OTTAWA — A prominent hospital chief says it is time Canadians stop treating medicare as a religion and gained the right to buy private health insurance.
Michel Bilodeau, who has worked at virtually every major hospital in Ottawa over nearly four decades, argues provincial governments should take lessons from the health systems of France, Germany and Sweden and shift to a consumer-driven culture that gives patients more choice. That includes allowing patients to purchase private health insurance to cover treatments the government ordinarily covers as a means of easing the strain on long waiting lists in the public system.
The practice is forbidden in many provinces; only Quebec allows a limited form of private health insurance.
“We have to stop considering the current system as a dogma or a religion and start looking for real at what works and what doesn’t work,” said Mr. Bilodeau in an interview.
“We’re missing opportunities because we consider what we have now as a dogma that cannot be changed, and we just keep adding more money.”
Mr. Bilodeau points to France, where he has lived, as an example of a system that has successfully blended a universal, taxpayer-funded health-care system with a second tier of care paid for privately by insurance companies or patients.
‘If seniors need transportation, they should be able to call there. If they need a doctor, they should be able to call there’
“They have co-payments for everything. For example, if you see a specialist through your family physician, you would pay 15 (euros, about $20). If you decide not to wait for your family physician and call yourself to get an appointment, you’d pay 20 (euros).”
The Canadian Medical Association, representing the country’s 74,000 physicians, has also advocated that private insurance for medically necessary services be considered a policy option. Hospital chiefs, however, have largely kept mum on the controversial issue.
Mr. Bilodeau is urging a new take on this country’s much-dissected medicare woes as the Baby Boom generation reaches retirement age, resulting in the largest-ever cohort of Canadians to move into their golden years.
A Boomer who turned 65 last month, Mr. Bilodeau retired in 2011 after five years at the helm of the Children’s Hospital of Eastern Ontario. Last month, he returned to Bruyere Continuing Care, a hospital he once led for 13 years, to serve as interim chief executive.
Mr. Bilodeau echoes the views of many experts who point to the potential for aging Baby Boomers to bankrupt the existing health system, if reforms are not made. “I was thinking, ‘What do I want for myself when I get older? What will happen if my wife dies before me, or vice versa?’ ”
Given that his generation is healthier and wealthier than their parents in old age, Mr. Bilodeau has concluded that more needs to be done to support seniors who want to live in their own homes for as long as possible.
He advocates expanding the role of the 14 provincial Community Care Access Centres (CCACs), which oversee home care in Ontario, to make it a one-stop referral centre for all kinds of in-home supports, not just for health services.
“If seniors need transportation, they should be able to call there. If they need a doctor, they should be able to call there. If they need housekeeping, they should be able to call there. Right now, the CCACs don’t provide a full range of services that somebody who becomes frail can really access.”
Indeed, with demand increasing for home and community care, even families that can afford to pay for extra in-home support are hard-pressed to find people to fill those jobs, making an expanded role for the CCAC that much more important, said Mr. Bilodeau.
He suggested high-income seniors could be charged user fees for the service.
“A lot of people would be willing to pay to be a member of that service. And those who could not afford to pay would not have to,” said Mr. Bilodeau.
“But it’s better for me as a senior, and probably less costly than living in a nursing home. Maybe for the price of one nursing home in the region, we could have enough people managing that system.”
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