In her Jan. 20 article, Maria Lily Shaw presents dual insurance with a “double benefit” of reducing the length of time people have to wait on waiting lists and reducing the pressure on the public system. We are talking about an instrument to protect the right to health. But how can we speak of a right to health if only a minority of the population would benefit from it? Do more complex patients, who tend to be older, more vulnerable and unable to afford private insurance, have a lesser right to health?

The Mirage of “Double Advantage”.

Instead of patient satisfaction, let’s look at objective data from M^me Show.

Australia, for example, introduced a parallel private system in 1997 and public patients now wait twice as long for their surgeries as private patients.^⁠2.

In addition, citizens in the lowest socioeconomic group are 37% more likely to die from cancer as a result of out-of-pocket payments than in the highest socioeconomic group.^⁠3. Do we really want to open the door to such a deeply unfair scenario in Quebec?

In the UK, researchers at Oxford University concluded that increases in outsourcing to the private sector were significantly correlated with increases in mortality rates^⁠4.

Increased pressure on the public system

So that we understand each other. Allowing double insurance means people have priority over others. However, this does not create workers and therefore does not increase the capacity of the entire system to perform more operations.

Given the glaring labor shortages, where do we find the health workers so vital to the public grid when the private sector is hiring them?

More recently, the British Columbia Supreme Court examined the impact of paid private healthcare in its 2020 Cambie decision, finding that studies show that if dual insurance is allowed, physicians reduce their time and effort to the public system. This inevitably leads to longer waiting times for care in the public system. It is simply wrong to say that such measures relieve the pressure on the public system.

Finally, it is recognized that a single-payer system (a single insurance system) is more economical and allows resources that directly benefit patients to be maximized.

telemedicine

Since the December 7 secretly passed decree, nothing prevents a doctor from abandoning his waiting lists on the public network in order to give preference to patients who pay more in telemedicine. In addition, the government allows telemedicine services to be covered by employer insurance.

This inevitably leads to a two-tier insurance system and, in short, two classes of citizens.

So far, the ban on physicians being paid by both the state (participating physician, paid through RAMQ) and the private sector (individuals, insurers, etc.) has prevented them from picking the easiest cases (and paying more). Move them to private space faster.

The rise of telemedicine is a major advance in access to care. Why should this advance only benefit the richest?

In Quebec, access to health care must be based on need rather than ability to pay. We call on the government to back down on the December 7 decree to guarantee the right to health for all Quebecers.