Listening to Jeffrey Simpson hold forth on medicare this a.m. on Michael Enright's Sunday Edition on CBC, I was struck by how disengenuous his prescriptions are for privatizing health care service delivery. I say disengenuous because he is well enough informed to know better. There is much that can be said about the problems of opening the door to private investment in the health sector -- and under NAFTA, once the dyke is breached, grab your life jacket! But let me just respont to the key argument he makes: "who cares who provides health care services so long as they are publicly regulated?" (I paraphrase).
The problem of course is that if it was easy -- or even possible to regulate against established economic interests we would have a carbon tax, the banks and hedge funds would not have made off with all the money in the world, and president Obama would have at least been able to utter the words "single payer."
As it now stands, MDs are private actors in the system -- but their desire for more income is greatly tempered by their ethical obligation to care for patients. Private investors in health care clinics and private hospitals have no such divided loyalty, in fact their only obligation is to maximize profit. That too often has meant prescribing services that aren't necessary, turning difficult cases away, and cutting corners on quality. All of this has been documented, and documented -- see Bob Evans and P. J. Devereaux's work if you want the evidence.
Apparently Jeffrey Simpson doesn't.
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