Common Sense and the CMAs Campaign for the Partial Privatization of Health Delivery

Here's a true story from Canada. It looks like 'market-friendly' forces in the Canadian Medical Association (CMA)are campaigning to allow the part-privatization of health delivery services. To be fair, a lot of health delivery services in Canada are actually private. For instance, much like in the UK, for some bizarre reason dental care isn't part of 'free at the point of delivery' care that public health care systems usually take pride in. Pride one should take in such public systems because they permit equitable access based on health needs as opposed to individuals' capacity to pay.

Well, the current CMA leadership aims to permit doctors to take on private patients. The argument is that this could reduce public sector waiting lists. Surely, this is either disingenious or mischievous. Public sector waiting lists in this country are seriously out of sync with delivery needs. This suggests that Canada likely invests insufficient resources into the training of future health care professionals.

Whatever the cause of the suboptimal supply of health care professionals (certainly GPs) in Canada, one thing is clear, the proposed piecemeal privatization of the public service will not change that status quo. If you have X numbers of physicians working today in a given country's public health service (and X is a fixed number), permitting those professionals who make up X (the group) to work in private practice is not going to change the number of professionals making up X.

What it does, however, is to create a market for health services. Those who are able and/or happy to pay will be able to jump the queue that exists in the public sector. They indeed will see their waiting times slashed. Of course, privatization is fundamentally about (not to say against) equal access. Equal access is undermined because if X remains stable (ie the number of GPs per 100 population), a smaller number of clinicians would have to serve the larger number of folks who couldn't afford private services. A large numbers of people will predictably be worse off, a smaller number will equally predictably be better off.

Which shows that the CMA is a doctors' trade union. It's more concerned about increasing doctors' income then patient welfare.