LETTER: Private healthcare violates fundamental Canadian values

SooToday received the following letter to the editor from reader Robert Rattle in response to an earlier letter under the heading Need to change our perspective on private healthcare.

The five principles of the Canada Health Act (CHA) are public administration, comprehensiveness, universality, portability and accessibility.

The CHA reflects Canadians’ universally held value of equitable access to healthcare. Private healthcare that violates these principles deepens inequality, harms population health and raises healthcare costs.

Mr. Mosher suggests that driving a long distance to access healthcare “is but one small area where a private option could benefit northern communities.”

It is not. Driving (a long distance) to access healthcare is jumping the (Ornge) queue, and not everyone has the money, time or other resources to do that. That violates the universality and accessibility principles of the CHA.

Further, viewing healthcare as a consumer choice, as Mr. Mosher also implies, is deeply problematic. The market is fine at efficiently allocating resources, but has no mechanisms to ensure equitable distribution or sustainable scale.

Indeed, market mechanisms and lobbyists operate precisely to expand efficiencies (resources allocation - profitability) at the expense of equity and sustainability. Lobbyists advance private interests, and they already hold far too much traction in the halls of power. That in itself undermines our healthcare systems by generating inequalities.

Public administration of the CHA exists to protect against such market distortions. The inequalities of privatization have been demonstrated through extensive work such as the social determinants of health and intersectionality research and practice.

We are not the United States, and we do not support inequality. Taxes exist to redistribute wealth to benefit everyone and society equitably.

Mr. Mosher’s private health insurance is great for those who have a job or can otherwise afford it as an addition to state funded healthcare (i.e. it does not violate the principle of comprehensiveness). Which is why private healthcare that violates the CHA is a slippery slope.

One only needs to look at the quality of life and life expectancy outcomes in the United States, or the extreme inequality compared to most other wealthy countries. Private delivery of healthcare is fine as long as the five principles are not violated. But it’s not fine at the expense of those principles.

Ironically, healthcare is a downstream response to the illnesses that inequalities produce. If we ultimately wish to relieve the burdens on the healthcare system, Canada will need more upstream interventions that reduce inequality. These include a Universal Basic Income, more affordable housing, food security, fully paid education to terminal degrees, along with the many existing social supports.

Upstream interventions - like an ounce of prevention - can save substantial amounts of healthcare (downstream) costs and reduce taxes. Privatization that violates the CHA sweeps smarter, upstream interventions under the carpet, and generates deeper inequality, harming population health regardless of ones income.

If ever we are to reduce healthcare costs, the last thing we need is privatization that violates the CHA and increases inequality. Indeed, greater wealth redistribution that supports upstream interventions to reduce social inequalities is the only long term solution to rising healthcare costs and public expenditures.

The five CHA principles support this goal.

Robert Rattle