rabble blogs are the personal pages of some of Canada's most insightful progressive activists and commentators. All opinions belong to the writer; however, writers are expected to adhere to our guidelines. We welcome new bloggers -- contact us for details.

How private clinics lengthen wait times for all of us

Please chip in to support more articles like this. Support rabble.ca today for as little as $1 per month!

Photo: Nellies Beemster-Klaucke/flickr

You can change the health-care conversation. Chip in to rabble's donation drive today!

Have you ever asked yourself or been asked, isn't a two-tiered health-care system a good thing if it shortens wait times? If the rich want to pay out-of-pocket for their health care and free up space in the wait line for public care, shouldn't we let them? It sounds logical, right? It isn't.

I'm going to try and explain how private clinics lengthen wait times for the 99 per cent of us and I'm going to do that by using the example of the grocery store.  

We've all probably been in line at the grocery store when the place is packed and only two cash registers are open. Let's name the lanes 1 and 2. The for-profit clinics argue that if you opened a third lane (number 3) and you make it an express line -- eight items or less -- you'll shorten the other two lines. I should explain why lane 3 is an express lane. Private, for-profit clinics are just that, for-profit. Their goal is to make money for themselves and their investors. In order to make money in health care, you need to perform profit-making surgeries with profitable patients. This means patients are cherry-picked by age and care required. If you're young, healthy and rich, you've got a good chance of seeing a doctor at the private clinic. If you're elderly, if you have a chronic condition, or if you can't afford private care, you will be promptly sent back to public health care -- you're not profitable enough.  

Additionally, if anything goes wrong with your surgery at the for-profit clinic, or if you require follow-up care, you're often referred to the public system. Complications are expensive and for-profit clinics won't make money off of them. They want healthy, young, rich patients with straightforward surgical needs. Eight items or less.

Still with me?

If a grocery store has an extra staff person on hand, this works really well. People with eight items or less move over to lane 3 and lanes 1 and 2 shorten.

Here's the problem when we try to apply this third express-line analogy to health care -- where are the extra health-care professionals to staff lane 3? Where's the extra surgeon, radiologist, nurse practitioner that can be taken away from the tasks they're doing now? Removing medical professionals from the public health-care system means one less person to see patients.

The true picture of an express lane means that the cashier at lane 2 abandons their post and moves over to lane 3 (express lane). Now the people at lane 2 need to merge with lane 1. Lane 1 has become a much longer line. Lane 3 is now open -- but only to people who have eight items or less (healthy, wealthy, young). Also, people in the express lane are going to need to pay 100 times more for their groceries than people in lane 1. So lane 3 is looking pretty empty with a cashier just waiting for the occasional shopper with eight items or less who is willing to pay extra for their groceries. If you can go to lane 3, you'll certainly not add yourself to the line in lane 1. But let's be honest, by removing the lane 2 cashier who could serve any customer in the store and putting them in an express line with strict requirements for service, you certainly haven't reduced the wait time for the 99 per cent of shoppers -- in fact, you've significantly lengthened it.

A two-tiered health-care system means longer wait times for just about everyone. It also means a lot more; it changes the ethics of health care in Canada. Instead of pooling our health-care resources, triaging our residents and ensuring everyone gets the care they need when they need it, a two-tiered system says that Canada thinks the healthy, young and really wealthy deserve care before others.

While the idea of blogging about health care using the analogy of a grocery store may be silly, understanding the injustice inherent in a two-tiered health-care system is essential, especially now. There is a court case making its way to trial very soon in B.C. (likely September, 2014) on two-tiered health care. Dr. Brian Day of the Cambie Surgical Clinic was found during a provincial audit to have illegally billed both the clinic's patients and the public health-care system $566,000 in only 30 days! The B.C. government was taking Dr. Day to court when he launched his own lawsuit. He is suing the B.C. government for "the right" to make a profit off sick patients and the province. Dr. Day is challenging Canada's medicare laws and if he is to win, we would lose single-tiered health care in Canada.

The Council of Canadians is supporting the work of our allies the British Columbia Health Coalition and Canadian Doctors for Medicare who have intervener status in the case.  On December 3, the Council of Canadians ran a fundraiser to help raise funds for the legal intervention. The Canadian Federation of Nurses' Union generously matched all the funds raised. Thank you to everyone that participated and donated. Please continue to donate if you can and please talk to your friends, neighbours, colleagues and community about what a two-tiered health-care system would mean for Canada. We need your help to get the message out that Canada believes in a single-tiered public health-care system that ensures everyone has access to care regardless of their ability to pay. No eight-items-or less requirements for care and no lengthening wait times for the 99 per cent.

Like this article? Chip in to keep stories like these coming!

Photo: Nellies Beemster-Klaucke/flickr

Thank you for reading this story…

More people are reading rabble.ca than ever and unlike many news organizations, we have never put up a paywall – at rabble we’ve always believed in making our reporting and analysis free to all, while striving to make it sustainable as well. Media isn’t free to produce. rabble’s total budget is likely less than what big corporate media spend on photocopying (we kid you not!) and we do not have any major foundation, sponsor or angel investor. Our main supporters are people and organizations -- like you. This is why we need your help. You are what keep us sustainable.

rabble.ca has staked its existence on you. We live or die on community support -- your support! We get hundreds of thousands of visitors and we believe in them. We believe in you. We believe people will put in what they can for the greater good. We call that sustainable.

So what is the easy answer for us? Depend on a community of visitors who care passionately about media that amplifies the voices of people struggling for change and justice. It really is that simple. When the people who visit rabble care enough to contribute a bit then it works for everyone.

And so we’re asking you if you could make a donation, right now, to help us carry forward on our mission. Make a donation today.

Comments

We welcome your comments! rabble.ca embraces a pro-human rights, pro-feminist, anti-racist, queer-positive, anti-imperialist and pro-labour stance, and encourages discussions which develop progressive thought. Our full comment policy can be found here. Learn more about Disqus on rabble.ca and your privacy here. Please keep in mind:

Do

  • Tell the truth and avoid rumours.
  • Add context and background.
  • Report typos and logical fallacies.
  • Be respectful.
  • Respect copyright - link to articles.
  • Stay focused. Bring in-depth commentary to our discussion forum, babble.

Don't

  • Use oppressive/offensive language.
  • Libel or defame.
  • Bully or troll.
  • Post spam.
  • Engage trolls. Flag suspect activity instead.