Home » No private healthcare in Canada, only public service. And for people it’s better this way

No private healthcare in Canada, only public service. And for people it’s better this way

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No private healthcare in Canada, only public service.  And for people it’s better this way

Last week, the Court of Appeals of the British Columbia rejected a request by a surgeon to review a judge’s decision preventing the execution of private health services. Both sentences are in line with Canadian law which provides for the existence of the public health only. The doctor in question had argued his right to privately paid benefits by patients to protect their own health, which was put at risk (in the doctor’s opinion) by the long waiting lists.

In Canada, medical activity is in fact fully integrated into public health system, albeit often with the support of private structures (facilities and equipment, not doctors). In some provinces it is also allowed for doctors to invoice health benefits to patient insurance rather than to the government, but never receiving them directly compensation from patients themselves. In short, in Canada, private healthcare as we know it in Italy does not exist; there is only the public one, and people are fine with it.

People are fine with it because the existence of public health alone guarantees the right to equity among citizens, making them all equal in the face of the need for medical assistance (not just in front of the law). Yes, all the same, from the president of a company that bills billions, to the propertyless. The path is the same for everyone: you think you have a health problem and go to your family doctor (or the emergency room of course if it’s something that requires immediate medical attention). The family doctor (or the emergency room doctor) tries to solve the problem, and evaluates whether to request a specialist visit or not; if there is a need for a specialist visit, the doctor evaluates the urgency, and this evaluation will have a decisive weight on waiting times.

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In other words, if you notice a mole on your arm and think it is a tumor, go to your family doctor; the doctor performs the examination and establishes that it is a simple mole, not a tumor; you decide instead that it could be a tumor and insist on seeing a specialist (which you cannot see for a fee!); then the doctor at your insistence requests a specialist visit, which you will receive after about eight or nine months (a long wait by Canadian standards). If the doctor, on the other hand, has doubts and thinks that it is really appropriate to carry out a more in-depth investigation on the presence of that mole, then he will make the same request and you you will see the specialist in five or six days at the most.

It works like this. For some it is not easy to accept, but in Canada it is in the hands of doctors when it comes to health.

Obviously, the most discussed topic in the public debate regarding the co-presence of public and private medical assistance in the health system itself is the effect that this creates: a health system for the rich, who thanks to their financial possibilities can access the private system, and a health system (the public) for the poor who cannot afford the private and which are forced to suffer the effect of decades of spending cuts which (coincidentally!) are always paired with cuts in education. But this is known, and it is an old story.

Instead, what is often ignored is the existence of another effect, the scam / illusion effect affecting both rich and poor alike. In fact, working privately does not necessarily mean having superior knowledge. Even the private is made up of charlatans, who, however, had this brilliant intuition of taking advantage of the financial disposition of the rich and the profound desperation of the poor; in this case, it would be better for rich and poor a good public system. A good public system can only be created if you choose to avoid it a conflict of interest among the professionals who work there.

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In the past, the United States has made the choice to avoid conflict by creating a private health system, which, however, only the rich have access to but which lets the less rich (not necessarily only the poor) die on the street. In Canada, the choice was luckily differentinvesting in a public system that is gradually able to guarantee decent health care to all citizens.

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