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Does the Canadian health system work? Canadians are voting with their feet and their pocketbooks
by Kieran A.G. Bridge,
General Counsel
TU Group
 This is the fourth in a series of
articles on the present state and future of private health care and health insurance in Canada. This piece examines whether the current government-run health
care and health insurance systems are meeting Canadians’ needs.
One litmus test to answer this question is this: when given a choice, do Canadians want to rely on Canada’s health care and insurance systems? Based on
experience with Canadians who have taken ill or been injured while travelling outside the country, it appears that increasingly the answer is, “No.”
Many of us have experienced the frustration and anxiety of being on a wait list for treatment, or had a family member or friend on one. No one wants to
wait for important medical care, perhaps while in pain and fearful of deteriorating heath. Yet few people welcome the idea of having government bureaucrats
decide what is an “acceptable wait” for pain-relieving and perhaps life-saving treatment. Despite these facts, wait lists are the Canadian political system’s
response to a serious medical problem that politicians - not the medical system - created. Wait lists are Canada’s method of rationing so-called “free” medical care.
One of the greatest ironies is that although Canada has the closest thing in the western world to a universal government-funded health insurance system,
Canada’s medical care shortage and wait list problem is the worst of any major western country. In two decades of international health insurance work,
the only time I have heard reference to lengthy wait lists is in descriptions of what Canadian patients face if they come home after becoming ill in
another country. Wait lists and bed shortages are the main reason Canadians either do not want to, or cannot, come back to Canada for treatment even
when they are medically fit to return.
Consider the case of a Canadian who suffers chest pains while on holiday in Palm Springs. A cardiologist says he is medically stable but needs heart
surgery in the near future. The U.S. doctor talks to the patient’s GP in Canada, and the patient is told he can have the surgery in the U.S. within
the next day or two - which is typical - or fly back to Canada, wait for an appointment to see a specialist, and be put on a wait list for surgery at
some undetermined date. Even when faced with the possibility that travel-medical insurance will not cover the cost of surgery outside the country in
these circumstances, increasing numbers of Canadians are choosing to incur the cost of treatment in the U.S. or elsewhere, rather than coming back to
Canada and enduring the pain and anxiety of waiting for treatment here.
The growth of medical tourism is a result of the same problem. This involves Canadians taking pre-planned trips to other countries, such as
the U.S. or India, to receive prompt, high quality medical care.
Both of these situations, the vacationer who chooses to stay abroad for care and the Canadian who purposely goes to another country for treatment,
show that many Canadians believe wait times in this country are unacceptable, and are willing to part with their money in saying so.
These facts tell us there must be unfilled demand for private insurance to overcome the shortcomings of provincial health insurance monopolies and
government-run medical care.
In the next article: the Chaoulli case: what does it say and where will it lead? This will look at the impact of the Supreme Court of Canada’s decision
on provincial health insurance.
Kieran Bridge is General Counsel for the TU Group of Companies.
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