The Smart Case for Private Health Care

In Canada’s public system, patients are languishing on wait lists for years. How private competition can save medicare.

- Brian Day

I RECENTLY SAW A 75-YEAR-OLD retired dentist at my medical clinic in Vancouver. His cardiologist had told him to exercise regularly in order to improve his circulation and control his blood pressure. But the dentist was a former competitive athlete who now suffers from advanced osteoarthritis in his hip. He was experiencing severe pain after just a few steps and couldn't walk more than a block. He needed strong painkillers, even to sleep, and was concerned about the dangers of developing dependence. He was placed on a one-to-two-year wait list for hip-replacement surgery. I advised him to get the surgery as soon as possible—even if that meant leaving the province or country and paying for it. If he did, he wouldn't be alone: last year, Canadians took 215,000 trips abroad for private medical care to avoid torturously long wait lists at home.

While many other countries incorporate private insurance and clinics into their systems to spur competition and shorten wait times, Canada is the only country in the world whose residents are banned from accessing private medical insurance or paying out of pocket for publicly insured services, even when faced with life-threatening delays. My patient asked why private insurers that provide coverage for people with severe dental pain can’t cover those with severe hip pain—and why he couldn’t seek care at a private clinic. “It doesn’t make sense,” he remarked. I agreed. By waiting, he faces serious risks to his health. He is now planning to undergo surgery at a private facility in the U.S. at a cost of at least $40,000. This will alleviate his pain and drastically improve his quality of life. He’s lucky that he can afford that option.