Nothing Wrong With Two-Tier Health Care

In Canada, we have what is generally considered to be one of the best public health card systems in the world. The fact that people don't have to pay for things like child birth, most medical surgeries, etc. is definitely a big plus. Which is why I don't quite understand how critics of the health care system can complain about long wait times at hospitals and not enough funding for the the medical professions and not enough incentive for doctors to stay in Canada, yet at the same time are rabidly against instilling a two-tier health care system whereby those who have the means to pay for it can do so. Aside from being a hot topic of discussion in the current provincial election, this topic recently came to light when our former Prime Minister, Jean Chretien, last week was about to speak at a...well, speaking engagement, when he complained he wasn't feeling well. Within 20 hours, he was on an operating table, receiving quadruple heart bypass surgery.

This is, of course, a turnaround time that most citizens would never see for themselves, so people started grumbling about how unfair it is. The critics generally state that this creates an inequality between social classes, whereby the poor and lower income citizens cannot afford expedited care. Primarily impacted as well are senior citizens who are on fixed incomes and are generally in need of more care than their younger citizenry. By offering the choice to pay for faster health services, you are in essence catering to the wealthy who can then get faster treatment and diagnosis.

Please don't tell me that this is any surprise to you, or that your idealistic morals have been wounded greatly. This is the way it's always been. People who have money can buy faster and better service. Those than cannot afford it simply find other ways to manage. I cannot afford a full time maid or a full time butler, so guess what? I cook my own food (or depend on my wife to do so whenever opportunity arises) and I wash my own clothes and clean my own house (or depend on my wife to do so whenever opportunity arises). My wife is pregnant now, so I spent considerably more time with household chores. It is now 1:11AM on a Saturday night/Sunday morning, and I just finished cleaning the kitchen. Do you see me bitching and griping that it is unfair that I don't have the same access to a butler or a maid, that tony people have? No....

OK, so perhaps I am doing the proverbial apples-to-oranges comparison. Domestic services are unlike health care services, but the same principle applies. Before my son was born, I had the option of taking a semi-private room or a private room. I knew that the private room cost extra, but I didn't care - I didn't mind paying the extra. If I couldn't afford it or didn't want a private room (the reasons for which I cannot imagine), I simply would take the standard room offering. This is not a communist country, thank God, so no, not everyone and everything should be treated the same, despite what the socialist politicians would like you to think. You don't have to like everything and you certainly don't have to like everyone.

Would I use two-tier health care? Damn right I would. If I need to pay at a private hospital so that my sick son or wife doesn't need to wait for 3 hours just to get out of the waiting room and and another 3 hours in a room, I certainly would do that. Besides, think about it - by people opting to use private hospitals and private doctors, what would end up happening? The crowded waiting rooms at public hospitals would be alleviated. There would actually be LESS waiting at these hospitals and as a result of a number of people going to the private hospitals.

OK, but what about the seniors? And their fixed income problem? It's not fair that they should be forced to wait when they need care the most, but at the same time, a number of them cannot afford to pay for private services. In general, I know that there are such cases, but with private hospitals functioning, again they would likely get faster service as a result of less people at the public hospitals. It can't be any worse than it is now. But I want to address one more touchy issue when it comes to seniors and their state of affairs.

I find it absolutely appalling that so many people nowadays are putting their elderly parents into nursing homes and hospital facilities. I suspect that part of the reason that seniors don't have much money (aside from being on a fixed retirement income) is because they have ungrateful children who seemed to forget about what their parents did for them, so when their parents got older, they do what so many people do these days: consume and discard. That is, children consume their parents resources and then when they are independent, they somehow develop this "to hell with my parents" mentality and put them in a nursing home or a hospital to rot, rather than financially support them, but more importantly, physically and mentally support them. This may be more of a North American phenomenon, but it's still sad and disturbing. Their middle-aged kids will bitch about the health care system not working for their parents; meanwhile, they haven't done much to contribute to bettering their parents' twilight years. Instead, they focus on travel, their kids, their careers...it's pretty sad, actually. I have to say that one aspect of Asian culture that I really respect is the familial responsibility of children to parents - which is why you see so many Grandmas and Grandpas living with their adult kids. The grown up children have their own kids to rear, but they don't think twice about reciprocating the love and care their own parents gave to them. Unfortunately, many North Americans have short memories. I would never, ever put my parents in a nursing home or expect the health care system to take care of them. If the time ever comes, I'd be ready to have them move in with us, and I'd have no problems with being a full-time caregiver.

Back to two-tier health care - I've read some arguments that if you bring on a private medical system, that will put more pressure on the public system. Yes, it will. And there is nothing wrong with some much needed competition for patients. That is good for doctors and it is good for patients. Right now, especially in Ontario, where we really have a monopoly of health services by the private system - there may be a doctor and nurse shortage, but I believe that to be slightly exaggerated. Part of making patients wait is because there is no incentive to expedite the service. There is no competition.

Finally, some have maintained that a competing private system will usurp all the best doctors and nurses from the public system. Again, tell me something that I don't already know. Just like having a public defender represent you, versus having a big Bay street law firm to represent you - we're talking different leagues here. Professionals, including doctors and nurses, no matter idealistic, will generally gravitate towards a system where their services, skill, and expertise will be rewarded, financially and otherwise. No different than seeing that the best, very handsomely paid chefs are at the fancy schmancy dining establishments; meanwhile, your friendly neighbourhood burger flipper likely does not even know what constitutes a diploma in culinary cuisine. Or being driven around by a professionally trained, well-mannered limo driver as opposed to a fellow in a turban who barely speaks English, driving you around in a taxi, while flipping the bird to everyone he cuts off in traffic. If you want to have better service, you're going to have to pay for it. It's always been this way, it will always be this way.