Research has shown that the healthcare system relies heavily upon the balance between “health inflation” and the ability of the system to pay for said inflation (Lee et al., 2021). It would stand to reason that in the case of private health clinics in Canada, the provincial government is trying to avoid the issue of “jumping the queue” as a way to give some relief to the publicly funded hospitals. After all, OHIP will be the one footing the bill for private clinic diagnostics and surgeries instead of allowing those of means to bypass the wait list in public hospitals. The government seems incredibly wary of opening up an even larger can of worms by allowing residents to pay for procedures covered under OHIP privately.
Nevertheless, the fact remains that private clinics will be allowed to set their rates for procedures and diagnostics in a healthcare system that is dominated by public spending. It also puts the demand squarely in the hands of the private clinics, which are specifically allowed by the government to do said procedures, allowing them to charge higher prices due to the demand. The plan would make sense if the only goal were to provide specific procedures and diagnostics to Ontarians, but it fails at every other planning step.
Furthermore, private healthcare has always had the spectre of “equity” and “fairness” haunting its shortfalls (Qureshi & Xiong, 2021). Research has shown that “in order for people to lead the lives they choose to live, they need access to healthcare despite their social or economic constraints” (Qureshi & Xiong, 2021). The implication is that anything infringing upon this right is causing healthcare inequality among residents. For Canadians, their biggest worry is ending up with similar inequality issues that the United States (a primarily privately run healthcare system) struggles with yearly (Taylor, 2019). Ironically enough, many Americans consider the Canadian healthcare system a symbol of proper healthcare management (Barua & Globerman, 2019). In the United States, certain people are afforded more opportunities than others, skewing the system in favour of those who have versus those who do not have resources. This type of policy directly contradicts the research shown by Qureshi and Xiong, as well as the advice of healthcare professionals.
It is also reasonable to conclude that there is a problem with the backlog of surgeries and diagnostics in Canada (Canadian Institute for Health Information, 2023). Private clinics are a way to reduce the backlog, but with the drawbacks of provoking the public by summoning an image of a vastly different American private-led system, although it is a different policy altogether. It also seems foolish to create an entirely new partnership with the private sector for what is essentially billed as a “duplicate health care coverage” problem (Lee et al., 2021); the public sector is capable of taking on this challenge without the need to shell out more money for inflated private sector costs. It just does not make sense.
Similarly, the Ontario provincial government has had ample opportunity to talk with healthcare practitioners, nurses, and doctors on the policy front. However, last year, the province decided it was best to use the notwithstanding clause for Bill 124 and Bill 28, which capped wages for nurses and education workers (RNAO, 2022). Not only does this undermine what the private clinic policy is attempting to accomplish, but it is also causing healthcare workers to burn out and quit working in the industry. Staffing shortages are a significant contributor to healthcare troubles – lacking the proper workforce is understandably ineffective to try and run an industry. There were already warning signs of the lack of fund allocation stretching back to 2016 when there was a shortage of several hundred doctors in the healthcare system (Niang, 2022). It would stand to reason that a key to improving hospital wait times is closely associated with lacking the proper staffing needed to run the procedures. Moreover, should private clinics begin to perform the same surgeries and diagnostics as Ontario hospitals, they are pulling from the same pool of staff. Private clinics will not magically create new trained and qualified people in the short term.
Instead of shifting funding to pay for the private cost of healthcare, including the more expensive services provided by for-profit clinics, the government should reallocate and invest back into the public system. Since 2019, the Ontario government has sought to cut healthcare spending costs after reports came in that spending was higher than anticipated (Thompson, 2022). Instead of cutting costs, a broader scope should include where the overspending occurs and help government officials and hospital administrators reallocate money to more efficient services. The Ontario Council of Hospital Unions (OCHU), which co-exists with CUPE, made it clear last year that despite the increased funding, spending shortages as well as policy failures such as low wages, not enough full-time employment, and overbearing workloads, have caused the current staffing shortages (Yeadon & Noorsumar, 2022).
In conclusion, the Ontario government must reinvest in the public system instead of sending funds to a costly private sector. Furthermore, it should bolster policies in staffing retention instead of cutting costs, as it has since 2019. Logically, it does not make sense to offer “duplicate” healthcare services through private means when funding can be better spent looking for solutions in the public sector; looking to better allocate funding by talking directly with healthcare providers will help to improve the situation of the people that are directly involved with taking care of patients.
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References
Barua, B., & Globerman, S. (2019, December 16). Lessons from the Canadian Health Care System. The Heritage Foundation. https://www.heritage.org/health-care-reform/report/lessons-the-canadian-health-care-system
Canadian Institute for Health Information. (2023, March 23) Long wait times persist as Canada tries to reduce surgical backlog [Media release].
Lee SK, Rowe BH, Mahl SK. Increased Private Healthcare for Canada: Is That the Right Solution? Healthc Policy. 2021 Feb;16(3):30-42. doi: 10.12927/hcpol.2021.26435. PMID: 33720822; PMCID: PMC7957357.
Niang, A. (2022, October 21). Dr. Judy Morris—Canada’s Health Workforce Crisis | CIHI. https://www.cihi.ca/en/podcast/dr-judy-morris-canadas-health-workforce-crisis
Qureshi, & Xiong, J. (Jie). (2021). Equitable Healthcare Provision: Uncovering the Impact of the Mobility Effect on Human Development. Information Systems Management, 38(1), 2–20. https://doi.org/10.1080/10580530.2020.1732531
RNAO. (2022, November 4). RNAO stands with education workers, decries Bill 28 and the use of the notwithstanding clause, calls for strengthening of public services and fair wages. RNAO.Ca. https://rnao.ca/news/rnao-stands-with-education-workers-decries-bill-28-and-the-use-of-the-notwithstanding-clause
Taylor, J. (2019, December 19). Racism, Inequality, and Health Care for African Americans. The Century Foundation. https://tcf.org/content/report/racism-inequality-health-care-african-americans/