Introduction
Common accessibility of medical assistance is an essential factor not solely for public health but for the social, political, and economic well-being of the population as well. Therefore, the question of what funding channels the medical industry should utilize to fulfill its functions productively remains of great importance. In one respect, effective cooperation of the public and private sectors allows for maximal coverage as well as the possibility to adapt to the needs of every patient. Along with this, the existence of private health care facilities is debatable in social terms, primarily from the viewpoint of equality. The given arguments are the most apparent but doubtlessly not the only ones, as the issue has been under discussion for quite a long. Throughout that period, both sides have developed considerable theoretical bases and collected sufficient evidence to illustrate and prove their positions.
Current Status of Private Health Care in Canada
The existing system of health care in Canada, whose commonly used unofficial name is Medicare, relies predominantly on public funding. This is natural, considering its “founding principle” of providing medical services to those who need them regardless of the patient’s ability to pay (Martin et al., 2018, p. 1718). Along with this, the state does not have any official ban on private practice, for which any specialist has a right to opt. The nuance is the impossibility for him or her to work for the public sector in parallel. However, the number of doctors who make such choices is dramatically small, mostly due to the legal limitations that differ from province to province.
Arguments for Legalizing Private Health Care
Coverage of Public Health Care System Is Insufficient
One of the most considerable weaknesses of public health care is its poor capacity. Public costs are limited, for which reason it is physically impossible to provide 100% of the population with timely services of appropriate quality. Therefore, some experts mention the growing discontent among Canadians resulting from queuing and subsequent long waits for procedures, including elective surgery (Lee et al., 2021). Such interventions as joint replacements, cataract operations, and other non-emergency manipulations can be postponed for years until the system is able to assist the patients.
Meanwhile, the latter continue to suffer without the necessary medical aid, which frequently has unwanted consequences. Thus, according to recent reports by the Canadian Pain Task Force (2019), approximately 20% of the country’s residents experience chronic pain, of whom in at least 14% it is severe (p. 9). The vulnerable groups of the population, such as children, adolescents, the elderly, and the indigenous, are especially likely to face problems of this kind. The agency mentions insufficient accessibility of medical care among the probable sources of the unpleasant syndrome. Other frequent consequences of waiting long for procedures are anxiety and depressive disorders that can develop as well as aggravate the background of constant pain.
It is also worth noting that chronic ache can affect not solely health, but economic well-being as well, of both a particular person and the entire society. First, it suppresses cognitive performance, particularly memory, attention, and processing speed. Second, it is responsible for increased school and works absenteeism as the consequence of permanent fatigue and exhaustion (Canadian Pain Task Force, 2019). This leads to substantial losses of productivity in workplaces and, at the federal level, even industries; the long-term perspective involves a lower quality of education as well.
The insufficient capacity of Medicare is apparent not solely in elective cases. Emergency departments are limited in number as well and consequently overcrowded on a constant basis (Lee at al., 2021). This causes excessive load on personnel, which, in turn, breeds medical errors that may have fatal consequences. These include mixing and misinterpreting prescriptions, incorrect dosing, delays in administering drugs to the patients, and inadequate identifications of the latter (Institute for Safe Medication Practices, 2021). The increased probability of such mistakes is among the most frequent arguments for legalizing private medical care in Canada, which decision presumably would release medical personnel from overload, at least partly.
Another problem is the scarcity of appropriate counseling, which is especially acute in the sphere of mental health care, where personal interaction frequently plays a more considerable role than medications. About a third of the population with mental issues report insufficient awareness of the origin of their problems as well as relevant solutions (Moroz et al., 2020, p. 1). Simply stated, one in three mentally disabled Canadians does not know what exactly he or she is experiencing and what to do with that.
Public Health Care Services Burden the Budget
The above problems root at the fact that the sums on which a socialized industry can count are limited by the other items that the budget covers. Nevertheless, severe shortages in a particular sphere may encourage the authorities to re-allocate the available resources and invest more in them. Notably, the Canadian Institute for Health Information (2019) highlights that the total health expenditures in 2019 were 4.3% higher in comparison with the previous year (p. 7). The second half of the decade was actually marked by a noticeable growth of investments in medical services, among which the largest categories were hospitals, drugs, and physicians. The latter, as apparent from the previous data, remains deficient; regarding medications, the supply of them satisfies only 85% of the demand (Moroz et al., 2020, p. 1). The statistics of this kind mean the need for rising medical spending further in the near future.
