Ralph Klein has gone and it is time to retire Ralph's World. Thanks to all of you who have supported this venture by contributing material and through your comments. It has been fun.

Should we get another blog underway? Let me know your thoughts by e-mailing me at johnnyslow@gmail.com.

John Slow
January 1, 2007

Wednesday, December 07, 2005


Dr. Colleen Flood, originally from Australia, holds the Canada Research Chair in Health Law and Policy at the University of Toronto. She addressed a large and interested audience of Students and Public on November 23/05 at the UofA.

This is a try at passing on Dr. Flood’s challenge to the assumptions made by the Supreme Court of Canada (Chaouilli June 9/05) as it’s ruling pertains to the future of Health Care. This writer hopes others will correct any errors of information or inadequate interpretations of her presentation.

Theme: The decision reached by the five Justices regarding access to private insurance was based on assumptions that do not stand up against the reality of Canada’s health care system seen in the context of other evidence from the world today.

False Conclusion #1: That he one source of funding for Canadian Health Care constitutes a “monopoly” which is the “cause” of the waiting lists that are presently seen as failing to provide timely access to medical services.

Reality #1: Drawing on her research and experience Dr. Flood points to several systems with varying levels of access to private insurance, (e.g. France) where access to health care is not better than our own and often worse, as in New Zealand.

False Conclusion #2: That having access to private insurance will reduce the burden on the public system.

Reality # 2: This is a “wrong intuition” based on the assumption that medical need is a static quantity. This assumes it’s like a niche market presently being served by one super store that doesn’t have enough personnel or store space to meet customer needs. By authorizing another marketer to move in claiming quicker access to the same products; not only won’t relieve pressure on the main system but will, in fact, attempt to draw from the already limited resources of personnel and space in the main system.
Dr. Flood asks ‘will physicians appear out of nowhere?’ Will market magic create medical personnel out of nothing?

False conclusion #3: Freedom to purchase private insurance will give many more people access to timely treatment.

Reality: A small percentage of people actually do purchase insurance where it is already available. “Ordinary” citizens are by far the majority in all systems. Dr. Flood illustrated that position from several countries. In the US, for example, 40% of the people in the top ten per cent income bracket have insurance. But 60% of ordinary citizens do not have private insurance. In Australia the state subsidizes private insurance. Dr. Flood even questioned how many insurers would cover Dr. Chaouilli’s 61 year old patient whom he claimed was being deprived of access to private insurance.

False Conclusion # 4 That the establishment of another system will not affect the Public System.

Reality: Again she gives examples from other systems- e.g. the Netherlands where 65% are still covered by the Public system and doctors are funded the same whether from public or private sources. Conversely there is motivation in Britain to dispense with publicly covered patients as quickly as possible in order to spend more time with people having higher paying privately insured illnesses.

Conclusion: The Supreme Court did not acknowledge the fundamental problem facing health care i.e. the limited capacity resulting from shortage of personnel and inadequate facilities. Points out that the Canadian Medical Association did not make a submission, nor did the Court talk about capacity. She believes the problem of waiting lists can be solved if Provinces and Federal forces want to. To do so, money and resources must go into increasing the number of trained personnel- costly as that may be.

Putting in an insurance system, no matter how fitted into public medicare, is the worst of all possible solutions.

Submitted by Sandy

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