Just a quick nitpicky thing
I use to work for Alberta Health and Wellness in Primary Care, so I studied and develop policy for this type of stuff
First off, technically speaking, all of our health care is delivered privately but publically paid. The doctor that sees you don’t work for the state, they work for themselves. However, you don't pay them directly; your physician (or medical assistant) instead bills AHW for the cost of your visit. AHW pays for all of this out of government revenue including taxes and royalties.
The idea that Gary is proposing is that physicians can charge the patient directly for services provided rather than wait in the public line. Currently under the Canada Health Act, physicians are not allowed to charge for services that are covered under the Universal Health Services. This is why people go to the States or other forms of medical tourism. As mentioned above, there are ways to get around this too (ie if a member of the flames wrench their knee, the team has specialists and MRIs).
Our public pay system is a source of national pride in our country. There are sensitivities when people mention change to it. However, from a policy planning perspective, we look to the more successful OECD countries like France and Scandinavia. Realistically speaking, the top performing countries in health care have a mix of public and private payer.
To combat other health services from moving away from the public system, each country sets up a combination of policies and mechanisms to ensure a balance. These include allowing full practice roles for health professionals (ie allowing nurses to perform physicals and most common procedures), different pay structure (salary vs Fee for service), government partnerships with private clinical outfits, expansion of home care and community health services...etc
In Alberta, there are a lot of things we look at to improve the system here including the examples I mentioned above. Other things to consider though:
- Increase more chronic disease and mental health issues away from the hospital. There can be a thousand ER doctors and nurses working at the Foothills, but doesn’t matter if there are no beds upstairs to move them out of the ER
- Develop universal standards with allied countries to facilitate foreign health workers to practice in Canada. Most health workers already have the knowledge and background, they would need the technical skills with our equipment and protocols. Popularize the intern system with these foreign health workers similar to what we do with medical interns and residence. After which, foreign professionals write the Canadian medical practice exam and can begin practicing here in Canada
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