Issues: What We Believe

The Association of Canadians for Sustainable Medicare [C4SM] is a non-profit society registered in Alberta comprised of patients, providers and businesses.

Your Voice for Patient Choice™

Fact: Canada’s publicly funded health care system – commonly known as Medicare – is a government-run monopoly. It prohibits private-sector hospitals and physicians for services under the Canada Health Act.

Canadians deserve a publicly funded health care system that:

  • Provides timely access to quality care.
  • “Walks the talk” with a care guarantee to access.
  • Is sustainable.
  • Promotes innovation.
  • Values the contributions of the private sector.
  • Is relevant for the 21st century.

Furthermore, Canada’s health care must become relevant for the 21st century. It must grow beyond the monopoly model, which was designed for the 1960s. Significantly, no other country in the world has copied Medicare.

  • Canadians deserve the right to have the choice of hospitals and physicians in the private sector.
  • The government-run monopoly for hospital and physician services must end!
  • Respect for entrepreneurship, innovation and competition will lead to an expanded, more vibrant and more robust health care system.
Misson-banner - Stethoscope and Test results

Medicare is a Subpar Health Care System

It’s a myth that Canada has the best health care system in the world. We spend more per capita on health care than many other countries. What’s worse is that, while we do this, we get poorer outcomes for our patients.   – Federal Health Minister Dr. Jane Philpott, in a speech to the Canadian Medical Association August 2016

“Mirror, Mirror on the Wall,” the 2014 update from the Commonwealth Fund ranks Canada’s health care system No. 10 out of 11 countries. No. 1, United Kingdom; No. 2, Switzerland; No. 3, Sweden; No. 4, Australia; No. 5, Germany and the Netherlands; No. 7, New Zealand and Norway; No. 9, France; No. 10, Canada; No. 11; United States.

Not surprising, Canada ranks last, No. 11, in “timeliness of care”; it’s No. 10 in “safe care” and “efficiency.”

But it’s Canada’s No. 9 ranking on “equity” that should have Canadians scratching their heads. After all, equity has always been the rationale for Canada’s ban on the private sector of hospital and physician services.

So, what gives? Eight countries that endorse the hospital-and-physician private sector not only outperform Canada overall, but also on the cherished Medicare ideal of equity!

The Commonwealth Fund defines equity as: “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location and socioeconomic status.”

It grouped adults into two income categories, with the results reported in 10 dimensions. They include: rated quality of doctor fair/poor; rated quality of care fair/poor; had medical problem but did not visit doctor because of cost; did not get recommended test, treatment, or follow-up because of cost; did not fill prescription or skipped doses because of cost; waited two months or longer for a specialist appointment; and, unnecessary duplication of medical tests.

Ten Priorities

  • Inject reality into the politics of the Canadian health care system.
  • Balance the public debate.
  • Introduce Patient Choice.
  • Give ordinary Canadians choice north of the 49th parallel.
  • Make Medicare sustainable.
  • Make Medicare accountable.
  • Value and encourage the innovations and contributions that the private sector can bring.
  • Reframe and modernize the Canadian health care system for the 21st century.
  • Introduce a Health Care Guarantee.
  • Adopt best practices from countries that outperform Medicare.

Myth, Misconception of Medicare

One enduring myth is that the rest of the world is envious of Canada’s health care system. As the saying goes, “the proof is in the pudding.” Medicare began in Saskatchewan in 1962 and across Canada in 1969, almost five decades ago. But not one other country has followed our example. Not one!

One enduring misconception held by Canadians is that Medicare is a high-performing health care system. According to a June 2015 Ipsos report, “three in four Canadians say that the health care system is among the best in the developed world [75% strongly or somewhat agree].”

A Privileged Few – Going to the Front of the Line

Under the Canada Health Act, three groups have preferred, expedited access to medical care.

  1. Members of the Canadian armed forces.
  2. Injured workers who have coverage through the Workers’ Compensation Board.
  3. Inmates in federal prisons.

Hush-hush, nudge-nudge, wink-wink – urban legend and water-cooler talk are that professional athletes [hockey, football, etc.] are obvious to the public’s wait times, sometimes because their clubs send them to the USA for treatment.

Is “Elective Surgery” Really Elective?

The three levels of medical care:

  1. “Emergency” is how it sounds. The care is needed now! The expression “life and death” comes to mind. Medicare is fairly good when it comes to emergency care.
  2. “Urgent” used to be a few days beyond emergency. Now, however, it can be weeks or months, e.g., waiting to have a urgent test.
  3. “Elective” isn’t emergent or urgent, but it is necessary. Waiting months, even more than an year, can cost people their jobs, their health can deteriorate, and there can be immense emotional and financial stress on the family.

The Alberta government classifies cataract surgery as elective. It imposes a quota on each ophthalmologist [with severe penalties for exceeding the quota].

You have to wait in the public queue; you can’t buy this surgery privately in Alberta.

What you can buy, however, is a 70-inch, high-definition television that you can’t see until you’ve had the “elective” surgery and your cataracts have been removed.

“Name one surgery that benefits from being delayed.”

– A surgeon challenging a top Alberta Health Services administrator a few years ago.

Canada’s government-run health care system – Medicare -- is a monopoly that prohibits private hospital and private physician care. Medicare is a subpar performer, ranking 10th among 11 advanced countries. Canadians deserve much better! Patients deserve timely access to quality care and choice of hospitals and physicians. Taxpayers deserve much more value for their tax dollars.

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