I’ve recently got into a discussion with my brother on the issue of universal health care. It’s a big debate and one which we may be far from agreeing on. It boiled down to two basic issues – freedom of choice and trust.
My brother doesn’t believe in the welfare state because he doesn’t think the state is better than its population and we shouldn’t depend on it. According to him, the state shouldn’t abandon education and health care but should focus on providing it to those who need it as opposed to those who want it. He was very alarmed when I mentioned there’s no private health care in Canada. He felt that the lack of alternative hurts his individual rights to choose the kind of health care he wants.
In theory, I have nothing against the co-existence of public & private education and health care. In practice, I don’t think it works. Take universal health care for instance. I think it only works when an influential segment of our population, the educated middle class, the opinion-makers, rely on the system and therefore demand a certain basic quality. If you have a private alternative, the minute the first glitch on the public system appears, this influential group moves on the private option, which is easier than demanding change on the public side. Soon all the ones left using the public system are only those who need it – those on the margins of society, who can often be ignored by the policy makers. The pressure to keep the system working well disappears and soon only those with money can receive quality care.
That, to me, limits my freedom of choice as an individual. If my choice of hospital or treatment is limited by the amount of money I have in the bank or the kinds of benefits I get from my employer, it hurts my individual rights much more than not having the choice to pay for private health care. Full individual freedom is illusory. Our freedom ends when it interferes with the freedom of our neighbour. We all have the right to quality health care irrespective of our previous health history, job, class, or financial conditions. If to have that I need to wait a bit more for a non-urgent test because someone else who has a life-threatening condition needs to be taken care of first, I’m happy to oblige. I don’t want to be able to do whatever medical test I want the next day just because I have enough money to pay a private clinic when there are other people who are denied that choice. That, to me, is no freedom.