Professor Gordon Guyatt on Healthcare in Canada
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2018/06/02
Professor Gordon Guyatt, MD, MSc, FRCP, OC is a Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact and Medicine at McMaster University. He is a Fellow of the Canadian Academy of Health Sciences.
Here we talk about the potentials for a private versus public healthcare.
In a March, 2017, Professor Gordon Guyatt talked about private healthcare versus public healthcare. He looked into the distinct advantages and disadvantages of public and private healthcare in Canada.
I reached out to him to become more informed on the topic. When I talked to him, he noted people want to know how to decide on the relative merits of public healthcare funding versus private healthcare funding. A few things arise for people, according to Guyatt.
Some of the questions raised is health outcomes. For example, the impact of people’s health, the access to care, the impact on the patient satisfaction, and the impact on autonomy or choice. Then there is healthcare cost or spending too.
Individual Canadian citizens who can afford and prefer private healthcare funding need a primer, first. Guyatt notes the large amount of misinformation. There is a misinformation coming for a number of reasons.
Guyatt states that the mindset as follows: “things aren’t working the way they are now. There has got to be a better way, at least with respect to physician and hospital services. Perhaps, we should try something different.”
That can be one driver for it. People want something different. They look for something different than the current setup. The benefits or the outcomes of the private versus the public funding will depend on the individual.
If someone is poor or rich, or penurious or wealthy, the considerations and benefits or outcomes become different for people. The changes in outcomes happen across this spectrum. It is also different if a healthcare provider compared to a consumer.
“When I talk to audiences, there are notions that people have about what is affordable. There are notions people have about what it will do to their own income,” Guyatt stated, “Those will influence things. Often it starts off with ‘public funding of healthcare is not sustainable.’ To deal with that, I ask, ‘What do you think has happened to healthcare expenditures as a proportion of the Gross Domestic Product (GDP) over the last 7 years?’”
He begins to give some options of the amount going up over every year, most years, and so on. Many people become surprised at the answer. The amount has stagnated or decline. “So, as a percentage of GDP, healthcare is lower than 7 years ago. Also, they tend to be surprised when you inform them: in 1991, it was 10% of GDP for all healthcare expenditures,” Guyatt said.
At the time of the interview, it was a bit below 11% over more than 25 years. With public healthcare expenditures, it becomes more extreme over 25 years at about 7% to 7.5%. This can shape the perception of people about healthcare.
Guyatt concluded, “In general, that leads people to rethink the unaffordability of public funding of healthcare. Often, that is the first thing in people’s minds.”
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The British Medical Journal or BMJ had a list of 117 nominees in 2010 for the Lifetime Achievement Award. Guyatt was short-listed and came in second-place in the end. He earned the title of an Officer of the Order of Canada based on contributions from evidence-based medicine and its teaching.
He was elected a Fellow of the Royal Society of Canada in 2012 and a Member of the Canadian Medical Hall of Fame in 2015. He lectured on public vs. private healthcare funding in March of 2017, which seemed like a valuable conversation to publish in order to have this in the internet’s digital repository with one of Canada’s foremost academics.
For those with an interest in standardized metrics or academic rankings, he is the 14th most cited academic in the world in terms of H-Index at 222 and has a total citation count of more than 200,000. That is, he has the highest H-Index, likely, of any Canadian academic living or dead.
He talks here with Scott Douglas Jacobsen who founded In-Sight Publishing and In-Sight: Independent Interview-Based Journal. We conducted an extensive interview before: here, here, here, here, here, and here. We have other interviews in Canadian Atheist (here and here), Canadian Students for Sensible Drug Policy, Humanist Voices, and The Good Men Project (here, here, here, here, and here).
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