MEDICARE at CROSSROAD
Canada is at the crossroad today. The number of older Canadians is increasing dramatically as the baby boomers age. All across the country, waiting lists keep growing and many patients cannot find a family doctor. Governments have huge deficits and hard-pressed for additional funds. Critics argue that urgent action is needed and that by encouraging people to pay will lessen wait times. However, in reality, Canadians would be worse off if they had to pay for some of their medical care themselves.
First, if patients have to pay for medical care currently publicly funded, many families will avoid going to the doctor endangering their health. A study found that, patients charged user fees in Saskatchewan in 1968 and eliminated seven years later reduced the annual use of medical services by about six per cent (Beck, R.G. & Horne, J, 787). In 1996, Quebec implemented a scheme requiring patients to pay part of the cost of drugs. The Journal of American Medical Association conducted a study on this, which revealed that patients reduced their use of fewer critical drugs and critical drugs and seriously affecting their health (421). This would deter or delay using the health system until their illness gets serious. User fees would deter the frugal, less advantaged and lower-income from getting the help that they need. Do we as a society want parents to decide whether parents should take their kids to the doctor or buy groceries?
Secondly, health insurance policies are inconsistent, expensive, cumbersome, hard to discern, full of fine print and contain many loopholes. Most Canadians face a huge tax burden, rising cost of living and will not be able to pay for these additional medical expenses out of the pocket. To offload risk, most individuals will resort to buying health insurance.
In their article Raisa Deber and Noralou Roos rightly noted that insurance policies discriminate the needy people:
The insurance package that patients buy is susceptible to rapid change. In their article, expert’s highlight, a report from the Commonwealth Fund that raises concerns regarding premiums increasing thrice the rate of median income. Deductibles have also increased by 80% during 2003 to 2009. Furthermore, the report contains grim warning that the most vulnerable and in need of medical attention have trouble finding an insurance company that will cover them.
Insurance companies will be cherry pick the young and healthy and avoid patients with complicated medically issues. One can draw parallels with car insurance where selected drivers having low premiums while neighbourhoods with newcomers have very high premiums. Insurance companies will be discriminate against patients with known pre-existing conditions and use the fine print to deny coverage of certain ailments. Even worse, patients face the prospect that the insurance coverage can be cancelled – leaving the vulnerable at the mercy of their company.
Finally, Allowing Canadian to pay for more of their medical care will lead to the slippery path of US two-tier health systems. A system where as former Prime Minister, Jean Chretien said, “down there, they check your wallet before your pulse” where well-off has access to quality medical care, while roughly 50 million people are without any health coverage (10). Allowing a two-tier system would lead to a private paid health care sector to draw doctors from the public system. We already have a shortage of doctors and if physicians work outside of the public system, the supply will be reduced [in the public system], and thereby actually increasing waits times. Ask yourself, how many