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Commentary

The hip that changed health care history
David Gratzer, National Post, 3-7-06

Gratzer, a senior fellow at the Manhattan Institute, chronicles the glacial but relentless pace of another healthcare revolution, this time in Canada. Rebellious doctors and rebellious patients are fighting the government to increase access to private health clinics for a wide range of treatments and diagnostic services that are only available after long delays (months or even years) through publicly funded hospitals.

Left-leaning policymakers in the U.S. like to laud Canada’s single-payer health care system as an egalitarian utopia; the reality is far more complex. Middleclass and wealthy Canadians buy their way out of long waiting lists by traveling abroad (mostly to the U.S.) for critical treatments.

A recent ruling by the Canadian Supreme Court, however, has opened the system to more private competition in at least one province (Quebec), with more sure to follow. In this article, Gratzer interviews one health care maverick, Dr. Brian Day, who opened his own private clinic and is even the president-elect of the Canadian Medical Association.

His clinic grows, covering a variety of surgical procedures, and there is talk of expansion to Calgary, Toronto and Montreal. Dr. Day is now president-designate of the Canadian Medical Association. "I'm suddenly respectable," he jokes about the new title.
Life is not without complications. … The Ontario government warns of legal action if his clinic hangs a shingle in Canada's largest province. Yet Dr. Day is undaunted. He looks forward to representing the medical profession in the public eye and, if need be, his clinic in the courts of Ontario.
The personal success of Brian Day reflects the remarkable change in Canadian attitudes toward private medicine. Not that long ago, of course, "private" couldn't be used in the same sentence as medicare. So-called experts touted our public health care system as the envy of the world. And while they reluctantly admitted there were some problems, they argued that everything could be fixed with new public money. Talk of private health care was dismissed as "Americanization."
Some in academia still speak in these terms. But most don't. Last June, the Supreme Court of Canada had a harsh appraisal of medicare, declaring: "access to a wait list is not access to health care." The Justices' decision -- involving a patient awaiting a hip replacement in Quebec -- has up-ended the debate. Call it the hip that changed history.


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