It's been said that the Canadian model of healthcare insurance promises three things: high-quality care, for everyone, quickly. Reality falls short of the promise, of course. As the saying goes: pick two.
But David Caplan (left), the man selected to follow the controversial George Smitherman as health minister of Ontario a year ago this month, intends to make good on that promise. Universal coverage is a given, of course, but as for quality and efficiency -- well, let's just say that Canada is no Andorra. Maintaining a high level of quality has in some cases meant reduced access and longer wait times, and it's likewise assumed that providing all patients with family physicians (and the enviable same-day access patients in some other countries get) would compromise doctors' ability to give patients sufficient attention and deliver appropriate care.
Complicating matters is the fact that the rate at which governments' health spending has been increasing has outstripped growth in GDP for years, and seems likely to do so for years to come.
Mr Caplan's ambitious goal as health minister is to turn that move beyond the quality/wait-times binary and to save money in the process.
He explained his thinking to me in a long interview for the June issue of Parkhurst Exchange magazine:
"What I want to do is raise the quality of the healthcare experience, of healthcare service, because all of the literature I've read says that when you increase quality you increase efficiency and you increase sustainability and cost-effectiveness. That's the real way. The mistake I think governments have made in the past is they've tried to contain costs first and what you've seen is a degradation of quality. If you raise quality, and that's the goal, almost by definition it will logically follow that cost-effectiveness will result."Read the full Q&A on the Parkhurst Exchange website, for more on health policy as well as a discussion of following in his mother's footsteps as health minister of Ontario, the decline and future of solo practice, Mr Caplan's struggles with his weight and smoking addiction, and more.
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