Canada is alone among developed nations in prohibiting private financing of medically necessary care. All of the other nations maintaining the goal of universal access to insurance allow individuals to seek care on their own terms with their own resources when they desire to do so. Again the reasoning behind introducing such a policy is simple: a public monopoly in health insurance means a more expensive and lower standard of care than would be available in a competitive marketplace.

Canada is clearly in the minority among developed nations who maintain universal approaches to insurance when it comes to cost sharing, private competition in the delivery of publicly funded services, and competition in the financing of services.

Canada’s policy approach is also at odds with those of the top performing universal access health care programs, all of whom employ all three of these policies to the advantage of patients and payers alike. Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland all deliver universal access to care without waiting lists; and all have cost sharing, private competition in the delivery of publicly guaranteed care, and private competition in the financing of medically necessary care. The same goes for Australia, Sweden, and Japan, who deliver the very best outcomes from care among universal access nations in the developed world.

Of course, proponents of the status quo continue to raise fears of the “Americanization” of Canada’s health care in response to these policy choices. That’s simply not the case: none of these policies would require abandoning Canada’s universal approach to health care. Rather, implementing these policies would allow Canada’s provinces to do a better job at delivering on the promise of universal access to high quality care in a timely fashion regardless of ability to pay.

"Sir, you need an MRI for you knee, you have two choices. You can wait 8 months and it's free, or you can get one tomorrow but it will cost you $1500" (not sure what the price would be).

Paul