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This article was published 26/10/2010 (3441 days ago), so information in it may no longer be current.
There's a central fallacy in the privatize medicare crusade. "Unsustainable" public health spending will magically become sustainable simply by shifting costs from the taxpayer to the patient and from the wealthy to the sick.
"Bluntly, this is a lie," says Canada's pre-eminent health economist, Dr. Robert Evans.
Canada can afford medicare, Evans told a June 17 House of Commons MP breakfast briefing and press conference sponsored by the Canadian Health Coalition. What it can't afford is the $300-plus billion in tax cuts handed out by Ottawa and the provinces since 1997, coupled with the double-digit rise in private health costs not covered by medicare and the inappropriate use of expensive and often unnecessary services.
Evans went on to debunk what he calls the four "myths" fuelling the campaign to destroy medicare. Driven largely by the insurance industry, it hasn't stopped since Saskatchewan founded medicare in 1962. It took on dramatic new life recently thanks to three developments. A recent report from the Organization for Economic Cooperation and Development (OECD) warns Canada faces "unsustainable" health costs and says "revenues could be raised and excess demand curbed, by implementing... co-payments and deductibles." Disgraced former Conservative cabinet minister Maxime Bernier is fronting a national campaign to terminate all national social programs, including medicare, and transfer the federal tax points to the provinces. And former Reform-turned-Liberal MP Keith Martin is calling medicare "obsolete" and a "shibboleth" and proposing it be "modernized," allowing patients "to pay for care if they wish in entirely separate facilities funded solely by the private sector."
All three initiatives are buttressed by a sympathetic federal government and a weak official opposition, according to Mike McBain, head of the Canadian Health Coalition.
"The OECD always clears its reports with the government of the country first," continues McBane. "No one can believe Bernier is doing this on his own without the prime minister's blessing. We're talking about the end of our national health system and allowing the provinces to do what they want. (Prime Minister Stephen) Harper is looking the other way and (Liberal Leader Michael) Ignatieff is weak."
And this despite the fact Canadians consistently rank health care their top priority and a CHC-commissioned Nanos Research poll found only eight per cent of Canadians want to switch to private health insurance.
The 92 per cent of Canadians who know they're better off financially with medicare can take solace in Evans' evisceration of the privatizers' "myths:"
Myth One: Canada's aging population will make health care unaffordable. Private health-care services, not an aging population, are driving health-care spending, says Evans. "The key cost-drivers in health-care services are the private, for-profit parts — pharmaceuticals, dental, diagnostic tests and other non-insured services. Population aging increases health-care costs at only 0.8 per cent annually."
Myth Two: Health-care costs are eating up all the provincial budgets and crowding out other services. Medicare spending takes up about the same share of provincial revenues as it did 20 years ago, says Evans. "However, between 1997 and 2004, cuts in personal and corporate taxes removed about $170.8 billion from government revenues." An additional $35 billion annually has been lost to tax cuts every year since. "As a result, other non-health-care programs were cut, making it appear that the share of the budget for health care was increasing."
Myth Three: Public health-care spending is skyrocketing out of control. Not only is Canada's public health-care spending not skyrocketing, it is stable and below the OECD average, says Evans. It's spending on private care that is driving cost increases. Between 1975 and 2009, medicare spending — on doctors and hospitals — has remained steady at between four and five per cent of Canada's GDP. When private spending on services not covered by medicare is included, the cost escalation shoots up to 12 per cent per year. "Clearly a public, single-payer system is the way to control costs," Evans says.
Myth Four: Privatization of health services will control health costs. "Privatization is a way to avoid cost containment and provides greater income opportunities for providers of care and private insurers outside public control," says Evans.
Last week, former Conservative prime minister Brian Mulroney called for a "serious, adult discussion" on medicare and said "some form of user fees and greater scope for competition within the system will be necessary." Counters Evans: "It's long past time for an 'adult conversation' about the winners and losers from eroding or dismantling public health care in Canada."
Frances Russell is a Winnipeg author and political commentator