TWO-TIER HEALTHCARE Few can deny that healthcare is one of the most important things we require as citizens. Without our health, we have reduced capacity and a reduced enjoyment of life. It is therefore very important that we find a way to access the best possible healthcare…
Canada is a fortunate country as it guarantees healthcare for all. But again the problem of costs arises. The government pays for everything, no matter how expensive. The result is that the Canadian healthcare budget is growing out of control. We need reform. The most moral and just kind of reform would be to implement a two-tier or mixed system of healthcare delivery. This will lower costs and ensure that healthcare does not become unaffordable for all. The truth is that healthcare is as Norman Daniels puts it “a special good” (146). It it not like other things in our economy and society. The economist Brian Lee Crowley puts the issue succinctly as follows: Two-tier health care is a slippery concept. Everybody seems to think they know what it is, but I think that there is a lot more confusion than people realize. As some have already pointed out, we have a lot of angry discussions about “preventing” two-tier access in Canada, and yet we clearly already have multi-tier access, including to insured services. If you are on workers comp, are in the RCMP or the military, if your company has its own salaried physicians, if you use a private hospital like Shouldice in Toronto, if you are a member of the medical professions or know someone who is, or are just articulate and determined, or if you travel abroad to the US or any one of a number of other places, you can get better, faster or more satisfactory care than someone who just lets the wheels of medicare grind on. Moreover, technology is allowing the remote delivery of more and more health services, so the ability of governments to frustrate patients’ desire to get better and faster treatment than the government is willing to provide them, is declining, and that decline will accelerate. (Crowley) The very phrasing of the debate as one of different tiers suggests something about unfairness. Ideally, this would be a debate about a mixed system which offers public and private, not a system for rich and poor. There are many in Canadian who consider the healthcare system the thing they are most proud of. But this is an idea that belongs to an earlier phase of Canadian history. Throughout most of Canadian history, Canadians have defined their identity in the negative. They have seen what happened south of the border and had a knee-jerk reaction, saying: We're not like that. They have refused to consider how they can learn from the best examples in the United States. The attitude to many on the left in Canada, is that nothing must change about the healthcare system. It must remain exactly as it is. Otherwise, Canada will become like the U.S. This is a very simple argument which works best on children and not on reasonable adults. This is, at its heart, an immoral argument. It is based on jingoism, not reality. The truth is that by denying Canadians the rights to choose between public and private healthcare we are limiting freedom and increasing the burden on the public system. The most moral thing to do in this situation is to permit the market to work, permit the market to lower prices and allow competition. That is the best possible way for consumers to get what they need. The alternative is to continue to allow the healthcare system to be centrally planned and controlled, and to continue the immoral rationing that already happens. It is important to note the Supreme Court of Canada decision in Chaouilli, which stated that not providing ...
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