The single-payer model: a foundation for professionalism

http://www.pnhp.org/print/news/2014/october/the-single-payer-model-a-foundation-for-professionalism


Dr. Brian Day, founder of Vancouver’s Cambie Surgery Centre, and other commercial specialty clinics are suing B.C. to allow private funding of medical care. This would facilitate expansion of private diagnostic and surgical procedures and undermine the single-payer model. The integrity of Canada’s entire health system could be at risk.

Advocates for commercialized healthcare funding, now prohibited by the Canada Health Act, often promote a “hybrid model.” In 2012, Dr. Day wrote in a newspaper column that European countries successfully combine universal care with a public-private system, but he failed to address the different contexts of North America and Europe.

European insurance and healthcare sectors are highly regulated. For instance, in France, even supplemental health-insurance funds are not-for-profit, unlike in Canada, where supplemental insurance, now limited to pharmaceuticals, dental, vision and complementary care, is offered by for-profit corporations.

Canada has extensive commercial ties to the United States, not to Europe, and were the “hybrid” advocates to prevail, U.S. insurers could invoke NAFTA to gain access to an expanding Canadian health-insurance market.

U.S. insurance companies are unlikely to submit to a European-style model in Canada, where regulation in most sectors is already more American than European because of harmonization under NAFTA.

Furthermore, these insurance companies have the resources to get what they want. In 2013 the leading U.S. health insurers reported $12.7 billion in profit on $313.7 billion in revenue (U.S. dollars). According to OpenSecrets.org, that same year health insurers spent $154 million on lobbying U.S. lawmakers.

Using their financial clout, they could quickly change the landscape in Canadian healthcare funding for not only procedural medicine but primary care, mental-health care and other specialties.