The Immediate Threat: Private Delivery

I was in Ottawa on Dec. 1 lobbying Members of Parliament to extend the health accord. One of the organizers stressed that the government’s objective was to expand opportunities for private health insurance.  While this is undoubtedly part of the long-term goal, making the defense of public insurance the focus of our strategy plays in to the conservative’s hands.

There are reasons why Harper and other strong free market proponents say they support Medicare and the Canada Health Act.  These programs have broad public support; they are, in truth, the “third rail” of Canadian politics.  Also, Medicare works for broad sections of the business community by keeping their employee health costs down and increasing their international competitive advantage. Currently dismantling universal public health insurance is not politically viable.

But there are immediate opportunities for more private delivery and it is becoming increasingly obvious that this is the immediate objective.   Prime Minister Harper has mentioned expanding alternative delivery methods, i.e. for-profit delivery, as part of the new health accord.  Don Drummond, the architect of the next round of Ontario’s health care restructuring, has explicitly said that the public health care system will not touched. Yet he followed this reassurance by a statement that he would like to see more private delivery of publicly financed services.

Along with the obvious advantage for private health care companies – more markets with stable government backed funding for their services – private delivery also can become a wedge to open the door for more private insurance.

  • The private profits from government financed services are often invested in more for-profit companies.
  • The larger the private health care sector the larger the lobby for more private involvement
  • For-profit companies often try to increase their income by marketing some of their services directly to patients who can afford to pay more than government reimbursements, for example, in Canada, rehab, diagnostics, and primary care clinics have all taken this route.
  • The more opportunities for private payment to for-profit companies for essential health services, the more demand for insurance, which brings us back to private delivery as a wedge expand the private insurance sector and limit Medicare.

Strategically, for those favoring a public health care system, it is important to focus on limiting and stopping private delivery.  Along with maintaining public services, it directly addresses the Conservatives current for-profit health care goal.

Identifying dismantling public insurance as the primary goal gives the Harper government a free pass.  They plausibly deny it, because there is no short-term plan, and our claim becomes a distraction from the push for more for-profit delivery. Reinforcing the public vs. private insurance debate also muddies the water on which is meant by public health care, a key strategic goal of the right.

It is time to target for-profit delivery.

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Explore posts in the same categories: Funding-Cost For-profit Delivery, Ontario Government Policy

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