The current health care staffing crisis has reignited the debate over privatizing the Canadian system — and while more needs to be done to take pressure off hospitals, critics say more private care is not a “simple solution.” This week, Ontario Health Minister Sylvia Jones revealed a plan to help stabilize the province’s health care system that included increasing the number of publicly funded surgeries performed at existing private clinics, though he declined to provide details on which specific facilities would be involved or which surgeries would be were covered. “Health care will continue to be provided to Ontarians through the use of the OHIP card,” she said at a news conference Thursday, declining to answer a question about whether she would consider allowing more private clinics in the province. Depending on who you ask, increased privatization is either a growing threat or a potential solution to the staffing crisis being felt across the country. When asked recently about the role of private clinics, Ontario Health Minister Sylvia Jones said the public should not fear “innovation” in the health care system. (Evan Mitsui/CBC) But for-profit surgery clinics and other medical practices have existed in varying degrees across Canada for decades, and for-profit companies have been quietly filling staff shortages during the pandemic — at increasing costs to hospitals and taxpayers. Proponents argue that some privatization would take pressure off the public system and better triage care, while opponents worry it would drain resources and increase inequality among Canadians. “Right now, we’re in a really tough situation because the health care system isn’t working well — and I think that’s becoming more and more apparent every day,” said Dr. Katharine Smart, president of the Canadian Medical Association. CMA). “Privatization is always one of the things people bring up in this conversation,” he said. “But I think what we really have to look at is how would this actually improve service delivery for Canadians to suddenly have a private, for-profit model?”
Private clinics aim to fill gaps in care
Canada faces one critical shortage of family doctorswith millions of Canadians without access to primary care due to physician retirements and fewer medical school graduates choosing the specialty due to lack of resources and high overhead costs. The pandemic has also worsened the lack of access to urgent care and increased waiting times for surgery, with nearly 600,000 fewer surgeries performed between March 2020 and December 2021, compared to 2019, according to Canadian Institute for Health Information (CIHI). Almost half of adults in Canada’s 10 provinces had difficulty accessing health care in 2020 and 2021, while nearly 15 per cent said they did not get the care they needed at all, according to a 2021 survey by Statistics Canada. WATCHES | What’s Behind Canada’s Shortage of Family Physicians?
What’s Behind Canada’s Shortage of Family Physicians?
The family doctors Dr. Kamila Premji and Dr. Rita McCracken discuss the shortage of family doctors in Canada and what can be done to alleviate the situation. Private clinics have been set up to try to fill this gap in some provinces, including Quebec and Nova Scotia. Others oppose the idea of offering more private healthcare. In British Columbia, the province’s highest court recently upheld a lower court surgeon layoff in VancouverThe Medicare Protection Act challenge, which ruled that co-pay and private insurance bans do not violate charter rights. As it stands, Canadian health care spending is split between the public and private sectors at about 75-25, and at a cost of about $6,666 per Canadian, according to CIHI. Private health care services are paid for by patients mostly out of pocket, as well as through private insurance. The country was projected to spend more than $300 billion on healthcare in 2021, representing nearly 13 percent of GDP. That puts Canada on about the same level other rich countries. (The United States spends the most on health care of any OECD country.) Dr. Adam Hofmann owns Algomed, which has private clinics in Quebec and Nova Scotia, where he charges clients a $22 monthly out-of-pocket fee, plus $20 per visit. Hoffman said that while he was once a strong advocate of a publicly funded health care system, he now believes that private clinics are part of the solution. “A large number of patients who end up in the emergency room are there for conditions that can be treated or prevented in a primary care outpatient clinic,” he said. CPC Home. “And these patients almost universally lack access to primary care.” These kinds of private options should be explored on a larger scale as Canada seeks to solve its health care challenges, said Janice MacKinnon, a professor of public policy at the University of Saskatchewan and a former provincial finance minister. “We have to do everything we can to make the system more efficient, more cost-effective and more accessible to people,” he told The House, adding that other countries, particularly in Europe, have developed models where both public and private systems can coexist. “No government is saying: We don’t want to fix the public system, we want to create a separate one. They say we need to fix the public system, and we see private options as a way to do that.” Staff attend to a patient at Toronto General Hospital earlier this month. In a two-tier model, critics of privatization say the more complex cases are left to the public system. (Carlos Osorio/CBC)
Privatization “is not a simple solution”
Colleen Flood, research chair in health law and policy and professor at the University of Ottawa, has looked at health care systems around the world and says private care tends to make access more difficult for low-income residents. Flood described privatization as a “zombie solution” that “we keep coming up with instead of focusing on how to fix the public health care system.” “It’s not a simple solution,” he said. “Countries that have public and private systems spend a lot of time trying to figure out how to regulate the private [sector] so that it does not absorb all the resources from the public health system”. In general, he explained, private clinics tend to target less complex procedures — such as knee and hip surgeries — but the public system is still relied upon for emergency services and complex treatments for conditions such as cancer and heart disease. “So you’re diverting work … not only to the relatively small percentage of the population that can pay for it or have private insurance,” he said, “but you’re also diverting them from really important care.” Colleen Flood, professor and research chair at the University of Ottawa, says that countries with public and private systems “spend a lot of time trying to figure out how to regulate private [sector] so that it does not absorb all the resources from the public health system”. (Submitted by Colleen M. Flood) Ontario’s plan to fund private clinics with public money could potentially be a more cost-effective way of providing services, which ultimately goes to taxpayers, said Maude Laberge, a professor of health economics at Laval University in the city. of Quebec. “This is an aspect of negotiation between the government and these clinics,” he said. “As long as the patient doesn’t have to pay… If a clinic can do something very well — just like a hospital or a public one — then there’s no problem with such private, specialized clinics. the patient has to pay, then he brings equity issues.’ Hiring staff from private temp agencies doesn’t appear to be solving the crisis in Ontario, where some hospitals have paid millions more to such firms to help staff intensive care units and emergency rooms, at an hourly rate more than double that of unionized nurses. . first reported by Toronto Star this week. “Where is the stewardship for our tax dollars?” said Dr. Michael Warner, medical director of critical care at Toronto’s Michael Garron Hospital. “And then what isn’t that money being spent on because it’s being spent on nurses?” WATCHES | Critics are sounding the alarm over Ontario’s reliance on private nursing offices:
Critics raise alarm over Ontario’s reliance on private nurse practitioners
With a shortage of nurses in Ontario, hospitals are increasingly relying on temporary nurses to help fill the gap. Critics raise concerns that public dollars are going to these private offices, instead of better salaries for nurses. The University of Toronto Health Network (UHN) spent just over $1 million to recruit nurses from various agencies in 2018 — but that’s increased to more than $6.7 million in 2022 alone, more than $4 million of which is related with the recruitment of private nurses to work in the ICUs of . “What we’ve seen during COVID is that these agencies are charging a lot more, and I’m not sure where their money is coming from, but hospitals are paying much higher hourly rates,” Warner said. “What they did during the pandemic was predatory and exploitative.”
Transformation of the public system?
Those in favor of privatization say Canada’s health care system desperately needs to be open to new ideas, with Jones, Ontario’s health minister, saying last week that Ontarians should not be afraid of “innovation.”
But critics say there is little evidence to suggest the situation is improving with the private services we already have — even though they cost much more — or that more of them will help.
“While there may be ways to improve the…
