaigns ofright-wing think tanks.
Expect to hear lots more from the Fraser Institute, whose ideas are just asunpopular with Canadians today as they were a week ago, but who now havefour judges backing their cause.
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