The Canadian healthcare system is broken—or at least problematic in many respects. Problems include long wait times for urgent care, long delays for surgery or specialized care,[1] difficult access to certain kinds of care, an increased tax burden, a lack of innovation, and Canadian doctors working in other countries. We know that these are significant issues because in election season our political parties vow to improve and fix Canadian healthcare—yet it is growing worse rather than better. No matter what our leaders say, when they travel to the US to get treatment done, their actions speak louder than words.
I will suggest a few ideas for improving our healthcare system. I realize that the title of this article promises more than it will deliver. I do not intend to rethink healthcare from the ground up or give a theology of healthcare in an ideal society. I will propose ways to incrementally improve what we have in Canada and seek to see it more aligned with biblical values which will bless a nation.
In addition, I do not intend to give a comprehensive list of suggested fixes. There are many ways to improve health services in Canada. I believe much of the bureaucratic bloat, so common in large corporations, and especially plaguing government-funded corporations, needs to be eliminated. By cutting bureaucracy and executive waste, more funding goes to beds, doctors, and nurses—what the end user sees and needs.
I also believe privatizing more services will lead to greater efficiencies, better quality, more innovation, competitive pricing, and greater accessibility for health services.[2] Consider the success of a company like Space-X which is now contracted by NASA. A private company has been able to deliver a better product at a lower cost than a well-funded government agency.
Undergirding it all, we must understand that socialism is not a biblical (nor viable) model for society and the same applies to socialized medicine. In a bid for equality of outcome, everyone receives marginal care.[3] By privatizing medicine and allowing free-market principles, rather than equality of (a mediocre) outcome, there will be an equality of opportunity to access excellent care. Our country is going the wrong way with socialized pharmaceuticals and socialized dental care.[4] As the government gets bigger, taxes go up, wastefulness increases, and medical choice and quality plummets. Sure, we’ll be in it together, but we’ll all be at the bottom together.
A Needed Attitude Change
It is easy to criticize the government for healthcare problems—and they must own how they’ve perpetuated such problems—but there are also problems with the users of Canadian healthcare. It is not just the provider that needs a worldview shift, it is the user that needs an attitude adjustment.
If you visit the emergency room in a Canadian hospital, you’ll likely be confronted with a room full of people that make you think, “What’s the emergency?” Many people go to the hospital for minor, non-urgent needs. Some go because getting an MRI through your family doctor will take too long, but the emergency department can give you one if you’re willing to wait several hours. Some go because it is better to be safe than sorry. Others go because they haven’t been educated about home treatments or when visiting a doctor is advised. Whatever the reason, many go who do not need to go.
There is also the attitude that health services are free. You can be a hypochondriac and go to emerge once a month and you will never see a bill. You can get scans at radiology, receive physiotherapy, and access many other services and never see a single bill. This gives the impression that health care is free. Whether you use it a lot, or never do, the impression is that it is just there at no cost to you. Deep down, most people know that the government pays for it, but they do not realize that the government doesn’t make money but takes your money.
A Simple Solution
One small way that can help our healthcare system is to introduce a fee for a hospital visit or to access health services. Would the emergency room be just as full if people had to pay $100 for their visit? It is not as if $100 is covering their cost, far from it, but this teaches people that government-funded healthcare operates more like insurance rather than a free service.
Fees or deductibles of this sort have been used by private insurance companies for as long as can be remembered. Private companies must be profitable lest they cease to exist. (Sadly, this is something that government-funded agencies do not need to worry about. When you have your hand in the pocket of the taxpayer and can print your own money, you can afford to never be profitable.) Why wouldn’t an insurance model work with health care?
Consider car insurance. What if there was no deductible for any damage claim for your car? What if you could take your car to an autobody shop and get it repaired or checked without ever seeing a bill? That little scratch you made in your car when it was just a few weeks old would be enough justification for you to bring it in and get it fixed. I can testify that there are a few scratches on our vehicles that I would get fixed if it were free. Yet, the deductible and possibility of increased rates are enough to leave me content with a few scratches and dents. I would willingly pay the deductible for major damages and be thankful for insurance covering the cost for the bulk of the work.
Why not use a similar model for healthcare? The amount of a deductible could be debated. It could even be waived in certain circumstances. The point is not to collect fees but to teach people that healthcare is not free and to incentivize discernment on whether care is truly needed.
Biblical Basis
It can be good to toss around ideas about improving the healthcare system, but is there truth in which we can ground our principles in? The Scriptures are a treasure of wisdom and knowledge. While the Bible doesn’t speak about everything, it does speak to everything. So what are some biblical principles that should undergird our thoughts on this matter?