Although specific funding decisions may differ from one region to another due to the decentralized structure of Medicare, the general tendency doubtlessly involves a closer focus on health care services. Such a trend can have a considerable impact on local budgets, which consequently makes it critical to refill them. The most apparent result is a reconsideration of taxation policies; thus, the increase in personal tax rates throughout the previous decades is 10.6% to 23.1%, depending on the province (Hill et al., 2020, p. i.). This, in turn, discourages people from economic activity, putting the prosperity of the entire Canadian society at serious risk. Specifically, the country is losing its competitive advantage in attracting skilled labor force as well as investors.
Limitedness of Public Resources May Aggravate Social Disparities
Although, as said above, Medicare rests on the principles of equality, these are not necessarily possible to follow in practice. Notably, the pandemic of COVID-19 revealed the system’s inability to provide proper care to all categories of the population in an emergency. Having focused on the risk groups of the coronavirus infection, such as seniors, the hospitals could not pay sufficient attention to the other. The governmental programs were impossible to realize due to the lack of funding. Consequently, drug addicts, the disabled, and other people with unique needs were almost or completely unprotected (Ruckert et al., 2021). Meanwhile, a well-developed private sector could have provided assistance in emergency cases.
Arguments against Legalizing Private Health Care
Private Medical Services Cannot Be Commonly Affordable
As it has already been mentioned, the cornerstone of the the Canadian health care system is relying on need rather than paying capacity to provide aid. Therefore, medical facilities do not charge their patients for core procedures, which is the key principle of the industry’s performance. Such an approach doubtlessly is helpful for the categories of people who find themselves below the poverty line. Those make a more considerable share of the population than it may seem. The biggest group to mention in the given context is working-age single adults, especially females, of whom almost a third have dramatically insufficient income (Petit & Tedds, 2020, p. 17). Considering the gradual but stable increase in the amount of unmarried Canadians, this fact acquires special importance.
The COVID-19 pandemic apparently has added to the quantity of those who live beneath the poverty line, as many businesses were bound to limit or cease their operation. Many people consequently lost their income or a part of it, due to which at least three million Canadians currently are able to classify as poor (Segal et al., 2021, p. 394). These statistics illustrate the irrelevance of charging the population for health care services while the economy remains in a recession.
Private Medical Facilities Are Difficult to Control
A unique feature of Medicare is the balance between centralization and autonomy that allows for appropriate control over the medical industry. In one respect, it is sufficiently decentralized to consider a particular province’s demographics. Funding is the responsibility of local governments rather than the federal, which enables allocating of resources in accordance with the region-specific needs of the patients (Martin et al., 2018). The contact with those also is closer than it would be at the state level, due to which the feedback is more informative.
The above does not mean a complete absence of unification and supervision. Notably, the system is “harmonized through standards in a federal law, the Canada Health Act of 1984,” which presupposes certain commonly mandatory quality measurements (Martin et al., 2018, p. 1718). The provision of medical aid in Canada, in fact, happens by a sort of a social contract between health care facilities, authorities, and the population, in accordance with which the latter two control the former. Therefore, integration into the system simplifies both meetings the actual demand and following the legal requirements, while providers who are beyond it are not necessarily ready to cooperate with the other sides.
Effectiveness of Private Health Care May Be Lower in Practice
It is quite apparent that a spread of private medical institutions would add noticeably to the overall amount of those, hence increasing the reception capacity of the industry. However, not all categories of the population are equally likely to feel the changes. Lee at al. (2021) highlight that developing “a free healthcare market” can hardly reduce waiting time for the less wealthy, who will not acquire access to it, even if it does appear (p. 33). Considering the above statistics of poverty in Canada, the opponents of private health care doubtlessly have reason to question its effectiveness in terms of coverage.
