We don't know if private health threatens the welfare state -- lacking data

In DN Saturday, April 27, Victor Norman and Øystein Olsen fundamentally disagree about the impact of private payment in health care. Norman says that The welfare state is under threat, while Olsen believes The private sector can strengthen it.

The truth is, we don't know. We don't even know how many people buy healthcare privately, who they are, and why they do it. And lacking basic data, we can't say anything for sure about the effects of private funding on the public health provision.

The reason we know so little is that the state does not collect data on private health care transactions. When the state funds the services, it requires documentation to comply with what services are provided. The same requirement does not apply when the payment is private.

The difference in treatment is understandable. It is not desirable for the state to collect data on all our transactions. Data collection is also a form of surveillance.

Nevertheless, there are predominantly reasons to secure community information about private healthcare transactions, as the government proposes in a parliamentary message out for consultation.

The ability to deliver a good health care service presupposes knowledge of it total the health care provided to citizens and how public health care is affected by the private. Is it the case that the cleverest doctors go to the private and thus impoverish the public health care system? Is it the case that people choose to go private because the quality is higher or because they perceive the wait times as too long?

If citizens and politicians are to be able to make informed choices about how we want to organize our health care, we need information about every health care transaction. Absence of data is a democratic problem.