By Daniel McHardie
As appeared on page A1
Injecting a dose of private health care delivery into the New Brunswick medicare system could help cure long wait times and skyrocketing budgets, says the operator of a private health clinic.
Dr. Richard Bendor-Samuel, who started the Landings Surgical Centre in Halifax, said he opened the facility to perform uninsured services, like cosmetic procedures, but was still accused of trying to undermine the universal health system.
What’s driving much of the opposition is the fear that rich people will start receiving services before others with less money, he said.
But that doesn’t have to be the case, said Bendor-Samuel, adding the two systems can complement each other.
The Halifax-based physician said private health care is already clogging up spaces in the public system, such as procedures done for workers’ compensation boards, the military and the RCMP.
He said those procedures should be removed from the public system to ease the wait times. There are advantages to the public system by looking at alternate-delivery systems for procedures such as MRIs, he said.
If 10 people get an MRI scan in a private clinic that is 10 fewer people left in the public queue, he argued.
“If we don’t have that option and those 10 people want to go out of province or out of country they can still do that but we have lost their tax dollars,” he said.
Health Minister Michael Murphy says he wants to have a debate with New Brunswickers on the direction of the health system, including whether they want a system where people can pay for some services.
Dr. Dennis Furlong, a former Conservative health minister and author of a health policy book, said a parallel, private system would lead to devastating effects in the health system.
He said that doesn’t preclude the government opening up certain services to private delivery. The Canadian health system is not sustainable with its current $150 billion price tag and growing at seven per cent a year, he said.
“Growing a seven per cent a years, 10 years from now it will be over a quarter of a trillion dollars. So is there urgency here, yes there is. Is anybody daring to say anything about it, well a few of us are and I think Minister Murphy is correct the debate needs to happen.”
Dr. Colin McMillan, the president of the Canadian Medical Association, said he hasn’t seen any evidence that introducing the private sector into the health system saves much money. McMillan said this isn’t the first time a health minister has made these types of bold statements.
“We’ve heard ministers talk about this sort of thing before, they send it out as a trial balloon and we wait to see if anything will happen,” he said.
Private health delivery may not be a new discussion but Tom Bateman, a political scientist at St. Thomas University, said he feels Murphy may be launching the debate at just the right time. After 20 years of fierce opposition to even mentioning private health care in any serious political debate, Bateman said Canadians are getting older with more disposable income and they will start leading the charge in demanding health reforms.
“I think the political agenda is changing because the demographic nature of the country is changing,” he said.
Charles Cirtwill, the acting president of the Atlantic Institute for Market Studies, said Murphy’s demand for a full debate on the direction of private health care makes sense. The think tank executive said the New Brunswick health minister just needs to look across the border into Nova Scotia to see a pioneering piece of legislation that would open the door to the private delivery of health care.
Former premier Ralph Klein mused at one time about how his reforms would violate the principles of the Canada Health Act. Despite the saber-rattling of the controversial former premier, Alberta’s reforms never quite lived up to its billing.
“Even in Alberta which is supposedly a bastion of private care hasn’t gone beyond the embryonic stage,” Cirtwill said. “So this is an opportunity for New Brunswick not to play catch up but for New Brunswick and perhaps Nova Scotia as well to leap to the forefront and lead here, which is something that from time to time we do.”
Brett Skinner, a health expert with the Fraser Institute, held a similar view that the problem with the current public system is not providing taxpayers value for money considering the huge amount of cash that is thrown at those budgets.
“We don’t get good value for money and on top of that it’s not sustainable,” Skinner said.
Bateman, of St. Thomas University, said New Brunswick could consider using health care as economic development by boosting research funds to the sector
“Fold it into the post-secondary education system and devote more resources to research and development in health care, also make New Brunswick a centre for certain specialized services perhaps so we become a magnet for what becoming a market in health tourism,” Bateman said.
New Brunswick may not have the private clinics that have popped up in places like Vancouver, Montreal or Halifax, but that doesn’t mean the debate hasn’t cropped up in the past. NB Power had a pilot project terminated that saw some of its senior managers sent to a Montreal-based health clinic to receive hearing and stress tests, nutrition analyses and recommendations and other conventional medical checks between July 2003 and March 2004.
The Workplace Health, Safety and Compensation Commission does have a practice that it will send injured workers to Maine for a specialized treatment or evaluations that are not available in New Brunswick.