BDO Dunwoody/Chamber Weekly CEO/Business Leader Poll by COMPAS in the Financial Post for Publication June 20, 2005

Transcription

1 Excellent Supreme Court Decision on Private Healthcare: Montreal to Become Healthcare Mecca, Quebec Public System to Improve, Strong Investment Opportunities BDO Dunwoody/Chamber Weekly CEO/Business Leader Poll by COMPAS in the Financial Post for Publication June 20, 2005 COMPAS Inc. Public Opinion and Customer Research June 20, 2005

2 1.0. Introduction The overwhelming majority of CEO and business leader respondents in the weekly COMPAS/FP poll believe that the Supreme Court s decision to allow private healthcare services in Quebec was excellent. Most feel that it was overdue. Even while embracing the decision, a sizeable number about half feel that the Court was over-reaching, poaching on policy-making authority that rightfully belongs to Parliament. Respondents are almost unanimous in predicting that Montreal will become a kind of healthcare mecca. Quebec s biggest city would end up drawing patients for health services, especially diagnostic services, from Ontario and Atlantic Canada, and perhaps even from western Canada and northern New England. The respondents themselves would urge their friends to purchase private diagnostic services rather than wait in line in the public system. Not surprisingly perhaps, most see an investment in private medicine as potentially delivering above average returns. Most panellists believe that insurance companies will ultimately be marketing policies that pay for private health services. Quebecers will benefit not only in having new investment opportunities and easy access to private medicine, but Quebecers will also benefit because the province s public system will improve as a result, say CEOs and business leaders. Respondents do not foresee a beneficial impact on the public systems in the rest of Canada. In the wake of the Supreme Court decision, panellists believe that major corporations will give increasing thought to offering access to private health services as a way of attracting talent. These are some of the key findings from this week s web poll of business leaders and CEOs, sponsored by BDO Dunwoody LLP and the Canadian Chamber of Commerce. 2

3 2.0. Great Decision The overwhelming majority of CEOs and business leaders on the panel believe that the Supreme Court made an excellent decision but there remain some nuanced differences of opinion among panellists, as shown in table 1. Almost all (84%) view the decision as excellent. Most (68%) believe the decision was excellent, albeit overdue. Table 1: (Q1) In a case brought to it by a Quebec doctor and his patient, the Supreme Court decided that private healthcare services should be allowed in that province because government health services have not been delivered quickly enough. Would you say that the Court decision is [ROTATE POLES] % An excellent decision that is long overdue 50 An excellent decision that is somewhat overdue 18 An excellent well timed decision 16 A poor decision 9 A bad decision 5 Don t know or not sure 2 The following verbatims capture some of the business leaders satisfaction with the Supreme Court s decision: It s about time - i.e. lack of debate about viable healthcare delivery alternatives has stifled our ability to sanely address the fundamental issue of the lack of long term sustainability of our system. It is already 30% "private"; there already exists a "dual" system. We need to stop putting artificial blinders on in terms of finding solutions. We need to debunk the myth that allowing discussion of reasonable alternatives means automatically that we are cutting off access to those in need. One does not automatically follow the other; it has become a sacred cow, to mix metaphors. It's high time we admitted that the "emperor has no clothes" and started talking about the elephant in the room that no one wants to talk about. We can no 3

4 longer afford to be dogmatic in looking at solutions. I think that the courts are now requiring us to have meaningful debate! Thank goodness that we are starting to wake up to the fact that our healthcare system is archaic and is not the envy of the world. We have a shortage of doctors and nurses (at least in Ontario) because of our national hubris with respect to training in overseas countries (many of which had medical universities before Canada existed). If the Supreme Court had/has the right to get involved in matters such as gay marriage (an issue many Canadians regard as a lifestyle issue), it certainly has the right, and indeed the obligation, to involve itself in issues that prevent citizens from taking steps to save their own lives and those of their families, by timely recourse to necessary medical services. Private and multi-tiered health care has existed in this great country for many years. There has also been an increase in private diagnostic centres in Canada as well as utilization of U.S. centers for both diagnostics and treatment. The healthcare system in Canada has requirements of change to exercise on the opportunities and efficiencies available. The government has been lying to us about Medicare for decades, saying it is the best system in the world. Now we have legal proof of the opposite. While the overwhelming majority of respondents embrace the Court s decision, not all the enthusiasm is unreserved. Panellists main caveat is one expressed in a recent National Post column by David Frum, who suggested that the Court had gone beyond its mandate. Almost half the panellists subscribe to this view. In practice, 37% praise the decision while feeling that the Court went beyond its mandate while 10% condemn the decision while also feeling that the Justices are treading on Parliamentary authority, as shown in table 2. The following unsolicited comment reflects respondents enthusiasm for the substance of the decision along with their reservations about the Court s going beyond its legitimate authority: A public debate about the complementarity of the public and private health care delivery systems in Canada has been long overdue, and 4

5 we have to thank the Supreme Court of Canada for creating the space for that debate to take place, whether or not the decision is a robust one in law. Table 2: (Q2) As you may know, there s a debate about whether the Court had a right to get involved in policy-making that some say rightfully belongs to Parliament, and, separately, whether the Court s decision was good or bad. Which of the following opinions is closest to your own? [DO NOT RANDOMIZE OR ROTATE] % Good decision and the Court had every right to be involved 47 Good decision even if the Court was wrong to be involved 37 Bad decision and the Court was wrong to be involved 10 Bad decision but the Court had every right to be involved 4 Don t know or not sure Business Fallout Montreal Big Winner as Health Mecca, Private Health Investments to Deliver Above Average Investor Returns, New Insurance Policies The business panel considers Montreal to be the big winner from the Supreme Court decision. By a margin of nearly 5:1, respondents foresee Montreal s becoming a kind of healthcare mecca, drawing patients for many services from across Canada and northern New England, as shown in table 3. Seventy-two percent take this view. A fractionally larger majority, 76%, see Montreal as becoming a centre for diagnostic services in particular. Out-of-province patients would come to Montreal for quick diagnostics or assessments in the private sector, and then return home for treatment under existing governmental systems. The majority of business leaders say that they expect the rate of return from investments in private medicine to be above average (54%), as shown in table 4. 5

