By Janice MacKinnon, September 15, 2021
The federal election has reopened the long-standing debate about private health care in Canada. Yet only in Canada would the topic of private health care spark debate. In many OECD countries that have health-care systems that are less expensive and produce better health outcomes than Canada’s, private health care is common and noncontroversial.
In Canada, private health-care facilities that allow patients to pay directly for services covered by medicare are contrary to the Canada Health Act, although many such facilities exist. So, why have neither Conservative nor Liberal governments acted in a sustained way to penalize such facilities? Perhaps because health-care delivery is a provincial responsibility and provinces, especially Quebec, are adamant that the federal government should not be telling them how to run their health systems.
Another form of private care is the use of private companies to deliver health-care services that are paid for by provincial governments, which is permissible since the Canada Health Act only requires public administration of services. Many services, such as diagnostics, are run by private companies and doctors operate as private contractors.
However, when provinces act to move services currently provided in hospitals to privately operated clinics, they encounter a barrage of criticism: quality of care will be compromised; health-care professionals will be drained from the public system, creating shortages of doctors and nurses; and the clinics will “cherry pick” patients requiring the least complicated procedures, leaving the public system to pay for those with more complex medical problems.
All of these challenges were addressed when Saskatchewan moved 34 day procedures — such as cataract, dental and orthopedic surgeries — from hospital settings to private clinics, as part of its plan to reduce wait times. The Ministry of Health was transparent about the principles upon which the clinics would operate.