We are days away from the start of the next federal election. As political parties of all stripes take to the campaign trails, we can expect there will be a good deal of discussion about what’s to be done to fix Canada’s health care system. But when we talk about improving health care in Canada, what are we talking about? We all agree that reform is necessary, and there are two distinct approaches we can take. We can improve the way we pay for health care, and we can improve the way we deliver health care.

Payment reform has regrettably been the focus of our debate, much to the benefit of those capable of earning hearty profits from a two-tiered, U.S.-style system in Canada. Although payment reform has its place, and can positively affect delivery¹, the most effective solutions lie in changing the way health care is delivered and streamlined. Focusing on delivery rather than money puts the needs of patients, and their relationship to their health care, above the profit motives of private

investors.

Much has been written recently about Cambie Surgery Centre’s constitutional challenge now before British Columbia’s Supreme Court. Regrettably, much of it promotes a multi-payer health care system as the only viable alternative for reforming Medicare. This would allow the wealthiest among us to buy private insurance for faster care, resulting in longer waits for the vast majority of us. This focus on payment reform distracts us from the important work and potential of health delivery reform.

As an intervenor in this litigation, Canadian Doctors for Medicare knows that as public policy reformers, we can defend the fundamental values upon which Medicare was founded while also advocating for bold change. Standing up for universal publicly-funded health care, while also fighting for reforms where the system falls short, is not a defence of the status quo.

Canadian Doctors for Medicare has won the right to bring key evidence in favour of public health care before the court, and we are privileged and proud to represent the vast majority of people in Canada who believe that access to our health care system should be based on need, not ability to pay.

Rather than being content with a health care system that is already far more equitable and affordable than those envisioned by private interests, Canadian Doctors for Medicare consistently advocates for evidence-based reforms that will improve the accessibility, quality, and sustainability of our universal health care system. Targeting major reform efforts towards dismantling the single-payer structure of our health care in Canada is a step backwards, at a time when other countries are moving towards their own single-payer models. Delivery reform, in contrast, focuses on improving the care that patients receive, and funding those improvements to ensure that they are sustainable and scalable.

Consider, for example, the development of the Rapid Orthopaedic Consult Clinic (ROCC), a Shared Care project designed to reduce wait times and increase access to orthopaedic specialist care for all patients, not just the few who could afford to pay for priority access². Working together, GPs and orthopaedic specialists implemented a variety of reforms aimed at improving communication and reducing misdirected referrals. The result was a dramatic reduction in wait times, from 18-24 months to just 12 weeks.

A recent CBC poll³ noted that Canadian voters have identified health care as one of their top three election priorities. People in Canada want and deserve a public health care system that benefits patients, families, employers and communities across the country, not simply the few who can afford a better class of care. Through bold and innovative reforms, a more equitable and affordable model of health care is not just desirable, but achievable.

Advocates for a multi-payer health care system that benefits the privileged few depend on the support of those who believe that a public health system is doomed to fail. Canadian Doctors for Medicare is proud to represent the majority of Canadians who are well-served by our health care system, who demand the best of it, and who recognize the need to defend it.

Canadian Doctors for Medicare emerged in 2006, through the effort and coordination of a group of physicians and advocates who recognized that while Canada’s public health care system wasn’t perfect, the solutions do not lie in increasing profits for investors and reducing access to care for those who cannot afford to pay.

Dr. Danyaal Raza is an academic family physician and the Chairperson of Canadian Doctors for Medicare.

Dr. Vanessa Brcic is a Vancouver-based family doctor and mother, as well as a member of Canadian Doctors for Medicare’s Board of Directors.

Dr. Robert Woollard is a Professor in the Faculty of Medicine at the University of British Columbia and the Executive Vice Chairperson of Canadian Doctors for Medicare.

References

1. http://www.cmaj.ca/content/190/39/E1162

2. http://www.sharedcarebc.ca/results/success-stories/gps-and-orthos-rocc-n-roll

3. https://www.cbc.ca/news/politics/election-message-poll-analysis-1.5193047