Politicians, health care providers and various other leaders in the health-care field often proclaim the danger of practices that lead to a two-tier system.
The definition of “two-tier” can be far reaching, but in general it refers to the concept of those with the ability to pay having better and more timely access to health care than those who can’t. The basic tenant of medicare is care for all, regardless of ability to pay. It’s a lofty principle, but it doesn’t really follow through in the reality of delivery.
Yes, Canadians can go to a hospital to be treated in emergencies or for other problems and not be saddled with a huge, life-sucking bill that they would face if they lived in the United States. In those situations and others, medicare delivers.
There are many areas of health care, however, where the system doesn’t treat everyone equally.
At my age, private insurance is a boon, covering prescriptions, eyeglasses, most dental procedures and even — who knew that day would ever come — compression stockings. But my younger colleagues in the newsroom grumble every time the premiums we pay into our employer-supported program rise, because to them it is simply a cost that they see no benefit from. In fact, what they are paying for health care is supporting my generation, giving us the leg up into “tier two.”
And what about Canadians with no access to private insurance? Are their dental care, vision care and prescriptions any less crucial to their health than to mine? If they can’t afford these things then their health suffers and they are solidly relegated to the lower tier of the system.
And of course the “free” system has a cost. A recent Fraser Institute study revealed the typical Canadian family of four will pay almost $13,000 for public health care this year.
According to the institute, “using data from Statistics Canada and the Canadian Institute for Health Information, the study estimates the average Canadian family (two parents, two children) with a household income of $138,008 will pay $12,935 for public health care this year. After adjusting for inflation, that’s an increase of 68.5 per cent since 1997, the first year estimates could be calculated.
“For single Canadians, health-care costs more than doubled over that same time period — from $2,115 (in 2018 dollars) to $4,640 this year.”
So not only are my younger colleagues boosting me into tier two with their private insurance contributions, they are also doing so with their tax dollars.
The goal of the Fraser Institute study was to help Canadians understand the public system.
“It’s important for Canadians to understand how much they pay for our public health-care system so they can better decide whether or not they get good value for their tax dollars,” said Bacchus Barua, associate director of health policy studies at the Fraser Institute.
At this point in my life, my tax dollars that support the public system are giving me good value, but many are still occupying the lower tier and are not garnering the same benefits.
