With the recent Supreme Court decision on wait times, and the moves by some provincial governments to allow a bigger role for the for-profit sector in health care, advocates of for-profit care are pretty pumped.

Finally, we’re informed, we’ll have the much needed “public debate” about for-profit care. Those dinosaurs who’ve insisted we shouldn’t even think about a for-profit role will now have to face the crucial “debate” which we’ve apparently never had the courage to face.

Give us a break. That whole line of argument is extremely disingenuous.

First, there’s actually a difference between a debate and legislation imposed by a majority government. News flash: Government majorities sometimes act in ways not sanctioned by their electorates.

Second, the pretence that there hasn’t been a debate about the role of the for-profit sector in health care, that Canadians have somehow refused to discuss it, is preposterous.

As one example only, what was the Romanow Report if not the most intensive democratic public debate about health care that we’ve had since the origin of the Canada Health Act?

We’ve had the debate, repeatedly. Repeatedly, public non-profit care has been shown to be the overwhelmingly better choice.

It still is, for everyone except those who want to make a profit from this change, or those who believe, as an ideological principle, that profits always trump people.

Let’s look, once again, at some well known facts.

Fact one: For-profit care will not reduce wait lists. Wait lists are caused mostly by shortages of health care professionals. A parallel for-profit system will not create a single new doctor, or nurse, or paramedical professional. It will simply, inevitably, make health professional shortages worse. Instead of a limited supply of professionals to serve one system, that same limited supply will have to serve both the for-profit and public systems.

Fact two: For-profit care is more expensive. The Romanow Report proved that, after extensive research. Studies in the Canadian Medical Journal, and many others, prove this point. The evidence is simply incontrovertible.

For-profit care is inefficient. Each for-profit company has its own administrative costs. For-profit companies pay their executives more, including executive bonuses. And for-profit companies must deliver a profit, the bigger the better.

Fact three: The quality of for-profit care is lower. This is not opinion, it’s as well proven, as inevitable, as gravity. The studies are totally consistent — a recent study of 38 million patient records in the U.S. showed that patients treated in for-profit facilities had an eight per cent higher mortality rate.

The sole purpose and legal obligation of for-profit companies is to make a profit. What they actually do to make that profit is secondary, only a means to an end. So, corners get cut, cheaper processes are used, fewer health care providers are employed and patients are moved out more quickly.

Of course the biggest myth we still face is that the rising costs of our public system can’t be sustained, that radical changes are needed to control these costs.

How can anyone seriously argue that even partially adopting a more expensive system, for-profit care, will help lower overall costs? Every international comparison shows the same thing — the more a country adopts for-profit care, the more expensive the overall system is.

The U.S., with the largest for-profit health sector of all industrialized countries, spends over 50 per cent more per person on health care than Canada.

The affordability of public health care is really a matter of political choices. As of about 2003, cumulative tax cuts have resulted in foregone revenues for our various governments of about $250 billion. During that same period, health care spending increased by just $108 billion.

Clearly, many governments in Canada have chosen to make tax relief for the wealthy and profitable corporations a bigger priority than health care.

Equally clearly, the increases in health care spending of recent years were mostly the result of governments scrambling to back-fill the cuts they made during the 1990s.

As a percentage of our overall economy, health care spending is now back where it started. By 2004 we were spending just over 10 per cent of our GDP on health care — about the same as we were before all the cuts of the 90s.

The Canadian Institute for Health Information says “there is no evidence the health care system is not sustainable.” A federal Finance Department study concluded that spending on health care will remain essentially stable at about 10 per cent of GDP until at least 2040.

The argument that “what we need in Canada is an open and honest debate about for-profit health care,” is specious, dangerous, and driven by a self-serving for-profit lobby.

It asks Canadians to ignore the facts, ignore the vigorous and conclusive debate that has already taken place.

Canadians understand that for-profit care will strip the public system of scarce health care professionals, will cost more, and will provide a lesser quality of care.

Those are the facts. Canadians are not fools, and they will not be fooled.

Larry Brown

Larry Brown

Larry Brown has been Secretary-Treasurer at the National Union of Public and General Employees (NUPGE), one of Canada’s largest unions, for over 25 years. In addition, Larry is the President of...