Provided by: Canadian Press
Written by: JOHN COTTER
Sep. 27, 2005
EDMONTON (CP) – World-renowned cancer specialist Eduardo Bruera is homesick for Canada’s health-care system.
Dr. Bruera left Edmonton’s Cross Cancer Institute after 15 years in 1999 to become chairman of the department of palliative care at the University of Texas M.D. Anderson Cancer Center in Houston. After working in both countries, Bruera, an oncologist, has a message for people who complain about medicare or who want to expand the use of private health insurance in Canada.
“The portability and the universality of health care in Canada are unbelievably good. I think Canadians are not aware of that,” said Bruera, who was to compare care in the two countries in a speech Wednesday at the annual conference of the Canadian Hospice Palliative Care Association.
“Don’t look at the United States. The public health-care system makes it possible for patients to access palliative care in Canada earlier and more effectively.”
Since moving to Texas, Bruera said he can’t get over the spectre of crushing debt that even upper-middle-class Americans face when a family member is dying from an advanced illness.
Even premium private health insurance in the United States rarely covers all the costs, which can lead to bereaved survivors facing an almost never ending list of medical bills, he said.
Of every $100 spent by families on medical care at the M.D Anderson Centre, only $32 is paid for by private insurance, he said.
More than 41 million Americans don’t have health insurance, he said. Of those who are insured, one in three will lose all their financial assets during illness.
“To me it is an enormous impact on quality of life. The burden of dying in the U.S. of cancer is much heavier than the burden . . . in Canada.”
Bruera’s remarks come as the federal and provincial governments work to come to grips with a Supreme Court of Canada decision in a Quebec case earlier this year which approved some uses of private health insurance.
Since the ruling, provinces such as Alberta have been actively considering expanding the use of private health insurance.
The province is expected to announce by the end of October which private insurance firm will be chosen to conduct an actuarial study of the pros and cons of such a scheme.
Premier Ralph Klein has said allowing private insurance firms to sell policies would benefit Albertans who want to shorten their waiting times for non-emergency medical procedures.
However, the province has yet to define exactly what it means by “non-emergency.”
Bruera said he is “100 per cent sure” that private insurance would not improve palliative care.
“In general, services such as palliative care, that is not highly profitable or high tech, are generally not insured very well in the U.S.,” he said.
“If you privatize parts of the system, the juicy parts, the ones that are more profitable, will be taken by the private insurers. The most costly and less rewarding will be left for the government services.”
