When B.C. health minister Kevin Falcon recently suggested that B.C.’s health-care system open its doors to foreigners with cash, the predictable and narrow-minded chorus of opposition followed. On the surface, this health tourism seems to benefit foreigners, but in reality the big winners would be British Columbians. Importing health tourists would bring in much-needed cash, help retain Canadian-trained doctors and reduce wait times for all.
Some seem to think the reason people suffer and sometimes die waiting for healthcare in Canada is because the system is overused. That’s only part of the story. People languish and die on wait lists because government rations—or limits—the amount of healthcare it supplies.
The government rations heath-care supply because healthcare costs money—the less it provides, the less tax it has to collect to spend on it. When government is the monopoly provider, and single payer, of what people believe is a “free” service, government must find the balance between providing enough healthcare to barely satisfy the majority, while avoiding having to raise taxes.
One way to bring more money into the system without raising taxes is to open it up to foreign citizens willing to pay cash.
According to a 2009 report by Deloitte, in 2007, an estimated 750,000 U.S. patients traveled overseas for health-care services. Deloitte estimates that number will grow by 35 percent each year and reach 1.6 million by 2012. In the U.S., employers and insurers are pushing health tourism as a cost-savings measure, and U.S. states are looking to pass legislation to create incentives for insurers to offer health-tourism options in their plans. Those are a lot of dollars that could be flowing into Canada rather than to other countries.
But wait, don’t we have a doctor shortage? Won’t this mean the limited number of surgeons in B.C. will leave the public system, start doing more private surgeries and leave British Columbians on longer wait lists?
Not at all.
In fact, more demand could mean the opposite—more surgeons performing more surgeries. Supply is rationed by government in a number of ways. For example, operating-room time is restricted—the government isn’t allowing surgeons to work. According to Dr. Brian Day, former president of the Canadian Medical Association, “Fifty per cent of our newly trained orthopedic surgeons and 50 per cent of newly trained neurosurgeons are leaving within five years of graduating because there isn’t enough work here.” It’s not that doctors couldn’t provide the service; it’s that government doesn’t let them.
Minister Falcon has a problem. If he were to openly explain that health-care rationing is the reason for long wait lists, he would expose what is wrong with B.C.’s health-care scheme. But, if he allows foreigners to purchase healthcare in B.C., British Columbians will soon demand the same right. When they do, the existing capacity will be used and increase the supply of health-care services. If operating-room time opens up to paying patients, some will leave the public wait lists and shorten the wait for others.
As long as people languish and sometimes die on wait lists, allowing access for foreigners remains politically unacceptable. This is a shortsighted miss of a great opportunity. The current dysfunctional economic model of health-care funding and delivery must be revised not only to allow the emergence of an international health-care industry, but to increase access for all British Columbians. Access to a wait list is not access to health care.
Maureen Bader is the B.C. director of the Canadian Taxpayers Federation.