Canadians want choice in health care

There is one policy approved by a large majority of the Canadian electorate that has not been debated during the election campaign. The great absent is private health care.

A Canada-wide opinion poll carried out in December by Leger Marketing asked respondents. “Would you find it acceptable or not if the government were to allow those who wish to pay for health care in the private sector to have speedier access to this type of care while still maintaining the current free and universal health care system?” All over Canada, 58% of respondents answered yes, while 37% said no.

There is an absolute majority for allowing private health care everywhere, from 51% in the Prairies to 72% in Québec. The only exception is Ontario, where 49% answered positively, but note that only 45% answered negatively – still a relative majority for private health care.

The 58% majority in favour of parallel private health care seems to be increasing. In May 2004, the same question elicited a positive answer from 51% of Canadian respondents, seven percentage points less than today.

Add to this a crucial fact: in June 2005, the Supreme Court ruled, in the famous Chaoulli case, that it is a violation of the Quebec Charter of Rights and Freedoms to prevent individuals from purchasing private insurance to cover health services now covered only by the public monopoly. A Compas survey just found that 7 out of 10 Canadians favoured the Supreme Court decision.

Soon after the federal election, a public consultation in Quebec will mark the first step towards abolishing the prohibition of private health insurance for basic health care. This will change the health care environment not only in Quebec, but all over Canada. It is impossible that other major provincial governments will continue to let only the very rich obtain private health care in the U.S. and elsewhere around the world, while ordinary people in Quebec will have the option of purchasing insurance to get similar services in the private sector.

Poorly represented electors?

The puzzle is that, in the current electoral campaign, none of the major political parties has addressed this issue in order to satisfy the wish of a majority of the electorate. The Liberals are stuck in their “10-Year Plan to Strengthen Health Care,” their “multi-year targets,” their throwing more money at the public system. As on so many issues, the NDP and the Bloc Québécois more or less follow the Liberals.

Even the Conservatives have basically defended the same approach. Like the Liberals they propose that patients on waiting lists should be able to receive treatments, at public expense, “in another jurisdiction.” They oppose any breach in the public health care monopoly.

Why do all major political parties ignore what seems to be the views of a clear and increasing majority of the electorate? Why doesn’t one of these parties play the role of political entrepreneur and promise what the majority wants? Why do all these parties play ostrich with a process of demonopolization that seems irreversible?

Whatever the answers to these questions, the new government to be elected on Monday will have to take the bull by the horns. This cannot mean throwing more money at a system where the lack of competition and diversity is the problem. This cannot mean adumbrating a second “fix of a generation” during the same year, or a “multi-year fiscal framework” or yet another “plan.” It means abolishing the only public health insurance monopoly in the Western world.

Valentin Petkantchin is Director of Research at the Montreal Economic Institute.

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