As efforts to further privatize health care ramp up—particularly in Ontario—The Breach spoke to three doctors from Canadian Doctors for Medicare about some of the myths driving the growth of privatized care.
Dr. Melanie Bechard is a fellow in pediatric emergency medicine and Chair of Canadian Doctors for Medicare.
Dr. Amit Arya is a palliative care physician and board member of Canadian Doctors for Medicare.
Dr. Danyaal Raza is a family doctor in Toronto and a board member of Canadian Doctors for Medicare.
As the pandemic and funding cuts stretch Canada’s healthcare system beyond its limits, there’s a big push for increased privatization.
Arguments for increasing private care provision are based on three principle myths:
- that privatization saves money,
- that it cuts down on long wait times and
- that it increases service capacity.
In a truly public system, public money is used to cover the real costs of care: doctors, nurses, hospitals and supplies for everyone.
In a private system, there’s an additional cost: profits.
The first step towards a private system is channelling public money to private institutions.
Patients have a similar experience, but the system is drained of resources to pay for profits…
As the quality of care degrades, pressure mounts to provide two-tier care, where those who can pay more can jump the queue
We spoke to three doctors about what would happen if some of the private care proposals went forward.
Danyaal Raza: “The first step towards privatizing a health care system is not asking people to pay out of pocket for health care services, it’s taking public dollars and starting to direct them more and more to for-profit care.”
In reality, private systems raise prices and lower quality by introducing middlemen like insurance companies and for-profit clinics
Melanie Bechard: “If we do start seeing more private pay health care where people need to pay in order to receive care, we would start to set up a parallel system where people could, in theory, pay more for faster care. This would be supremely inequitable, and it would also really damage Medicare.”
Amit Arya: “Whether it comes to private pay, or it comes to private for-profit, delivery of care inequities get worse, waitlists in the public system get worse, and in fact, it can be quite dangerous.”
A private system results in overpriced healthcare for those who can afford it, while the public system is drained of personnel and resources.
Melanie Bechard: “We have a very limited number of health care professionals in Canada. If we start inducing doctors and nurses and other health care providers to work in a private pay system, there’s going to be less people to care for the vast majority of us who would rely on that public system. As I see it, there’s fundamentally no way to have private pay health care that doesn’t completely undermine Canadian Medicare.”
A shift towards more private care would in fact deplete the public system of essential healthcare workers, leading to a degradation of healthcare infrastructure.
Melanie Bechard: “And we’ve seen this in other countries when there’s been private parallel systems brought in wait times actually worse than overall for select rich few. They might be marginally shorter, but I think we have to ask ourselves as Canadians is that really what we value and is that what we want our healthcare system to be?”