By: Andrew Kotaska, MD
Re: Two-for-one private health care: A Canadian compromise. Author replies
Issue: BCMJ,
vol. 60, No. 4, May 2018,
Page 188 Letters
Dr Figurski says that I suggest imposing financial barriers that would delay treatment and impose suffering on patients. I do nothing of the sort. I propose offering affluent patients expedited service for an additional fee that will be specifically applied to providing services for patients with lesser means. This is the fundamental basis of a progressive taxation system. The net result will be additional capacity and shorter waiting lists for procedures undersupplied by the public health care system. The approach is ethically sound and improves the well-being of all patients compared with the status quo. With competition, market forces will indeed come to bear. For the system, private facilities may increase efficiency. For patients, as the service in economy class gets faster, fewer will choose to fly first class.
Dr Figurski seemingly defends and derides the Canada Health Act, yet does not appear to understand the conflict with the Charter of Rights and Freedoms that engendered my suggestion in the first place. The Supreme Court has not doubled down on the Canada Health Act: it has declared it unconstitutional. Free health care is not enshrined in the Charter. As the growing myriad of current violations demonstrate, the Canada Health Act is on life support. Some would happily see it die; however, I believe that most Canadians would prefer a measured compromise to the Wild West of unregulated private health care.
—Andrew Kotaska, MD
Yellowknife, NWT