Commentary on the Mazankowski Report on Alberta’s health care system

Don Mazankowski and the other members of his committee deserve congratulations for a good first step. They had the courage to expose and confront some of the most glaring and politically sensitive flaws in medicare.

Their job was to recommend ways of saving and improving Alberta’s public health care system. Their report says the system is under strain. It can take up to 6 months to get a hip operation. People wait as long as 18 weeks for more major surgeries. All this while Alberta is spending more and more on health care every year. Spending could hit 50% of the provincial budget by the year 2008.

But given these disturbing statistics and many more like them, Mazankowski was reluctant to go for the ultimate reform. Instead, he chose a middle ground – maintain a virtual government monopoly in financing health services but contract out some services to the private sector. This quasi-internal market approach certainly deserves a trial. But so does the free regulated market of parallel public and private health services and insurance.

It was unfortunate that Mazankowski stopped short of calling for the repeal of provisions in medicare legislation that discourage or prevent parallel private health care.

It would assure universal and timely access to quality health services; It would restore a full measure of individual freedom, responsibility, and market competition in health care.

Take a look at the city of Stockholm in socialist Sweden. Five years ago it sold one of its public hospitals to a private corporation. Today it provides quality medical services delivered by formerly unionized workers who are now freed of restrictions on what they can do. The workers’ salaries have increased; medical care has improved… while costs have been reduced. No wonder Stockholm is planning to sell off seven more of its hospitals.

This is happening all over Europe. All of the OECD countries now have parallel private health systems. Canada stands alone with Cuba and North Korea in having a virtual public monopoly over healthcare. Perhaps that’s one of the reasons, why the World Health Organization ranks Canada 30th in the world in health care performance.

An environment of health system freedom and personal choice has been strongly supported by public opinion surveys in Canada over the past four years. Now it is up to our forward-looking provincial and federal politicians to undertake this reform project with some urgency.

Otherwise, it will be left up to patients to challenge the system – like the Montreal man who waited a year for his hip surgery. The government wouldntt let him have the surgery done privately.

The Alberta proposals clear the air, improve the language of debate and are important steps in the eventual liberalization of Canada’s deteriorating health system.

For Commentary I’m Edwin Coffey in Montreal.

J. Edwin Coffey MD is an Associate Researcher with the MEI and co-author of Universal Private Choice: Medicare Plus, A Concept of Health Care with Quality, Access and Choice for All Canadians.

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