The quality, accessibility, and affordability of Health Care are important issues today. How can democracy be applied to remedy the ills of the current "system"? First we keep in mind our new definition of "democracy" as "a society which recognizes, celebrates, incorporates, and protects the inherent value of each individual". For those of us who have spent 6 hours waiting on a stretcher in the hallway of an ER unit, it is immediately apparent that the current "system" de-values us. In no other context would we put up with such shabby treatment. Would we wait 6 hours to see our hairdresser, our auto mechanic, our lawyer? No. In part, because we have alternatives. We could take our business to another hairdresser, mechanic, etc. So one obvious problem with our Canadian health care system is that it is a statist monopoly.
I once commented to Gary Mar, when he was Alberta's Health Minister, that we had a "soviet-style health care system". He dismissed my comment out of hand, with all the contempt of those who subscribe to the fantasy that we have this "wonderful Canadian health care". However, it is indeed like the soviet reality, where hapless peasants stood in line-ups for hours to receive shoddy goods from surly bureaucrats.
The antidote is to empower the individual consumer. The question though is how? Introducing elements found in a market economy is one way of doing this. It is not a perfect solution either but to evaluate the pros and cons we need to consider one other central element - power. During my years teaching political science I developed an effective definition of "politics" as "the struggle for the power to set the rules for a society". This definition helps us to focus on the fact that what is crucial is who has the power to decide how resources will be allocated. In a market economy, power derives from money. Those who have money can command resources. The Canadian health-care alternative substitutes administrative bureaucracy, rather than money, as the source of power. This "political power" is, in theory, capable of a more equitable distribution of resources than the "economic power" model.
However, both systems have their own inherent logic. While the "rich will attempt to get richer", it is much more the case that "those with political power will use it to grow and preserve their power". While in the economic model there is some incentive to improve the quality of "customer service", since by doing so I might get even richer; there is no such incentive in the political model. Improving "customer service" will not give me more power. In fact, growing and defending my power will require me to be less sensitive to consumer concerns.
What then are the solutions? Many can see that the political power model is not working. Is there any way the economic model can work to the benefit of all individuals and not just "the rich"? Well, if we focus on the inherent value of each individual, one approach that suggests itself is based on the old maxim - follow the money. This would mean funding support for the consumers of health care, rather than funding the producers (doctors and hospitals) or administrative bureaucracies.
As of 2009, Canadian governments spent an average of $5,452 per person on health care (Alberta was highest at $6,072 per person). 1 All major political parties have recently committed to increasing this amount by 6% annually for the foreseeable future. What would happen if we ended all top-down funding and instead provided each and every Canadian with, say, $4,000 annually toward health care. There would be a saving to Canadian taxpayers of $50 billion annually (not an insignificant number) but more importantly, money in the hands of individuals would allow them to make decisions that could reward good outcomes and punish poor performers.
The soviet style food distribution system of standing in line all day for cheap but often poor quality bread eventually collapsed. Maybe someday we will look back on Canadian "health care" with the same rueful smile and ask; "What were they thinking?"
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