Small business perspective on health care
Canada’s health care system remains an important aspect of our society and our economy. Yet many concerns have been raised about the challenges facing this system, whether it is from the perspective of a health care provider, government policy maker, or a business owner—all of whom are essentially consumers of the system. Finally, many business owners, through CFIB’s survey process, have now had an opportunity to share their views on some of the broad policy directions. An opportunity, it appears, they greatly desired. Effective reform of the health care system depends upon the willingness of policy makers to take these views into serious consideration.
Many factors such as changing demographics and fiscal constraints will continue to put pressure on the system to meet the health care demands of Canadians in the 21st century. This will require new, innovative approaches to providing health care, while at the same time remaining true to the core principles of the Canada Health Act as outlined in the background document Health Matters contained in Appendix 1. Health care is a key responsibility which rests with the provinces, each with their own set of unique delivery mechanisms and programs, as well as varying degrees of fiscal capacity to meet the needs of Canadians. As a result, the satisfaction level with provincial health care systems varies widely. Alberta has the highest level of satisfaction, while Quebec has the lowest.
Contrary to the views of many commentators and big businesses, the publicly funded Canadian health care system is not seen as providing a competitive advantage to the majority of small- and medium-sized businesses. Further analysis shows that a competitive advantage is absent for Canadian SMEs that compete in U.S. markets. These findings need to be addressed in the national debate on health care given that some proponents of the exclusively public sector healthcare system resort to the “competitive advantage” argument as a rationale for limiting reform of the system in any meaningful manner or as a rationale for proposing higher taxes on business. Improving efficiency and adopting a more preventive approach are the two most preferred options of small business owners to improve the health care system.
Business owners also support an expanded role for the private sector, which would help facilitate an entrepreneurial ethic in health care, resulting in more opportunities for investment and growth, as well as innovative ways to meet the health care needs of Canadians. One prime example is to expand the use of the private sector in providing non-medical services. There is also an openness to the notion of user fees, provided that the amount is nominal (e.g., $5-$25) and would not detract from Canadians accessing medically necessary services. Overwhelmingly, the least preferred option to fund improved health care is to increase spending through higher taxes.