6 The panel as a whole predicts that insurance companies (85% of panellists) will market new policies that pay for private health services (table 3) and that employers will give increasing consideration to offering private health services as an induce to talent in their hiring efforts (table 5). Table 3: (Q3) Suppose the Supreme Court Quebec healthcare decision remains in force but the right to private health services does not extend to the rest of Canada. Please then score the likelihood of the following scenarios using a 7 point scale where 7 means very likely to happen and 1, the opposite [RANDOMIZE] Insurance companies would start to market new policies that pay for the private health services of policy-holders Montreal would increasingly draw patients from across Canada willing to pay for quick diagnostics, and then these patients would return home for treatment under existing governmental systems In Quebec, the public health system would improve because its load would be lightened as some patients moved from the public to the private system Montreal would gradually become a kind of healthcare mecca, drawing patients for many services from Ontario and Atlantic Canada and perhaps even from western Canada and northern New England Mean DNK

7 Governments would encourage the development of medical excellence in Quebec so that Montreal, a natural tourist destination, would end up competing with top U.S. centres for international patients with medical needs In the new climate of opinion, more patients would be thinking about going to U.S. medical centres Outside Quebec, the public health systems would improve for fear of facing private sector competition of the kind allowed in Quebec Mean DNK Table 4: (Q5) As a place to make a financial investment, how would you rate private medicine today? [ROTATE POLES] % Well above average for return on investment 9 Above average 45 About average 23 Below average 16 Well below average 1 Don t know or not sure 8 7

8 Table 5: (Q4) There s some talk about whether companies can attract senior talent more readily by offering access to private health services paralleling the governmental system. Given the recent ruling, will major corporations give [ROTATE POLES]1 June 2005 May 2004 Giving a lot more thought to such inducements than, say, a decade ago Somewhat more thought About the same level of thought 20 NA Somewhat less thought 2 10 A lot less thought to such inducements 0 6 Don t know, not sure Healthcare Fallout Business Leaders Recommend Private Diagnostics, Predict Public System Will Improve in Quebec as a Result of Court Decision, But Not in TROC Given that business leaders foresee major economic benefits for Montreal and private medicine, one would expect then to be personally enthusiastic about using private medical suppliers. They are. Respondents were asked to give advice to a friend worrying about a medical problem that had not yet been adequately diagnosed. Almost all respondents (94%) would recommend the use of private diagnostic services, as 1 May 2004 question wording: There s some talk about whether companies can attract senior talent more readily by offering access to private health services paralleling the governmental system. So far as you know, are major corporations 8

9 shown in table 6. Half of the panellists stated that they would recommend going to a private diagnostic clinic in Canada, most of the remainder to the U.S. As a result of the Court decision allowing private healthcare services in Quebec, most respondents predict improvements in the public system operating in that province but no corresponding improvements in the public systems in TROC, as shown in table 3. Table 6: (Q6) Suppose a friend of yours with a good job, no mortgage, and some savings asked you for advice about a worrying medical problem that had not yet been adequately diagnosed. Would you recommend that he/she [RANDOMIZE] % Go to a private diagnostic clinic in Canada 50 Go to one of the well known U.S. medical centres 28 Go to a private diagnostic clinic in a border city in the U.S. 16 Wait for analysis using diagnostic equipment in his province s public healthcare system 5 Don t know or not sure 1 In their volunteered comments, respondents anticipate that the Supreme Court s decision will have positive implications for Canadians: This decision by the Supreme Court will only have positive benefits in my mind. A lightening of the demands on the public healthcare system will improve care for the general public and ultimately lower costs. Good decision, long overdue. Canada already has a multitiered healthcare system as many people know, in spite of the protestations of Mr. Martin and Mr. Layton. It is time to make it more efficient and accessible. It is grand time that delivery of some medical services in this country becomes available through private delivery within a publicly funded system. This will provide some badly needed relief for emergency rooms and increase competition while maintaining quality of services. For years there have been fear campaigns about the 9

10 dangers of private delivery. This is nothing but the unions trying to protect their members. Guaranteeing access to medical services is already a reality for businesses of any size looking to get and keep good people, and not just at senior executive levels. The Quebec decision will likely cause the practice to grow more rapidly. Private health care options already exist for many people; they just happen to be located in the U.S. At least now we can keep some of the jobs in Canada. This is a serious business problem. I have paid for almost every senior employee of my business to get competent fast medical care from a centre in the U.S. because the cost to my business of poor senior employee health is too expensive. Senior employees are highly productive assets of Canada that we should provide an extra level of protection [for] as it is good economic sense for Canada. I suspect the corporate rush to private insurance will start with firms with high cross-border movement of staff, in order to get their U.S. people to accept a transfer to Canada Methodology The National Post/COMPAS web-survey of CEOs and leaders of small, medium, and large corporations and among executives of the local and national Chambers of Commerce was conducted June 15-17, Respondents constitute an essentially hand-picked panel with a higher numerical representation of small and medium-sized firms. Because of the small population of CEOs and business leaders from which the sample was drawn, the study can be considered more accurate than comparably sized general public studies. In studies of the general public, surveys of 155 are deemed accurate to within approximately 7.9 percentage points 19 times out of 20. The principal and co-investigator on this study are Conrad Winn, Ph.D and Tamara Gottlieb. 10