It is also worth noting that people with low income have special needs, such as addicts or individuals with physical and/or mental disabilities. Theoretically, private facilities provide such patients with the care that they need but typically lack within the system because of its insufficient capacity (Moroz et al., 2020). In practice, however, a certain share of them, which presumably is quite substantial due to the limited work productivity of the disabled, cannot afford appropriate consulting. This is one more reason why the actual effectiveness of private medical facilities may not be as high as it seems to be.
Existence of Public and Private Sectors Fosters the Culture of Superiority
Although defining poverty is a challenging task, socially vulnerable categories of the population are more likely to experience it, regardless of the approach to measurement. Those are, for instance, single individuals in comparison with couples, females compared to males, and so forth (Petit & Tedds, 2020). The inability of such people to afford private medical services probably will support the stereotype of their inferiority, hence making them even less protected than they currently are.
Personal View
Generally, I support the idea of legalizing private health care rather than oppose it. The limited accessibility of medical aid affects not solely the quality of a particular patient’s life but the prosperity of the entire country. As said above, individuals who live with chronic pain lose their productivity, which consequently reduces the spheres where Canadians perform. This, along with the growing taxes, demotivates the population seriously, making the country less attractive to international entrepreneurs and investors (Hill et al., 2020). Such tendencies, in turn, bear a long-term threat to the well-being of the population.
An essential nuance is the growing popularity of private health insurance. According to Canadian Institute for Health Information (2020), spending on it in 2019 increased by 2.3% as compared to 2018 (p. 7). This is a quite reliable marker of how insufficient Canadians consider the coverage of public services. Another frequent phenomenon, according to Lee et al. (2021), is out-of-pocket payments, whose existence means for me that people are ready to give their money for quality medical aid.
Regarding poverty as an argument against the private sector, I suppose a connection between it and the tax policies. Notably, Petit and Tedds (2020) proclaim that single individuals of working age are the poorest category of the Canadian population. This presumably is among the results of increasing taxes, due to which the disposal income of workers shortens. Meanwhile, developing the private sector would partly release the budget from the burden and reduce the need for additional taxation.
Conclusion
Whether the legalization of private health care facilities in Canada would be an appropriate solution or not remains a debatable issue. In one respect, a considerable percentage of the residents would not be able to afford them. For such people, nothing would change in terms of waiting time, which is the major disadvantage of Medicare, while their social vulnerability possibly would aggravate. On the contrary, the patients who do not receive the necessary medical aid, including surgery, immediately suffer from such syndromes as chronic pain and depression that limit their productivity and consequently affect the state’s economy. The fact that Canadians purchase private health insurance increasingly and pay out of pocket actually illustrates the insufficiency of public services.
References
Canadian Institute for Health Information. (2020). National health expenditure trends. Ottawa, ON: CIHI.
The Canadian Pain Task Force. (2019). Chronic pain in Canada: Laying a foundation for action. Ottawa.
Hill, T., Li, N., & Palacios, M. (2020). Canada’s rising personal tax rates and falling tax competitiveness. Fraser Institute.
Institute for Safe Medication Practices Canada. (2021). Balancing safety and efficiency in community pharmacy. ISMP Canada Safety Bulletin, 21(7).
Lee, Sh. K., Rowe, B. H., & Mahl, S. K. (2021). Increased private healthcare for Canada: Is that the right solution? Healthcare Policy, 16(3)
Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjee, B., & Marchildon, G. (2018). Canada’s universal health-care system: achieving its potential. The Lancet, 391(10131), 1718-1735. Web.
Moroz, N., Moroz, I., & D’Angelo, M. S. (2020). Mental health services in Canada: Barriers and cost-effective solutions to increase access. Healthcare Management Forum, 33(6), 282-287. Web.
Petit, G., & Tedds, L. (2020). Poverty in British Columbia: Income thresholds, trends, rates, and depths of poverty. School of Public Policy, University of Calgary.
Ruckert, A., Labontè, R., & Hillier, S. A. (2021). The Canadian policy response to COVID-19: What’s in it for health equity? University of Ottawa and York University.
Segal, H., Banting, K., & Forget, E. (2021). The need for a federal Basic Income feature within any coherent post-COVID-19 economic recovery plan. FACETS, 6, 394-402. Web.