On costly fees

We're still waiting on a strong national response to the Charest government's plan to impose health user fees. But Thomas Walkom offers a reminder as to why there's a need for one:

Quebec Premier Jean Charest says he plans to make patients pay a $25 user fee each time they see a doctor. Federal Liberal Leader Michael Ignatieff says that sounds fine by him. If this is the so-called adult conversation the country is planning to have on health care, we're in bad shape.

The reason? We've had this hoary, old conversation before – over and over and over again. Mike Harris suggested user fees for medicare when he won the Ontario Tory leadership in 1990. Former Liberal prime minister Jean Chrétien mused about them in 2001, as did Ralph Klein, then Alberta's Conservative premier, a year later.

Each one eventually dropped the idea. First, monkeying with medicare is political dynamite in Canada. But second and more important, user fees don't work.

That's the conclusion of study after study. Earlier in this decade, a Senate committee looked into medicare user fees and, indeed, was initially keen on the idea.

But in the end, it concluded that a low user fee would cost more to collect than it would raise in revenue. And a high user fee would deter the sick from seeking necessary medical help early, contributing to higher costs later on.
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(O)ff-loading medicare costs onto the sick might make governments look better in the short run. But in the end, we all end up paying as much or more.