Health versus wealth: Patients get pulled both ways

by RACHEL TUTTE AND BRIAN DAY ,  The Global & Mail | 2009-07-30

Rachel Tutte is co-chairwoman of the B.C. Health Coalition, and works as a physiotherapist at a public rehabilitation hospital in Vancouver. British Columbians are rightly concerned about Health Minister Kevin Falcon's decision to deny $360-million in funding to health authorities this year. Coupled with the minister's recent comments in favour of for-profit health care, they should be.

The evidence is clear. A single-payer, public health-care system that covers everyone is the fairest and most cost-effective way to provide high-quality care for all British Columbians. The evidence is equally clear that many innovative public solutions are available to address the health authorities' need to do more with less.

It was frustrating, then, to hear the Health Minister suggest that public health care is no longer financially sustainable – implying that we should resort to private, for-profit insurance and clinics, despite the evidence that they cost more, are less safe for patients and compromise the public system.

For example, the Canadian Health Services Research Foundation reports that annual overhead costs of public provincial insurance plans are 1.3 per cent, while Canada's private insurers average 13.2 per cent in administrative costs. And the Canadian Institute for Health Information found that knee replacement surgery in an Alberta public hospital costs on average $8,002, compared with between $14,000 and $18,000 in a private surgical facility.

Even the Health Minister's claims about Medicare's “unsustainability” need a second look. In reality, B.C.'s health-care spending has remained relatively stable over the past 17 years as a percentage of our overall economic output. The government's message that health-care spending is taking up a growing proportion of the budget is therefore misleading. There is simply no health spending-induced fiscal tsunami on the horizon – but there will be if we allow for-profit health care to expand.

Health care is a high priority for British Columbians, and most agree that it is a worthwhile investment. But Mr. Falcon's demand for budget cuts hampers our ability to manage costs over the long run and will have major repercussions on British Columbians' health.

Some health authorities have responded by cutting their diagnostic budgets, for example, making the wait longer for patients who require an accurate diagnosis and effective treatment. This means some patients will become sicker, and require more complex and expensive treatment and rehabilitation.

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