Every time a prominent, influential person argues for more private, for-profit health care, I hear the opposite: an inspirational defence of 100% public, non-profit health care.It’s inspiring when Canadian and BC Medical Associations encourage more public-private partnerships, when corporate-backed institutes call for “more choices”, and even when our pro-privatization Premier announces a “genuine conversation” on health care while severely limiting public participation.

Basically, I’m hearing powerful people expressing concern about improving public health care, just like the rest of us do. And that’s a beautiful thing. It shows we’re all in this conundrum together, rich, middle-class and poor. With this universal unanimity of purpose, we’re bound to make the improvements we need!

Unfortunately, yes, I do also hear that these (usually) well-to-do people are in fact proposing a competing system, where for-profit companies get greater control of Canadian health care tax dollars which currently go mainly to non-profit entities. And this, I know, will fatally fracture that very unanimity which is our strength and hope, and lead to health care class war.

It’s such a straightforwardly destructive fissuring, their denials are likely deliberate lies. Far from “alleviating pressure”, contracting out guts the public system. For-profit operators slice off the most profitable pieces of non-profit health care: relatively healthy patients, easy diagnostics, quick surgeries, competent, efficient doctors. The non-profit system ends up with much higher concentrations of the least-cost-efficient aspects of the system, like the most seriously ill patients, lengthy, high-risk operations, and the more incompetent, inefficient doctors.

Since the funding earmarked for quicker, simpler procedures is no longer entering the public system and contributing partially towards basic, shared expenses like building facilities, purchasing equipment, administering hospitals, and treating chronically-ill patients, our system develops an ever-deepening fiscal and quality crisis. This produces mounting incentives and pressures to allow people to take their public health insurance and willingness to pay surcharges into the growing for-profit system. Next: Private insurance to cover those escalating surcharges. Hello, America.

And why is all of that such a dire threat? Because once it’s done, very few of our prominent, powerful and well-to-do people will be complaining anymore. They’ll leave non-profit health care to rot along with the poor sods still stuck in it.

Is that cynical? Consider, by way of example, attitudes towards America’s Physicians for a National Health Program (PNHP). They’ve chronicalled the now well-known waste in the U.S. system, and generally hailed Canada for “low overhead”, “minimizing bureaucracy” and “maintaining the quality of care”, all at one-half of America’s per capita costs.

However, even though PNHP includes 10,000 physicians, former U.S. Surgeon Generals, journal editors and medical school deans, it’s widely regarded as some radical leftie fringe group. With few exceptions, neither the Democrats nor Republicans have embraced PNHP proposals, and national media rarely cover them.

U.S. conservative commentators aptly illustrate why. They typically regard improving public health care on par with raising welfare rates or building subsidized housing-just another way to enslave them to socialism and higher taxes. “Why increase government intervention,” they’ll say, “when my private clinic operates like my Bahnhofstrasse watch?”

Ominously, a similar disinterest in improving public non-profit health care is emerging here. Both a federal Senate Committee and the Romanow Commission together spent years digesting research and input, and proposed significant changes to ensure ongoing improvements and sustainability. Increasing for-profit partnerships was generally found to be unnecessary and unwise.

But since then, conservative-leaning politicians federally and provincially, along with conservative-leaning doctors and pundits, have made a practice of largely ignoring those findings. Campbell even ridiculously proclaimed his short, limited consultations “will be the most inclusive, exhaustive public discussion on healthcare ever in Canada”.

This evident disinterest in following solid, existing prescriptions to improve public health care is particularly dangerous when it comes from our politicians and doctors, because they are actually causing some of the public system’s worst waste. They should focus on changing themselves, instead of arguing for-profit models offer the only solutions.

Both federal reports, for instance, point to overall savings that can be accrued by boosting funding to long-term care facilities, prevention programs and complementary therapies, and independent assessments of health technologies–all areas where cutbacks by the BC Liberals hit hard.

Doctors, meanwhile, are notoriously wasteful. Overprescribing dominates pharmacare expenses. Our costliest medications include cholesterol, blood pressure, osteoporosis, and heartburn treatments which, for most patients, are only feebly or temporarily effective, and scarcely compare to free prescriptions of healthier diet and exercise. Health agencies also regularly warn doctors against overprescribing antibiotics, to no avail; as one British Medical Journal study reported, 20% of all antibiotic prescriptions are for respiratory infections alone, that “are almost always viral” and can’t be treated with antibiotics.

Worse, doctors’ hands, ties and cell phones are major sources for the resulting costly antibiotic-resistant epidemics in hospitals. Nevertheless, as Lisa Priest documented in Operating in the Dark, Canadian doctors’ organizations have been extremely resistant to allowing information about doctors’ skill levels, accidents, malpractice, success rates etc to be collected and analyzed.

So our public, non-profit health care system does need changes. And to maintain strong political momentum, we desperately need our politicians, pundits, executives, and off-duty doctors languishing on the same wait lists as the rest of us, and sitting in the same emergency rooms as homeless people. We need them becoming unanimously outraged. And more than anything, we need them proposing solutions that will truly benefit everyone.