Wait-Time Guarantees

 

A big conference on this topic – and key Conservative promise – gets underway in Toronto today. Here’s a CLC commentary, from Executive Vice-President Barb Byers..

“  The Federal government has been busy introducing Canadians to the idea of “Patient Wait-Times Guarantees”. If patients are unable to receive treatment in a timely manner, Conservatives argue, the public health system should pay for treatment “at another hospital or clinic, even outside of their home province.” Their approach is, however, not what it seems and actually presents serious threats to public health care in Canada.

A central problem with “care guarantees” is that they would not guarantee health care services will be delivered in the public system. Rather, this policy will require public funds to support the emergence of private for-profit specialty clinics and private hospitals to meet the demand for specifically targetted medical procedures. Medicare is under siege.

What we are witnessing, is an attempt to introduce a private health care system running parallel to the public system, and subsidized by that same public system. We already have universal health care. How can entrepreneurs and corporations find customers if the public system doesn’t send residents their way? Wait-Times Guarantees are the path from non-profit to for-profit health care.

This will take us to a two-tier health care system. Medicare prohibits the sale of private insurance for publicly-insured medically necessary services. Why are we witnessing the move towards the creation of a second-tier of health care infrastructure if not for the benefit of wealthy patients, their insurance companies, and the for-profit providers themselves.

The federal government could have committed itself to enforcing the Canada Health Act, or reducing long waiting times in the public system, as advised by Brian Postl, the government’s Federal Wait Times Advisor. Instead, Postl has not been reappointed, the government has buried the report, and is using the current debate to increase public suspicion about what is, in most respects, an excellent and equitable public health care system.

Unfortunately, the Conservative approach ignores the historical roots of long waiting lists. As federal and provincial governments starved public health care and post-secondary education of much needed funds over the past decade, health care workers were dismissed and the labour force was not renewed.

Even as federal money begins to flow into health care as a result of the Health Accords, we still face a shortage of health care workers in many key sectors. We lack federal leadership on training and the use of the Employment Insurance system to facilitate skills upgrading and job mobility. We need federal investments in public colleges and universities as part of a thoughtful health human resources strategy.

From a workers’ perspective, it only stands to reason that high quality care depends on high quality working conditions, but health care workers face reduced job security, higher patient-loads, and increased part-time work. Many health professionals lucky enough to find full-time work report their working lives have become too intense and the risk of injury too high, while health support workers are increasingly threatened by privatization. Still others spend an inordinate amount of time off-work, healing from their injuries and stress caused by work-overload. This is not a human resources strategy designed to increase timeliness, or quality of care.

If private networks of clinics and hospitals are established as a result of “care guarantees”, health care workers will obviously be needed to staff these new entities. This will siphon-off workers from the public system, leading to more shortages and more difficult jobs for those who remain.

At the same time, the federal government is using the excuse of labour shortages to encourage the active recruitment of internationally trained health care workers from countries of the global South facing staggering public health care challenges of their own. It is a disgrace that migrant and immigrant workers of colour in Canada are recruited only to find themselves in jobs where their skills and experiences are not recognised, and where their human rights are not guaranteed.

In sum, the “Wait-Times Guarantee” will not ensure a patient-centred approach to health care in Canada. Privatization is no substitute for increased coordination, primary care reform, better management of waiting lists and worker input into workplace reorganization.

If it is serious about expanding access, the Federal government will need to abandon its commitment to a profit-centred future for health care in this country and start working to save Medicare from privatization. Such a guarantee, however, is unlikely to come from this government. ”