Andrew at Bound By Gravity notes that the Conservatives have thus far been largely silent in the health care debate. Unfortunately, he suggests that you “[c]all Stephen Harper's office today and tell him that you're sick of the single tier medicare system, and that you want to hear the Conservative solution to our health care woes.”
In my view, the Conservatives should be vociferously supporting universal health care, not two-tier health care. Andrew is right, though, in arguing that the worst thing they can do is keep quiet. Ideally, the Conservatives should be talking about how they will make sure that all Canadians get the health care they need.
The fact that private health care is now an attractive option speaks to how the current system has been mismanaged and nothing more. While private care provides an important safety valve, it is not the answer to our problems.
There is a fundamental advantage to having a single-payer, universal health insurance system. The advantage is economic and moral.
Nonetheless, we should not preclude private options for those who so choose, but they must pay the full shot as do parents who choose to send their children to private schools (with the exception of Quebec which subsidizes private schools). I would add that doctors, who get much of their training at public expense, should also reimburse the government for the full costs of their training if they opt out of the public insurance system.
That said, the system we have now is clearly unsustainable. We need to explore other health care options. In particular, we must question the de facto monopoly public institutions have with respect to health care delivery. I believe we could realize significant economies with open competition between public and private providers for these services. No one would argue that a doctor in private practice is any worse or less efficient than a doctor in a public clinic. Similarly, why not encourage a little competition from the private sector for procedures such as hip replacements to keep the public sector honest?
Unfortunately, health care is a very emotional subject. While there are many things to discuss (nurse practitioners, co-payments, user fees, private medical accounts, etc.), the fact that it is a provincial jurisdiction is a possible reason for the federal Conservatives to steer clear of the debate. In reality, given the significant federal presence in funding the health care system, it is a debate that they cannot avoid without arousing very real suspicions about the CPC agenda.
In supporting universal health care, such suspicions about the Conservatives would be partly allayed. While it may not be necessary to get into the nuts and bolts of possible reforms, Canadians need to be reassured that they will get the health care they need under a Conservative government. Staying silent is the worst thing they can do.