Health matters, but so do plans for health

June 6

Promises. Politicians and political parties can promise anything during an election, and often do. Promises are essential during an election, because it is based on those promises that we decide who to vote for. It is then our hope that once the election is over the person or party to whom we gave our vote chooses to follow through on those promises. But, how does that saying go? "Promises are meant to be broken." And when that election is over there is nothing forcing politicians to keep their promises, nothing, that is, but their integrity and their desire for re-election.

This election is no different. Already we have heard many promises from every political party. The Liberals have promised a national childcare system, the Conservatives have promised to lower the cost of prescription drugs, and the NDP have promised to expand access to post-secondary education. So, I guess the question is, should we vote for the politician or party making the promises we like the best or do we vote for the one we think most likely to keep those promises?

I am struggling with this one. And nowhere are my struggles more difficult than in the area of health care. It is no secret that health care is an issue at the forefront of this election and extremely important to many voters. Every party has presented their plan to fix what they think is ailing our health care system. And not surprisingly, their promises are not that different. They all want to reduce waiting lists, increase access to homecare, and control the cost of prescription drugs. The difference I think will be how each proposes to reach these goals.

You may ask why the Canadian healthcare matters to me since I now live in the United States. First, because when I try to define Canada, one of my definitions is universal health care. It is something that Canada is known for and something that I am extremely proud of. Second, because I plan to return to Canada one day and I want return to a country where health care is strong and is still universal. And finally, because I believe that healthcare is a fundamental human right and should be available to all regardless of financial means. So for me, this is my starting point and any party that threatens universality will not get my vote.

I believe that shortening waiting lists is the most pressing issue for the Canadian health care system. One solution that has been suggested is the use of private clinics. While allowing the private sector into the system will certainly reduce wait times, it is a solution that I believe would eventually affect universality. And while no one has suggested that Canada turns to a fully private system, once we begin to go down the road of privatization, it is always a possibility. A fully private system, such the U.S. model, guarantees access to those with means, be it independent wealth or an employer-provided insurance plan and also normally provides access to those of no financial means through some sort of state welfare system. The people who get overlooked, though, are the "working poor", those who do not qualify for welfare, do not have employer-provided insurance and cannot afford private insurance. This is wrong.

When I first moved to the United States the fragility of healthcare access hit home for me. My employer-provided insurance plan did not begin until three months after I began my job. So, for the first three months I had a choice to either pay a large sum for private insurance or take my chances and live without access to healthcare. I realized I was now living without a social safety net, it was an awful feeling and something I had never experienced living in Canada.

Another solution that has been suggested is a two-tier system that maintains universal healthcare but allows the use of private clinics. And while a two-tier system would ensure universal access it would still creates haves and have-nots, and is certainly not perfect. Access and wait times are reduced for those in the private system but lines would continue to be long in the public system. And, remember, a private system is driven by economics and when the economics do not look favourable, do not count on the private sector to still be there.

Long-term care and health problems that are less frequent require expensive equipment and many costly resources. These problems will likely not provide the same level of profitability as simpler procedures, which can be dealt with relatively quickly and would cost the system less. Private providers, motivated by profits, may not be as interested in these less-profitable problems, requiring those suffering from such problems to turn back to the public system and join waiting lists likely as long as they are today. So, in reality, a two-tier system would be more of a band-aid solution for those that can afford to jump the queue and whose problems are attractive to the private sector.

The problems in health care are not easy to solve and they are even harder to pay for. However, if Canadians and our government do not commit 100 per cent to a public system, it may as well turn private tomorrow. Privatization is the easy answer, but if you ask me it is not the right one. I am confident that both the Liberals and the NDP would maintain universal access and would not readily invite the private sector to participate, if at all. I am not sure, though, either party has fully thought out the economics. Promising to fix every problem that ails the system, while admirable, may not be practical and is too financially burdensome. It is essential that a strong financial plan accompanies any solution. I am still listening for a party that promises to do great things for health care but also promises that it will assess and reassess the costs of those promises with every step. That would be a promise that would appeal to me and one that I am fairly confident would be kept.