Public Policy

We Should Build Back with Private Healthcare

Gwyn Morgan
October 26, 2021
Its many supporters claim Canada’s vaunted universal healthcare system was simply overwhelmed by the sheer number of Covid-19 patients and the relentlessly recurring waves of the pandemic. But if that is the case, how did the U.S. hospital system (with a few local exceptions) easily accommodate and treat a far higher per capita caseload than Canada? Examining key statistics in each country, Gwyn Morgan concludes that something serious is ailing Canada’s healthcare system that Covid-19 did not cause. It can only be cured, Morgan writes, when those who call the shots on healthcare policy overcome their ideological aversion to innovations and ideas that are already used in every other highly developed country around the world.
Public Policy

We Should Build Back with Private Healthcare

Gwyn Morgan
October 26, 2021
Its many supporters claim Canada’s vaunted universal healthcare system was simply overwhelmed by the sheer number of Covid-19 patients and the relentlessly recurring waves of the pandemic. But if that is the case, how did the U.S. hospital system (with a few local exceptions) easily accommodate and treat a far higher per capita caseload than Canada? Examining key statistics in each country, Gwyn Morgan concludes that something serious is ailing Canada’s healthcare system that Covid-19 did not cause. It can only be cured, Morgan writes, when those who call the shots on healthcare policy overcome their ideological aversion to innovations and ideas that are already used in every other highly developed country around the world.
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The coronavirus hit Canada in March 2020. By the time that first wave had subsided in the summer, hundreds of thousands of scheduled surgeries and other procedures had been postponed across the nation. But before that huge backlog could be substantially reduced, a second and then a third wave of the virus struck, increasing the backlog by hundreds of thousands more. Adding to the clinical risk of these surgical delays was the mental health impact of living with aggressive afflictions such as cancer.

Just as hospital wards became available once more to regular surgeries last spring, a fourth wave driven by the delta variant overwhelmed ICUs in Quebec and Ontario before moving west to plunge Saskatchewan and Alberta hospitals into their current crises.

xThis isn’t the patient’s fault: Prior to the Covid-19 pandemic, Canada’s perennially full and lavishly funded healthcare system was consistently assessed as woefully unprepared to handle any crisis, due to long waiting lists, overwhelmed hospital capacity, shortages of medical staff and lack of diagnostic equipment. (Source of bottom left image: The Canadian Press)

The pandemic will eventually subside. While Covid-19 deaths can be tallied, the death toll due to all those delayed surgeries is virtually impossible to determine, the path of each patient’s affliction being different. But given the hundreds of thousands who experienced both physical deterioration and mental stress due to delays in treatments ranging from relatively simple diagnostic procedures all the way to complex surgery and organ transplants, that toll could be as high or even higher than the deaths from Covid-19 itself.

The real tragedy for families who lost loved ones due to Covid-19-triggered treatment delays is that those deaths occurred mostly because our healthcare system was woefully less prepared than those in other developed countries. Canada is the only country that went into the pandemic with zero unused hospital capacity and long waiting lists. A report by the Fraser Institute in 2020 comparing the performance of 28 countries with universal healthcare found that, despite having the second-highest spending per capita on healthcare, Canada ranked dead last in providing timely care and had the longest waiting lists.

Canada also ranked second-last in hospital beds per capita, which helps explains why so many surgical patients were displaced by Covid-19 patients. Our other healthcare resources have also been in relative decline. Out of 28 countries, we ranked 26th for the number of doctors per capita and were also near the bottom in diagnostic equipment such as MRI and CT scanners.

Canadians are prone to thumbing their noses at American healthcare, but our neighbour’s much-disparaged system was vastly better prepared for the Covid-19 crisis. Compared with Canada’s virtually zero spare capacity, hospital bed occupancy in the U.S. was just 64 per cent at the beginning of the pandemic. The U.S. was hard hit by Covid-19 – especially in certain states such as New York. But because that country went into the crisis with ample unused hospital bed capacity and a world-leading 35 ICU beds per thousand population, nearly three times Canada’s meagre level of 12 per thousand, it weathered successive waves of the virus with little displacement of non-Covid-19 patients.

xAmong the 28 most highly developed countries, Canada is the only one that all-but outlaws private healthcare delivery and private medical insurance, and does so for ideological reasons. Pictured, private healthcare in Germany (top) and in the United States (bottom).

How was our healthcare system in province after province allowed to fall into this sad, dangerous state? As the Covid-19 crisis winds down, that’s a question grieving Canadians should demand an answer to. Given that we’re one rung from the top in the Fraser Institute’s 28-country ranking of healthcare spending, the answer isn’t lack of funding. Then what is it?

Among those 28, Canada is the only one that outlaws private sector participation in the delivery of healthcare. Can you imagine if you could only get food from a government farm or a vehicle from just one government manufacturer? Quality? Service? Innovation? Not likely! Gradual deterioration of quality, customer service and supply? Almost certain. And the outcome? Rationing of services, primarily via waiting lists.

Prime ministers, premiers and healthcare administrators have known for years that our sclerotic government-run monopoly system suffers the dual afflictions of unsustainable cost growth and ever-lengthening waiting lists. Unions, academics, much of the news media and other interests opposed to private clinics and hospitals vigorously perpetuate the myth that Canada has the “world’s best health system.” But the 28-country comparison clearly shows the opposite.

xCanada’s Deputy Prime Minister and Minister of Finance Chrystia Freeland’s tweet about Erin O’Toole’s alleged support of privately-operated healthcare delivery was later deemed to be deceptive, intentionally omitting O’Toole’s clarification comment of “inside of universal healthcare”; regardless, Prime Minister Justin Trudeau shamelessly repeated the deception.

Entrenched fear of private-sector participation played a role in the recent federal election campaign when Liberal candidate Chrystia Freeland posted a Twitter video of Erin O’Toole stating he would allow provinces to “experiment with real healthcare reform including private for-profit and non-profit options.” Twitter later flagged Freeland’s post as “manipulated media” because it omitted O’Toole’s words “inside of universal healthcare.”

Liberal Leader Justin Trudeau repeatedly ignored that clarification, saying, “Erin O’Toole confirmed he wants to bring private, for-profit healthcare to Canada…” It was a bitter result that Trudeau’s shameless use of Freeland’s deliberate deception was rewarded, helping the Liberals return to power. And ironic given the Liberals’ campaign focus on the perils of disinformation on the internet.

Canada’s doctors, nurses and other healthcare workers are indeed world-class and highly dedicated. They have continually risked their own health doing everything humanly possible to balance the needs of Covid-19 and non-Covid-19 patients alike, even as they labour under an egregious lack of facilities and inept allocation of funding that will see, for example, the construction of glitzy new facilities but then leave them largely dark and empty for lack of operational funding. Canada’s healthcare professionals and workers deserve our support, consideration and admiration. But once the pandemic is behind us, Canadians should demand that our dangerous and dysfunctional government-monopoly healthcare system be opened to private-sector competition – as in virtually every other country around the world.

Gwyn Morgan is a retired business leader who has been a director of five global corporations.

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