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  • COVID-19 crisis lays bare the importance of universal medicare

    Thara Kumar


    Nurses, doctors, respiratory therapists and support staff at Vancouver General Hospital's emergency department (Photo courtesy of Lara Gurney, RN)


    Co-authored with Melanie Bechard


    WHILE GOVERNMENTS, health care workers and the Canadian public are uniting to take on the COVID-19 pandemic, some critics have seen this as an opportunity to capitalize on public fear and promote a profit-driven health care system over Canadian medicare.

    Would Canada—as some claim—really have been better prepared for a pandemic in a health system where care would be delivered to those who can afford to pay for it, rather than based on need?

    Let’s look at the evidence.

    No country could have been fully prepared for a crisis of this scale—indeed, no country has been. No country in the world has an “on demand” health care system with limitless capacity. That would mean building empty “rainy day” hospital beds and stockpiling unused ventilators and personal protective equipment (PPE) for decades, in the event they would be needed some day.  

    But Canada’s single-payer health system has allowed us to impressively ramp up our “surge capacity” to expand in a time of crisis—while still ensuring universal access.

    In a matter of just weeks, Canadian hospitals have increased staffing for critically ill patients, reduced inpatient loads by 30-40 per cent to make room for a surge of COVID-19 admissions, and bolstered our supply of PPE and ventilators. 

    These measures were taken so that every patient who requires hospital care for COVID-19, or for any other medical emergency, can continue to access the highest quality of care possible, no matter who they are or what they earn.

    Our health care system is not traded on the stock exchange. 

    Fans of the American health system praise it for having lower average hospital occupancies of 64 per cent, leaving lots of room for surge capacity in a crisis. But what they fail to recognize is that these half-empty hospitals are a result of the most expensive profit-driven health care system in the world, in which hospitals are all competing to attract “customers,” over-selling tests and treatments just to keep themselves in business.  

    Tragically, those empty hospital beds are of no use to the roughly 30 million uninsured Americans with no access to care, or the millions of under-insured Americans who risk financial ruin if they seek care or choosing between paying crippling hospital bills or having a roof over their heads.  

    This is even more concerning in a viral pandemic where those with no access to medical care can put the rest of the community at risk.  

    Health care profiteers persistently and intentionally conflate health care “delivery” with health care “financing.” Canada does not outlaw private for-profit delivery of health care. There is no monopoly on health care delivery.

    What Canada does not allow is private payment—whether out-of-pocket or through private insurance—for care already covered by our provincial plans. Physicians can’t bill the government for publicly insured medical services and charge patients extra money on top of that. 

    Having just one payer in each province means we don’t waste money on paying overhead to private insurers, like in the U.S. model.  

    COVID-19 should not be exploited to make the case for a private pay health care system. In fact, the reverse should ring true. Now is a good time to think about expanding our universal health system.

    As hundreds of thousands of Canadians face job loss as a result of this crisis, it highlights the need for more publicly funded health care to keep our citizens safe and healthy. Many Canadians will face financial struggles through this crisis and may also lose their job-linked extended health benefits. 

    They will not lose their access to physician and hospital care, but a loss of work-related health benefits will have a huge impact on their ability to access prescription medications and dental care.

    Of course, our health system is not perfectly prepared for a pandemic.  

    When this COVID-19 crisis ends, we will have an opportunity to reflect on the challenges our health care system faced and take steps to adapt for the future. Creative solutions that have come out of this pandemic, such as the widespread use of telemedicine and novel triage systems, might be continued to improve access to care.  

    But one thing that should not change is our commitment to equitable access to health care for everyone in Canada. 

    This is no time for greedy profiteers to be distracting us from saving lives. As front-line health care workers, we will continue to show up every day, throughout this pandemic and beyond, to protect our human right to health care. We are counting on everyone to do the same.

    Dr. Thara Kumar is an Emergency Room physician based in Red Deer, Alberta. 

    Dr. Melanie Bechard is a fellow in Pediatric Emergency Medicine at the University of Ottawa. Both are members of the Board of Directors at Canadian Doctors for Medicare.

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