Employers have always depended on the public health system to treat their employees in a timely manner. However, because of health cutbacks and the resulting waiting lists, employees often face delays in receiving care and returning to the workplace.
That’s why the ability of the health system to provide timely and quality care should matter to employers. The system’s capacity to do so, however, is under significant strain.
Long waits a problem
The case of a 49-year-old service manager with severe back pain provides an example of the problem. Tests showed nerve root compression due to a displaced disc fragment that he needed to have removed.
Accessing neurosurgery was very challenging, however. It might take up to nine months or longer to have the consultation and then up to six months to get the surgery, followed by two months for rehabilitation. The duration of his disability could be two years.
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If the health system had more resources and was more efficient, the service manager could have returned to work more quickly, thus minimizing the costs to the employer and the insurer.
The worst scenario for employers and employees would be for the Canadian health-care system to simply stop operating. While that appears an unimaginable scenario, there are many signs that the health system has become unsustainable as the demands on it have risen exponentially.
The Australian approach
Recently, I participated on a panel with four other doctors to discuss the future of health care at the 2016 alumni dinner for the University of Toronto’s New College. We didn’t discuss when the Canadian health system would stop operating but we did talk about how to preserve universal health care for the next 100 years. At one point, the discussion turned to Australia where, similar to Canada, everyone has universal health care as a right.
About 30 years ago, the Australian government recognized that its single-tier, universal health-care system wasn’t sustainable. After considerable debate, it created a private health insurance company called Medibank Private.
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Medibank was an option priced for teachers, bakers, firefighters and plumbers. It wasn’t just for the wealthy elite.
Medibank successfully generated premiums paid by customers who opted in, with the funds invested in the construction of private health-care infrastructure. The result was that Australia had both public and private sector health-care infrastructure. In essence, the Australians had created a financial hedge for the health system.
Lightening the load
The private sector lightened the load on the public sector through shorter wait times and greater efficiency due to competition. At the same time, patients could access specialized technology by moving between the private and public systems at no cost.
And what about the doctors? They didn’t flee the public system because regulatory restrictions limited them to working only a small percentage of their time on the private side.
As the discussion at New College continued, it became apparent that Canadians, including business leaders, would be wise to observe Australia’s strategy. Given the issues at stake, employers and their insurers have an interest in ensuring the health-care system remains sustainable so employees can be at work, rather than at home on a long waiting list.
Dr. Raymond Rupert is the founder and medical director of Rupert Case Management Inc.
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