The Whole Story

Medicare Isn’t Sustainable – How Much is Enough?

 A former Alberta health minister once commented that his cabinet colleagues resented the fact that his budget “ate their lunch.”

In the early 1980s, health care expenditures took 30% of the Alberta government’s operating. Today, it’s 40%; and, Health Sarah Hoffman has raised a red flag that it could reach 60% in 2036, less than two decades from now.

In this sense, Medicare has become a zero-sum game. Every extra dollar spent on health care reduces the amounts available for other important government programs and services such as:

  • Affordable housing
  • Low-income support
  • Seniors
  • Public education
  • Universities and colleges
  • Bridges and roads
  • The environment

Government deficits and government debts further erode the sustainability of Medicare. Money spent on interest payments isn’t available to provide timely access to quality care.

A Herculean Challenge­­­

 Medicare carries with it more than 50 years of history, misconceptions, mythology and political correctness. It­ has achieved an iconic status among many Canadians. For example:

  • Medicare defines Canada as a nation. [If it does, it means Canada is a second-rate nation.]
  • It’s un-Canadian for the private sector to deliver hospital and physician services.
  • It’s un-Canadian to “make a profit” in health care.

Supporters of the public monopoly have been unopposed in defining what Medicare “is” and what Medicare “can only be.” They:

  • Oppose private funding for hospitals [except for hospital foundations and private donations] and for physicians.
  • Oppose private delivery of hospital and physician services.
  • Oppose patient choice.

The Medicare monopolists are committed, organized, vociferous, very well financed – and they enjoy a 50-year head start and the advantage of an unbalanced playing field.

Unions, especially health care and other public sector unions, are major champions of the monopoly, e.g., United Nurses of Alberta [UNA], Health Sciences’ Association of Alberta [HSAA] and the Alberta Union of Provincial Employees [AUPE]. They support a number of organizations, most prominently the Friends of Medicare.

Union support for the status quo is understandable. Union members + union dues = power, legitimacy, size and influence.

Politically, the NDP and left-wing/progressive elements of the Liberal Party are foes of the private sector. Unfortunately, when it comes to health care, business-oriented Liberals and conservative politicians tend to display timidity instead of leadership.

Patients Deserve Sustainable Health Care

Patients Deserve a “Health Care Guarantee”

Governments have no hesitation in hold holding the private sector to be accountable for its products, services and performance. They, however, refuse to “walk the talk” when it comes to Medicare and your health care.

As the Supreme Court of Canada observed: “Access to a wait list is not access to care.”

Two highly reputable advocates for patient choice are the Standing Senate Committee on Social Affairs, Science and Technology, which was then chaired by Liberal Senator Michael J.L. Kirby, and the Canadian Medical Association.

In its final and sixth report, aka the Kirby report, the Senate committee concluded:

“Governments can no longer have it both ways – they cannot fail to provide timely access to medically necessary care in the publicly funded health care system and, at the same time, prevent Canadians from acquiring those services through private means.”

The Senate committee recommended “a maximum needs-based waiting time be established” for “each type of major procedure or treatment.” When this maximum was reached, the Health Care Guarantee would require the government to “pay the patient to seek the procedure or treatment immediately in another jurisdiction, including, if necessary, another country.

The Canadian Medical Association agreed. It has called for “a safety valve” and alternative care choices when Medicare fails.

The Health Care Guarantee makes governments, bureaucrats and health administrators very queasy.

Patient Choice for the Average Canadian

“Rich” Canadians have always enjoyed choice in their health care by travelling to New York City, Rochester, Minneapolis, Palm Springs San Diego, etc. They include politicians such as former Prime Minister Jean Chretien and former Newfoundland-Labrador Premier Danny Williams.

Why shouldn’t the average Canadian enjoy the same opportunity for choice north of the 49th parallel?

The argument about equity has been exposed as fallacious, as merely another remnant of Medicare mythology.

“Mirror, Mirror on the Wall,” the 2014 update from the Commonwealth Fund ranks Canada’s health care system No. 10 out of 11 countries.


1. United Kingdom
2. Switzerland
3. Sweden
4. Australia
5. Germany and the Netherlands
7. New Zealand and Norway
9. France
10. Canada
11. United States.

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!

Patient Choice for the Average Canadian

The Power and Importance of Choice

Patient choice is one anchor of the Association of Canadians for Sustainable Medicare, and expressed in our trademark, Your Voice for Patient Choice™.

In 2015, the Supreme Court of Canada recognized the power and importance of choice in its ruling on a person’s autonomy, specifically a person’s right to die.

But, what about a person’s right to choose to live?

  • The right to have a choice as to when, where, and from whom we can receive our medical and health care.
  • The right to choose a hospital, in either the public or private sector.
  • The right to choose a physician, in either the public or private sector.

If, as the Supreme Court has ruled, a person has the right to die without undue pain and suffering, then what about a person’s right to live without undue pain and suffering? For example:

  • Not being on a wait list for months, even years, for a test, surgery or treatment for chronic care.
  • “Name one surgery that benefits from being delayed.”  – A surgeon challenging a top Alberta Health Services administrator a few years ago.
  • Not dying before Medicare decides it has the resources to provide the necessary care.
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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