Health Savings Accounts in Canada – Ground Zero of Single Payer?!

Born and raised in Canada, by the time I got to adulthood I was pretty fed up with my contemporaries’ claim that Canada’s uniqueness, relative to the U.S., was so-called “universal” health care. (I was born in 1962, so my contemporaries and I had no conscious experience of Canadian health care before the federal and provincial governments rolled out the state monopoly in the late 1960s. Although, I suppose the private coverage that our parents had when we were born had maternity benefits that were at least adequate!)

The fact that individual experience under state-monopoly health care was often appalling, combined with a social stigma against public criticism of this uniquely Canadian program, led many Canadians to conclude that the health-care status quo reigned (alongside ice hockey) as a national religion. I agreed, wryly and defiantly noting that our constitution commanded separation of church and state!

The days when criticising single-payer, government-monopoly health care was heretical are long gone. I’m back in Canada for Christmas, and was interested to see this story in the National Post newspaper, describing the efforts of Canada’s life insurers to convice the federal government that Canadian families should have more latitude to use tax-free money for their own health care. Indeed, the finance minister (comparable to the Treasury Secretary) today announced plans for tax-free health savings accounts offered through banks, but only to families with disabled members.

The article also describes the challenges of one type of health-related policy that Canadian life insurers already sell, which does not compete against the government monopoly (and is therefore legal). It pays out a lump sum in the event of a catastrophic event. The policy described pays $150,000 in case of a myocardial infarction (heart attack). It appears to be pitched at owners of small businesses or the self-employed who have no group long-term disability insurance.

What I found fascinating about the article is that the tax-preference for the proposed disability-related health savings accounts will go to Canadian families.

In the U.S., tax-preferences for health coverage are usually exclusive to businesses, not families. The tyranny of this status quo has many supporters, including the health-insurance lobby and some business lobbies (although I can’t imagine why).

Here’s a question to mull over the holiday season: By giving a tax-break to families instead of employers, could the Canadian government be en route (very tentatively) to more patient-friendly health care than the American government, which appears wedded to the goverment-corporate status quo?

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

Scroll to Top