For years we’ve been fed the line that the public healthcare system is in crisis. An injection of private money and efficiencies is the cure-all, we’re told.

But Canadians are not buying it.

In an Ipsos-Reid poll published this winter, a large majority of Canadians said that what’s needed is improvements inside the system rather than user fees or more privatization. The supporters of private healthcare won’t be pleased by such news. For years they’ve been trying to scare us to soften us up for healthcare profiteers. Let’s look at their arguments.

Healthcare costs are skyrocketing. It’s true that healthcare costs have been rising, but they are still only 10 per cent of the Gross Domestic Product (GDP). In the United States, they are 14 per cent of the GDP. And the only component where costs are dramatically increasing is already in the private sector: drugs.

Pharmaceuticals now account for 16 per cent of all costs, an even greater proportion than physician services. There are a lot of reasons for this increase in costs, but private funding won’t solve any of them.

As our population ages, the costs will really increase. The Canadian Institute for Health Information estimates that the aging of our population will result in an increase in per capita health spending of a little more than 1 per cent annually from 2005 to 2025.

The private sector is more efficient. Wrong again. A 1997 study in The New England Journal of Medicine showed that administration accounts for 34 per cent of costs in profit-making private hospitals in the U.S. compared with 26 per cent in public hospitals.

In the United Kingdom, where privatizing experiments similar to those proposed by Alberta premier Ralph Klein have been carried out, costs are greater than before and service is worse.

In what was touted to be the great reform of the National Health Service in Britain, doctors were permitted to work in both the public system and a new parallel private system. Private hospitals will reduce the pressure on public hospitals, the purveyors of privatization argued. And the result?

Patients have watched as waiting lists have grown enormously in the public system. Private hospitals have wound up costing more as well.

In Australia, too, costs have increased with privatization.

So why do the premiers of Alberta, Ontario and British Columbia insist on exploring privatization? Blind ideology could be one reason. The other might be the money to be made by privateers, many of whom fund right-wing parties.

Canada’s federal health minister, Anne McLellan, is a little tooaccommodating to these premiers for my liking. The federal politicians should be taking a leading role in preserving our public system. Instead, it is the Health Coalitions that are going door to door across the country to mobilize and make visible the massive support for public healthcare.

And preserving public healthcare is not that tough. The National Forum on Health — commissioned by the Jean Chretien government — provided the prescription in 1997; bring home care and pharmacare into the public system. Home care saves money by keeping seniors and people with disabilities out of expensive long-term care facilities and, with even greater savings, out of acute-care hospitals.

A study by Health Canada in British Columbia in 2001 compared two regions where home-care services such as housecleaning had been cut with two regions where it was provided. After three years, the healthcare costs per person where home care was provided averaged $CDN 7,808 Where home care had been cut, costs were $11,903 per person. That’s a difference of $4,000 per person with home care. What’s more, most people would much rather stay in their homes than live in institutions.

Reforming primary care — what you get when you go to your doctor — would also save significant amounts of money. Right now, doctors do piecework. They get paid per service. They have an incentive to see as many patients as possible and focus on specific symptoms rather than on the whole person.

Financing healthcare per patient, rather than per service — or organizing family physicians in clinics where other professionals like nurses play a more important role and doctors are on salary — would also cut costs.

Nurses could do many of the things that doctors do now, at a much lower cost to the system.

But the most important reforms that could be made are to invest more in prevention and in reducing poverty, which is the strongest indicator of poor health — both mental and physical.

Unfortunately, there’s not much profit in that.

Judy Rebick

Judy Rebick

Judy Rebick is one of Canada’s best-known feminists. She was the founding publisher of rabble.ca , wrote our advice column auntie.com and was co-host of one of our first podcasts called Reel Women....