Opinion

Canada's public health care system relies an awful lot on private money

A large proportion of the medical infrastructure and innovation in this country has been made possible by significant contributions of the donor communities. In a country that prides itself on a publicly funded health care model, this should not even be necessary.

Fundraisers, private donations and even parking fees are used to make up for funding shortfalls

A large proportion of the medical infrastructure and innovation in this country has been made possible by significant contributions of the donor communities. (Adrian Wyld/The Canadian Press)

A few weeks ago, my wife and I attended the Country Classic Auction, an incredible charitable event held annually to raise money for the London Health Sciences Foundation. This year, there were over 1,200 attendees who collectively donated millions of dollars to support the foundation's campaign goal of $200 million by 2018.

These types of hospital foundation fundraiser campaigns are commonplace in philanthropic circles across Canada. They include, among others, the popular Princess Margaret Home Lottery and the SickKids VS Initiative, which bring in hundreds of millions of dollars annually from private citizens. Most of the funds raised are earmarked for desperately-needed medical infrastructure and research development.

That raises an important question: why is it that our publicly funded health care system is so dependent on private fundraisers? Put another way, how deficient would our system truly be without individuals and corporations stepping in to fill the void left by the government?

Reduced health transfers

The simple answer to the first question is this: while individuals keep opening their pocketbooks, various levels of government have chosen to limit their spending on health care. Federally, the government has reduced the increase of Canada Health Transfers by three per cent annually, a curious decision by a government with a voracious appetite for deficit spending.

Canada will spend close to $242 billion nationally on health care in 2017, representing 11.5 per cent of our gross domestic product. While this seems, and indeed is an astronomical number, it is undercut by systemic inefficiencies that leave public health care still chronically underfunded. These most recent clawbacks will only serve to exacerbate the problem.

These shortfalls in funding are not isolated to the federal government. The Ontario Liberal government, for example, has long been self-congratulatory about medical care in this province, despite administering devastating cuts to the health care system. These cuts also include decreasing the number of residency spots for future physicians, which might be the most myopic health policy in recent memory, given our aging population and growing crises of doctor shortages and specialist wait times.

What is truly unforgivable is a government taking credit for health care service and innovation that is significantly funded by private citizens. When Kathleen Wynne hosted Bernie Sanders in Toronto recently, it was reported that he was particularly impressed by Sinai Health System's neonatal intensive care unit. This very same NICU was actually made possible through a $5 million donation from the Newton Glassman Charitable Foundation.

In fact, back in 2013, Newton Glassman excoriated the government's shambolic management of the health care system, saying, "the province should be ashamed of itself. [SickKids' NICU] looks like a 1970s Russian gulag." No wonder SickKids is in the midst of the most aggressive capital campaigns in Canadian hospital history, with a goal of raising $1.3 billion, in order to rebuild its hospital because its "facilities and infrastructures do not match the expertise of our people." If this is not the responsibility of the Ministry of Health, I don't know what is.

A tiered system

With a system riddled by inefficiencies, we have seen the proliferation of a tiered system in Canada, including the operation of private clinics in B.C. and Ontario.

The underfunding of the medical system has also been felt by patients who are forced to pay exorbitant prices for parking, which is used to offset operating costs and to fund necessary research. According to the Ontario Hospital Association, these costs have been passed onto patients because the government froze hospital budgets for years and encouraged hospitals to "find new sources of revenue."

Importantly, a large proportion of the medical infrastructure and innovation in this country has been made possible by significant contributions of the donor communities. In a country that prides itself on a publicly funded health care model, this should not even be necessary. Truly efficient government ministries would be able to invest intelligently in medical infrastructure, innovation and delivery without a reliance on private capital.

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

About the Author

Adam Kassam

Adam Kassam is currently chief resident in the department of Physical Medicine & Rehabilitation at Western University. Born and raised in Toronto, Ontario, Adam received an undergraduate education from Cornell University, an MD from Dartmouth Medical School and a Master's in Public Health from Columbia University. Follow him on Twitter at:

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