NB Minister Open to User Pay Health Care

User fees are not allowed under the Canada Health Act and so if they were used transfer payments ought to be stopped from the Feds. Of course there are already under the table user fees (tray fees in private clinice etc.) and de-insuring of some items. The Canadian system is not very generous in what is covered compared to many other countries. Generally speaking all universal systems have been evolving so that more expenditures become out of pocket rather than out of taxes. This is part of the continual erosion of the entitlements of the welfare state.
Of course user pay is a misnomer since users pay anyway. However they can pay collectively through taxation on the basis of income or individually out of pocket--or more likely by private insurance.



Friday » April 27 » 2007

N.B. minister open to user-pay health care
Wants option on table

Tom Blackwell
National Post


Friday, April 27, 2007


A key member of New Brunswick's Liberal Cabinet has signalled an unexpected new openness to private-sector involvement in health care, suggesting for-profit companies be allowed to compete for public health dollars and patients permitted to pay for medical services out of pocket.

Michael Murphy, the Minister of Health, also said in a speech yesterday that the health care system could make millions of dollars by selling surplus capacity in operating rooms to workers compensation boards, private insurers and corporations.

It could all be part of what he called a North American health care "hub" in the Atlantic province.

Mr. Murphy, the Minister for just seven months, acknowledged his ideas will be considered controversial, and he stressed that patients must continue to have speedy, equal and free access to health care.

But he said soaring health care costs and New Brunswick's determination to shed its dependance on federal transfer payments mean new ways of managing the system have to be explored.

"Right now, there are probably New Brunswickers in the United States, in India or even another province in Canada obtaining a health service that they'll pay for entirely on their own," the Minister said in his speech.

"What if they could do that here? This could reduce the demand on our public system."

"We need to open our minds to new possibilities in health care," he added. "We need to share ideas and, at the same time, respect other people's opinions."

Mr. Murphy said none of the suggestions in his speech to the Fredericton North Rotary Club are government policy yet, and his ultimate goal is to strengthen the universal system.

But his statements quickly generated controversy.

Dr. Gerald Maloney, head of the New Brunswick Medical Society, said the Minister should be lauded for being "brave" enough to float the sort of proposals that often backfire on Canadian politicians.

"He just wants to have a debate. He's not trying to prejudice any decisions," said Dr. Maloney, a family physician in St. Martins, N.B. "As long as the system allows for timely access by all patients, regardless of their ability to pay, then I think we're on side with holding discussions."

But Michael McBane, a spokesman for the union-led Canadian Health Coalition, a staunch defender of the public system, said the ideas have been proven ineffective and would only make health care more expensive and less accessible.

"These are the kind of stale ideas that have been batted around for decades," Mr. McBane said. "It doesn't work and it's been studied to death."

He said it is ironic that New Brunswick is looking at free-market health care when many in the United States are backing away from that approach and Alberta's Conservative government abandoned a similar plan it proposed last year.

An analyst with The Fraser Institute, a conservative think-tank, however, encouraged Mr. Murphy to follow through on his ideas, which he said would create parallel public and private systems similar to those of countries like Sweden and Switzerland.

"New Brunswick is actually having the conservation that we should be having in every province," said Nadeem Esmail of the institute's Calgary office. "These discussions are definitely a good thing for the residents of New Brunswick."

Mr. Murphy said he did not think a separate private health system would ever become very large in his province of 800,000, but suggested people should have the choice.

"Is it really right for us to tell people how to spend their money?" he asked in an interview.

His also proposed giving for-profit operators more opportunity to compete for public funding of services that would be available free to all.

If a private company can offer the care more cheaply, "We have to give this a very close look," he said.

The Minister asserted that operating rooms in the province's hospitals often go unused, even during the day, because of an "archaic" system of matching surgeons with patients.

Even if those problems could be solved and medicare patients served more quickly, there would still be excess capacity, he maintained.

That could be sold to the workers compensation board, insurance companies that want their clients to get treated faster or even "global corporations" anxious to get their sick or injured employees back on the job, Mr. Murphy said.

© National Post 2007








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