Ideas Diagnosing our Health Care Woes Health care privatization misses the real cause of Canada's health care funding problem: Big Pharma. By Ted Mitchell

Published November 28, 2005

With a federal election on the horizon comes the inevitable talk of imminent health care breakdown. Even physicians may be quick to leap to the conclusion that since the system is unsustainable, privatization of some sort is the only answer.

Whoa, just a minute. Before you suggest a solution, make sure that you understand the problem. The only meaningful question to ask is what parts of the system are unsustainable, growing at out-of-control rates?

Even a cursory examination of the numbers will show that patented drugs and high technology diagnostics and therapeutics come out on top. This sector is mostly privatized already, and we're talking large multinational corporations.

It is not a classic self-adjusting free market. This is a guaranteed market, with the taxpayer footing the bill. Big Pharma is spared the costs of competition and has no worries about not getting paid. And who politically would think of limiting drug benefits?

Realize also that at the root of most waiting lists is a hospital that balks at paying for some super-expensive patented technology. Physician factors are minor. Everywhere we see surgeons begging for more operating room time.

Public funding of large private interests is a recipe for unchecked overspending when the demand is driven by a third party, i.e. patients. This is always true.

The simple solution is to match public funding to public services (which includes payments to physicians), and private money to private ones. The former can easily regulate costs, and the latter self-regulates. Not politically correct, but sustainable.

Patent Law and the Public Good

But wait: what about patients who would benefit from these drugs and technology and can't afford them?

Indeed, there's the rub. But this ugly fact does not in any way disprove the above economic argument. Instead, it raises another even more difficult question, that of patent law and the public good.

Although profit is Big Pharma's primary goal, we have built a system where this private industry is almost solely responsible for research on drugs to improve the public good.

Should this unique arrangement fall under traditional patent law which will predictably limit access for a large segment of society?

If such patents were scrapped would all research progress cease?

Is there a middle ground and a more mature way of dealing with the problem?

These are not easy questions, and addressing them implies there are serious limitations with our precious dominant capitalist dogma.

The Real Problem

The only way that privatization can help sustainability is through replacing provincial funding of drug benefits and hospital funding of that latest gazillion dollar artificial joint.

But since that is tough medicine to swallow, expect arguments that privatization of peripheral things such as physician services and hospital beds can somehow accomplish the same goal. That is ridiculous.

If there are issues about inadequate hospital beds it is because funding has been slashed to attempt to pay for unsustainable private diagnostic and therapeutic advances. That is the root problem and it requires fixing.

Privatizing basic services will have no beneficial effect on health care sustainability because it is the solution to a different problem - one that currently doesn't exist.

Ted Mitchell is a Hamilton resident, emergency physician and sometimes agitator who recently completed a BEng at McMaster University. He is fascinated by aspects of our culture that are harmful, but avoid serious public discussion.

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