Canada should adopt European-style health care model: CMA (external - login to view)
TORONTO - Canada could transform its bogged-down health care system and shrink lengthy wait lists by adopting Europe's successful blend of private medicine and universal access, the head of the country's largest doctors group said Monday.
Kicking off a major new campaign to promote a European-style medicare model, Dr. Robert Ouellet said experts he met recently in countries such as France and Denmark were shocked by how long Canadians queue up for some health services.
Such nations have all but eliminated wait lists, partly by having private-sector contractors compete against public clinics and hospitals for government health funds, said the president of the Canadian Medical Association.
Such competition encourages more efficient use of personnel and tax dollars, he said in an interview.
"In other countries, they clearly do not understand why this population, we Canadians accept (long wait lists). They don't get it," Ouellet said. "Some told us, 'There would be a revolution here if we had that kind of problem.' ... We really need to make a transformation."
He was to outline some of his ideas for overhauling the system in a speech today in Toronto, before embarking on a cross-country discussion of the issues.
Ouellet also resurrected the idea of slapping a tax on junk food to discourage unhealthy eating, and advocated letting Canadians deduct any out-of-pocket health care costs from their taxable income.
He was most enthusiastic, though, about his road trip through Belgium, the Netherlands, France and Denmark, and the role played by private medicine in those nations.
However, one critic said Monday the Montreal radiologist is "cherry picking" aspects of the Europeans' systems that suit his market-oriented philosophy and ignoring others, such as the fact many of those countries have higher taxes than Canada to fund health care, and more extensive social safety nets that contribute to better health.
"He wants a Swedish health care system on American tax rates," said Michael McBane, spokesman for the union-affiliated Canadian Health Coalition. "That's completely disingenuous. I would argue it's intellectually dishonest."
Ouellet himself is in a conflict of interest by promoting more private medicine, as he is the founder of Canada's first private CT scan clinic and owner of other private radiology facilities, McBane charged.
Meanwhile, Ouellet said the medical association itself has stymied some important reforms, such as restructuring how primary care is delivered by organizing family physicians into group practices with alternative forms of payment.
Ouellet said he wants Canadians to open their minds to different ways of looking at health care, arguing the current system is not sustainable otherwise. Western Europe is a good region to examine because - unlike the United States - its countries have universal medicare that ensures equal access to health care regardless of the patient's ability to pay.
Part of their success stems from how they finance public hospitals and clinics, which for the most part are paid for individual services they perform, rather than receiving blocks of funding as occurs in Canada. At the same time, many countries allow the private sector to compete for that funding, he said.
About 60 per cent of elective surgery in France, for instance, is carried out in private facilities, but paid for out of the public purse, Ouellet said.
Such competition would bring about the same kind of efficiencies and cost-savings to health care as came to long-distance telephone service when monopolies in that industry were ended, he said.
Ouellet is the second CMA president to strongly espouse a bigger role for the private sector in health care, following on the heels of Dr. Brian Day, a B.C. orthopedic surgeon who owns a private clinic.
Their ideas, though, are not taking hold with the public or the governments who deliver health care, McBane said.