Public system achieved health-care success
Letter by Doris Grinspun, RN, Executive Director, Registered Nurses’
Association of Ontario, Toronto
Toronto Star
Dec. 30, 2005
… in Alberta, health-care success has come through much-needed reforms within the public system, not through privatization. Indeed, profit plays no role and is actually detrimental. The recipe for success in Alberta was based on establishing specialized teams of surgeons, nurses and physical therapists working together to move patients quickly through the system, performing surgeries according to well-managed waiting lists based on medical priorities.
In this pilot project in Alberta – which has seen wait times for hip and knee replacements reduced from an average of 47 weeks to 4.7 weeks – surgeons work consistently with the same team of nurses, focusing only on hip and knee replacements. The result: They are performing almost double the number of surgeries they used to perform.
Comment: We continue to hear the charge that single-payer public insurance programs inevitably result in rationing, primarily in the form of excessive delays (queues) for elective surgeries. What is not said is that responsible stewards of a well monitored public system can easily make adjustments in capacity that would eliminate excessive queues.
The problem is that vested interests from the more lucrative private sector will use the political process to sabotage the public system by blocking capacity adjustments, thereby creating excessive queues. The unhappy patients then become both a source of political support and a market for their private medical enterprises. Under such a scenario, the vested interests are motivated to expand further the queues within the public system. Privatization makes public queues worse, not better.
The orthopedic experiment in Alberta demonstrates that responsible public stewards can eliminate unnecessary queues for everyone, rather than merely for the more affluent who can jump the queue by moving into the private sector for care. The supporters of privatization are being dishonest when they contend that they have the solution for excessive queues when, in fact, they are deliberately attempting to prolong queues within the public sector.