Opinion: European-style healthcare may not work in Alberta

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In the mind-to-heart battle of health care, calling “American-style health care” is kryptonite. When NDP leader Rachel Notley accused Jason Kenny of seeking an American-style privatized system, the Prime Minister accused him of a “terribly flawed” American model lacking universal insurance. He argued that he did not intend to hire him. His preference is to align our system with the countries of Western Europe where the private sector plays a role.

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Kenny gave clients Ernst & Young, who recently advised the Alberta government on health care reforms, to clients interested in opening health care, the “biggest oyster unopened” in the Canadian economy. I am paying attention to the advice of 10 years ago. Recognizing that American health care is our worst nightmare, consulting firms have advised these companies to emphasize the European model to build a foothold in this potentially lucrative area. So what are these European models, and can they provide a solution to what afflicts us, or Premier uses them as red herring to distract Albertan? mosquito?

There are lessons to be learned from Europe, but there are also reasons why these models cannot move intact in the Atlantic Ocean.

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First, in addition to cross-country comparisons being a problem, each system is in a unique basket of social programs and policies that strengthen each other. However, there is a Western European consensus based on the principle of social solidarity. In essence, everyone is part of the same community, and it is a long-standing belief that young people help old people, healthy people help sick people, and rich people help poor people. Citizens understand that their taxes are paid for social support, which is highly valued, and acknowledge that the state has a legitimate role to play. Strong social safety nets in European countries include not only healthcare, but also dental care, pharmacocare, and other benefits, including free tuition at universities in some countries.

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Two broad approaches to funding healthcare are the Bismarck system with payroll deductions and the Beverage system funded by general taxation. Germany is an example of the former and requires compulsory health insurance with a deduction from wages. Germans pay more than 7% of their wages for medical expenses. This is the same number as the employer. Germans also pay almost 2 percent for long-term care insurance. The United Kingdom and Canada exemplify the Beveridge model, a model that is paid by general taxation.

In the UK, patients do not pay at the time of service. However, people can buy private insurance that provides faster access to elective surgery. This two-tiered arrangement does not reduce the waiting time for the rest of the population. The Guardian reported in March 2022 that 6.4 million patients were on the waiting list in the United Kingdom. These numbers are due to the system disruption caused by the pandemic.

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French people are less dependent on payroll deductions and are closer to the Beverage model. Employee deductions for health care are currently less than 1%, but employers’ share is about 6.8% of their income. There is another deduction of 9% or more from employee wages, most of which is used for health care.

In Europe, public and private hospitals coexist, with both private and non-profit insurance companies covering the population. Many European countries have a solid non-profit sector and are a legacy of charities that have provided their members with a form of social insurance. Private providers in most countries are paid by either the national health insurance system or the tightly regulated social health insurance system. In fact, the scope of regulation is so great that the German proceedings are called “smart competition”.

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The European model is more comprehensive and has many great features that we envy. However, when transplanted to Alberta, the soil may not be suitable for them to thrive. European models can die and die in conflict with the idea of ​​medical entrepreneurs who view health care as using unopened oysters for commercial purposes.

The benefits that Europeans enjoy are neither trivial nor the price they pay them. If Alberta employers must match their contributions to employee health, it is doubtful whether they would welcome such a move. But the most prominent question is whether governments working to reduce bureaucracy will monitor and regulate commercial providers as closely as European governments.

Doreen Barry is an assistant professor in the Faculty of Political Science at the University of Calgary.