I was discouraged to read Dr Arkinstall’s letter extolling the virtues of a private insurance system for those with the opportunity to get extra coverage, leaving the government to provide medical care for those without such coverage or unable to pay (BCMJ 2007;49:296). It sounds simple, but I have two words of advice: look south. Having spent most of my medical career working in the US, I can attest that such a system is a Pandora’s box of intrusive oversight, endless paperwork, waste of money going into insurers’ pockets, and gross inequality of care. I am ever impressed with the increased quality of life people in Canada experience due to the relative health security they enjoy. Retire early? No worries. Change jobs? Ditto. People are free to worry more about their health, not how to pay for it. Are there solutions to improving Canada’s system? Of course. The Romanow report had many suggestions. Other countries have their own solutions, but the suggestion in the letter looks way too much like the system in the US, which is increasingly wasteful, unaffordable, and dangerous. Beware.
—Khati Hendry, MD
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