Canadian Patients Unite

[Previous] [Contents] [Next]

Filip Palda

Hearing Claude Castonguay’s recent comment that Quebec needs to think about private health care is like catching Gloria Steinem proposing that women could learn a thing or two from the Taliban. The Berlin wall has come down in the mind of one of Canada’s great timoneers of socialist medicine.

Castonguay is not flying solo. A recent COMPAS poll suggests that 47 percent of Canadians earning $25,000 or less want the chance to pay for private health care. If noise from this avalanche bothers other politicians, they are showing about as much concern as shepherds snoozing in an alpine valley.

Their peace of mind may come from knowing that behind Canada’s health system there is a grey market for health services that acts as a safety valve through which frustrated patients can find some satisfaction. Like boaters on the Rideau Canal who pass each other on Labour Day holding open beers behind their backs, paying for health care in Canada is something many are doing and few wish to talk about.

This is the way things worked in Iron Curtain countries in the days of the red banner and appallingly cut suits. Government proclaimed that money would no longer determine who had access to doctors. But government said nothing about Cognac and stuffed geese. These and other good things became the currency with which subject peoples persuaded the doctor to fix that hernia in weeks instead of years.

Canada’s waiting lists for elective surgery and diagnostic procedures are so long they bring to mind the joke from communist Russia: "What is 200 meters long and eats cabbage? A Moscow meat queue." Is it any surprise that some of us are taking action? The patient whose best friend is a doctor can jump the queue and leave behind his "poorer" fellows. The doctor who does his accountant a favour may get better service at tax time and pick up free advice. Those of us who are good at complaining, pushing, and giving hell get all the oil squeaky wheels fantasize about. This sort of savvy and barter between professionals is what the French call le Système D, and is by and large the preserve of the elites. In public health care everyone is equal, except that some are more equal than others. Perhaps this is why only 39 percent of Canadians earning $75,000 or more want private health care.

Those who have no contacts with the people who count stand in lines that would humble the endurance of those Russian cabbage eaters. Can this be right? Something is stirring in Canadians that just maybe this is not the best system around. Free markets have their problems, but in some ways they can be a more productive and democratic means of providing services than when the state takes charge.

Free markets clear the path for each individual to express his or her preferences with money. Moving away from barter to money allows people to specialize at what they do well. In a free market the stone-mason who can lay bricks the way Michelangelo dashed paint on chapel ceilings does not have to worry about who he knows in the health care system. He just does what he does best and spends the money on health care when he needs it. Getting rid of barter also gives suppliers an interest in serving not just the needs of those few who can pay them back favour with favour, but of anyone who holds cash.

It has been a long time since we have had the chance to sample full private health care in Canada, but there are signs that people are willing to dip their sore toes in the free market pond. Perhaps they sense the point Thomas Sowell, a former Marxist, made in a recent interview when he stated that "the passing decades have taught me that political elites and cultural elites are doing far more damage than the market elites could ever get away with doing."

[Previous] [Contents] [Next]

info@fraserinstitute.ca You can contact us at the above email address for any comments or information requests. Please report any dead links or technical problems.

If you know someone who would be interested in this web page, please enter their email address below, and we will forward this URL to them: Email Address:

Last Modified: Friday, October 22, 1999.