Two-tier dogma from an Ottawa hospital chief

Some days it just feels like whack-a-mole.

It’s another city, another privileged individual, and another plea for two-tier medicine.

Michel Bilodeau, described by the Ottawa Citizen as the dean of Ottawa’s hospital chiefs, says he supports the right of Canadians to buy private medical insurance to pay for health services covered under Medicare.

Bilodeau was recently enticed out of retirement from his $373,000/year job at the Children’s Hospital of Eastern Ontario. He is serving as interim chief at Bruyere Continuing Care after the former CEO abruptly resigned.

Bilodeau says we have to stop considering the current system as dogma and look at what works and what doesn’t.

He would instead prefer his own dogma, given he presents no evidence to support his case, only a handful of personal anecdotes.

As if to disprove his own case, Bilodeau says with increasing demand for home care and community care, families who can afford to pay for additional support cannot find qualified staff to do it.

The reality is a private tier would find resources from the public tier, giving a cushy ride for those who can afford it, and making the situation a lot worse for those who can’t.

As the University of Toronto’s Colleen Flood stated a few years ago during a Medicare conference in Saskatchewan, there isn’t an ocean liner filled with health professionals waiting off the coast of Nova Scotia for private health care. Professionals needed in the private payer tier would be enticed from the public payer tier.

Worst still, in order to make private insurance viable, the public tier would need to get a lot worse. Otherwise, who would buy private insurance for something that’s already covered under their taxes? Just ask Quebec. In 2009, two years after two-tier private insurance was made legal, it was reported not a single policy had been sold. None.

Bilodeau and other wealthy elitists would have you believe that this all works well in Europe. He forgets that more – not less – of health care services are publicly covered in these countries.

If Canada were to implement user fees, as he proposes, how would this make health care any more efficient?

Among wealthy countries, Canada is second only to the United States for the proportion of our health care system that is totally private. This has an unmistakable impact on our overall health care costs.

Instead of making more of it private, there is evidence that considerable savings could be had by expanding Medicare, not by carving out a second private tier.

For example, the Canadian Centre for Policy Alternatives estimates Canada could save $10 billion a year if we had universal coverage for drugs.

Instead of advocating for a lifeboat for the wealthy, Bilodeau should be advocating for improvements to the system that will float all boats.

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