HJ-ED-DHJHerald Journal Columns
January 15, 2007, Herald Journal

Canada’s two-tier health care

By ROZ KOHLS

Tom Campbell is the deputy minister of health in the province of Ontario. He is in charge of health care services to nearly 10 million people.

Campbell is in a position to know how a single-payer health system works. He decides doctors’ salaries, what procedures doctors do, where hospitals will be built, and where hospitals must be closed down.

Campbell wrote a detailed paper about health care in Ontario and it is disturbing.

“It lags behind the best international standards in waiting times and availability of new technology and drugs,” Campbell said.

“Central funding leads to shortages and rationing as a means of cost control. We see the results in unacceptable waiting times and lack of adequate services,” he said.

“The current shortage of trained medical staff is the result of botched government decisions in the name of cost control. As a result, a significant number of people do not have a family doctor, Campbell said.

Canada provides free coverage of minor services to everyone, even rich people. That leads to not enough money left for timely cancer treatments and catastrophic drug plans.

Health care has two tiers. The rich people in Canada, who can pay for the drugs and travel to the United States for treatment, get health care, while the people of modest means are denied service, Campbell said.

Congress, however, is seriously looking into following Canada’s single-payer system.

I hope Congress pays attention to what Campbell advises.

First, take distribution of the funds out of the hands of politicians. Funds should be distributed by an independent, non-partisan board of outstanding citizens, he said.

Second, “create new funding through cost-sharing directly at the point of service, rather than indirectly through taxes and government.” The amount paid would depend on income, with those in the highest tax bracket paying the most, and tapering down to those with an income under $25,000 a year, who would pay the least.

Third, “Give service providers a share of the money collected at point of service, as an incentive. . . All services would become revenue generators,. . . a powerful incentive to provide more and timely service, rather than to ration it.”

Finally, “Deregulate enrollments and fees in all medical schools so they can accept all qualified candidates. . . Large numbers of our qualified young people have been denied career opportunities because of restrictive enrollments in our medical training institutions,” Campbell said.

Government should stick to doing what it does best. That’s not health care, especially in Canada.