1. Those Who Benefit Should Pay
In Romans 15 Paul speaks about a collection of funds being taken by the believers in Macedonia and Achaia for the believers in Jerusalem. He said that they “owe it to them” (Rom 15:27) since through the Jews these Gentiles have received the blessing of salvation. He also uses the same argument in 1 Corinthians 9 to speak about the church in Corinth owing him remuneration as he served them with the gospel of Jesus Christ.
The principle here is apparent. Those who receive a benefit should repay those who have provided that benefit. This is our duty and should be our delight (Rom 15:27; 2 Cor 8:1–15).
There should not be an expectant attitude that one receives without contributing in return. A fee to access medical services is not burdensome, but honorable. By introducing a (small) payment model for care, we’re affirming this biblical principle.
Conversely, those who do not access medical services should not be expected to carry the same financial burden as those who do. How does this incentivize healthy living? Someone can smoke for decades, another can overeat, and both have complex medical needs due to their lifestyle choices. We all want a society that incentivizes good lifestyle choices, don’t we?
2. Each One Should Bear His Own Load
Galatians 6 contains some interesting verses. It says, “Bear one another’s burdens, and so fulfill the law of Christ. For if anyone thinks he is something, when he is nothing, he deceives himself. But let each one test his own work, and then his reason to boast will be in himself alone and not in his neighbor. For each will have to bear his own load” (Gal 6:2–5). This passage is memorable to me because it says on the one hand, “bear one another’s burdens,” and then “each will have to bear his own load.” Which is it? It depends.
We do have a Christian duty to love our neighbor and bear one another’s burdens. However, this duty is not to be presumed upon or coerced such that we expect our brothers to carry our burden while we relax.
We want to be burden lifters, carry our own burden, and not be a burden to others.
In this regard, a person should never have the attitude that they are owed medical treatment at the taxpayer’s expense. A person should never be a perpetual “taker” rather than strive to stand on their own two feet and be a “giver.”
Socialized medicine encourages us to be takers rather than see our part in being self-sufficient and givers. Socialism is a system that coerces charity such that charity is no longer charity. Privatized services or paying a deductible for services reminds us of our responsibility to bear our own load, and not presume upon the kindness of others to bear our burdens.
3. Never Forget Sin
The universal principle of sin and the fallenness of humanity must inform every societal institution, law, or governing decision. Man is sinful (Rom 3:9ff, 3:23; Eph 2:1–3). This principle of sin means that we are selfish and will take advantage of the system. If we don’t see a bill, we take more. If we must pay for it, we restrain ourselves. If someone else is paying, we consume a little extra.
Because of sin, we are wasteful with other people’s resources in ways that we would not do if they belonged to us. Don’t believe me? Why is there so much trash in public places? Do our homes look like this? Why do we use company supplies or tools liberally or recklessly but are stingy and careful with our own? We are selfish creatures. Without restraint, we are greedy, wasteful, and selfish.
If you consider truths that our current culture neglects to its peril, this is certainly up there—man is sinful. This is why we believe in limited government, in checks and balances, in just laws, in quick consequences—because we are sinful people who need to be restrained (1 Tim 1:8–11; Rom 13:1–5). In like manner, a small fee for medical services can aid in restraining the selfishness in each of us.
Conclusion
While sin can be restrained in a society, it can never be dealt with apart from Christ. We’re reminded that a truly free and good society is predicated upon a moral people. We know that moral, self-governed people, are people who have been forgiven by the Lord Jesus Christ and have the Spirit of God in them, granting them desires to do what is pleasing to God and neighbor. Long-term reform in healthcare or any other public service can only happen if hearts are transformed through the gospel of Jesus Christ. Yes, we need some Band-Aid solutions right now, but more importantly, we need the saving aroma of the gospel of Jesus Christ to be the fragrance that molds and shapes our society to honor God and bless the nation.
—Tim Stephens
[1] “Specialist physicians surveyed report a median waiting time of 27.4 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 25.6 weeks reported in 2021. This year’s wait time is the longest wait time recorded in this survey’s history and is 195% longer than in 1993, when it was just 9.3 weeks.”
[2] I believe we benefit a great deal from being a border buddy to the United States. Advances in medical treatments, pharmaceuticals, and other technology flow northward as we benefit from their innovation. A privatized system allows companies to invest in innovation in a far greater capacity than publicly funded companies.
[3] Do we really want equality of outcome? Do we really want a cab driver to make the same money as a doctor? In fact, in Cuba, cab drivers make more than doctors. With socialism, Cuba will never be known as a leader in medicine.
[4] The national Pharmacare program is fast-tracking drugs for contraceptives and diabetes as a first order of business. It is noteworthy that the Health Minister says the government will be “providing these medications to people for free.” Spot the half-truth? These medicines are not free but are paid for by the taxpayer and the debt loaded on future generations.