Re: Two-for-one health care: A Canadian compromise

Issue: BCMJ, Vol. 60, No. 1, January, February 2018, page(s) 10 Letters
Jack Pacey, MD, FRCSC

I would like to comment on the proposal for permitting private health care by a surcharge system in BC. The notion that users of a private health care channel for accessing services that are rationed in Canada should pay additional taxes deserves some comment and thought.

Canadians have been burdened by increasing taxes based on the Liberal government’s propensity to overspend their revenue base and create unsustainable deficits.

The increasing tax burden is, to a considerable extent, caused by a political will to increase the number of individuals paid by government ministries as a redistribution of wealth “fairness notion.” This tax burden, which we pay with little complaining, is about to get higher with little increase in government services. Citizens pay taxes so that medical services can be provided, but because the revenue generated is not sufficient to pay for “free services” we must all experience rationing. Now, Dr Andrew Kotaska [BCMJ 2017;59:526-527] tells us that we should pay for our services three times. Once by paying a high tax rate to cover basic medicare, the second time by making private arrangements to access nongovernmental health care facilities, and then a third time by paying a tax penalty for getting timely care that the government has decided to ration.

This might seem fair to Andrew, but it does not qualify as fair in my view. Government has been unwilling to add any user-pay features that would supplement health care funding and moderate demand to the system, so we must ration care via a universal slow delivery model.

This equation should not be fixed by application of Andrew’s Band-Aid.
—Jack Pacey, MD, FRCSC