Private Medicine in Alberta: The Thin End of a Pernicious Wedge?

by John Patrick

Canadians are proud of their 'free' health care system. The problem is that almost every word in that sentence needs unpacking, qualifying and expounding.

First what about Canadians?

The moral norms accepted by modern Canadians would appall their forefathers and who knows what will be acceptable to our grandchildren? However, what is inevitable is that new ideas and new ideals carry moral consequences. The origins of Medicare in the Prairies had a lot to do with an unconscious Christian understanding of moral responsibility. If we have a right to health care that also means that those who are healthy have a duty to pay for it. This was an acceptable idea to the New Democratic Party. But if we continue to accept more and more libertarian ideas about what constitutes moral behaviour one inevitable consequence is increased disease. The sex education of the last thirty years has taught children that their desire for sexual activity is as normal as their desire for food is normal. They just need to use a condom. The consequence of which has been the explosion of sexually transmitted diseases and the associated consequences of these diseases. One is infertility (recurrent sub clinical infection of the genital tract is only one of many causes). Its treatment is very expensive. In a nonjudgmental society where it is accepted that there is a right to health care the answer must be yes. In the United Kingdom, where judgment apparently comes more easily, coronary treatment for heart attacks is not available for persistent smokers unless they pay for it. If this principle is accepted all sorts of other similar scenarios arise. In South Africa, amongst some identifiable subsets of students the HIV positivity rate is around thirty per cent because South Africa cannot afford the expensive modern treatments these students will be dead in about four years. Do they have a right to a university education? The common good which the Prairie Christians, who started the NDP understood, has got to figure into the equation somewhere. The HIV positive students, if they are wealthy can leave for Europe and North America where they can get treatment just as Canadians can go to the United States to expedite treatment not immediately available in Canada. Is this acceptable in a society where choice is all? Are there any ways to avoid the inevitable costs? Yes.

Christians who are committed to their faith are vastly more healthy than the general population. For example, divorce rates are much lower and men who have been divorced are approximately twenty times more likely to need psychiatric care and also more likely to get cancer etc., etc. (cf. Dale Matthews, The Faith Factor - Viking).

The conclusion is that...Canadians with modern morality will be more expensive to care for than their much derided straight-laced forebears.

Now to the second qualification - free health care.

It is not free; we pay through taxes and whilst we all do as we ought that is fine but when some folk not only persist in lifestyles that are dangerous and expect everyone else to pay it will not be long before issues of justice arise. Just as automobile insurance companies can identify low and high risk groups so with disease. What ought we to do? Disease patterns are changing: infections have diminished but lifestyle diseases are increasing. The major causes of premature illness are smoking, overeating (I am sorry but if you are overweight you are eating too much for you even if it would be insufficient for another person of the same weight, age, and sex), lack of exercise, and sexual promiscuity. Should we be held accountable for our behaviour and, if so, how? One way would be to de-insure 'lifestyle' diseases from the government's program and allow private insurers to look after this area.

Now, to the third qualification: health.

Under the banner of preventing disease, more and more money is being spent on health education programs which looks like a very sensible thing to do. The problem is that like many simple solutions many of them do not work and most have not been properly evaluated. Dietary counseling for the overweight has approximately a 90% failure rate at five years and since the objectives are to prevent chronic disease like arthritis and diabetes this must be said to be a wasted effort. Anti-smoking and anti-alcohol and drug abuse programs as well as sex education programs are not much better. Using the money to encourage parents to bring up their children virtuously would probably be a better use but this too needs careful study. The anti-spanking lobby is another example of misdirected altruism which believes that laws improve people. Beating children is always wrong but the biggest damage done to children is for parents to divorce. I know that this is not popular but it is true. Many marriages could be saved and for the sake of the next generation they need to be. But is this the role of a medical insurance system? Medicine is primarily about being with those who suffer. Every war on death is ultimately lost. We all die. Some battles en route to defeat can be won but a what cost?

What can Christians do? First talk about the health benefits of practicing your faith regularly in church. Second, take back our dying into the home and our burying into the church. Refuse the North American way of pretending death is not the ugly end product of sin. Jesus wept because it is, so do not spend thousands on caskets and making the dead look like dolls. Begin to use parish nurses. Start thinking about how to deal with 'lifestyle' diseases. Grow old gracefully. Mother Teresa, with her wrinkles, was beautiful because she practiced love.

Originally published in Christian Week (Vol. 14 No. 04, May 16, 2000) under the title: "Do Canadians deserve a "free" healthcare system?"