The Globe and Mail has been running a week-long series on the potential of innovation and private health care delivery. A Nov 9 article focused on private firms providing second opinions and health system navigation is in danger of missing the key point about this innovation: the point is not that the innovations they describe are private.
The vital directions covered – evidence-based practice guidelines and standards of care, sophisticated management of processes and people, building quality into routine delivery, and all based upon effective electronic health records – are all being done in the public system. But not broadly enough, and the lessons learned are not being effectively spread through the system. The challenge is to ensure these quality drivers are implemented everywhere, all the time.
The idea of supplementing public provision with private services – whether through employee benefits plans for those lucky enough to be covered or through paying personally for those who can afford it – is fundamentally inequitable. It means that large parts of the population are denied quality care (here is a link to broader Wellesley research on the damaging implications of privatization). While it is important not to defend Medicare purely on sentiment and values, and we do need to recognize that reforms are crucial to ensure quality, we do not need to retreat from fundamental values such as equity.