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Concern rises about health-care privatization following provincial announcement

Posted: August 23, 2022

(August 22, 2022)

By: Brigid Goulem, Kingston Whig Standard

Health care advocates across Ontario are concerned following the announcement that the Ontario government will be relying on private surgical clinics to attempt to alleviate the surgical backlog across the province.

In a media release issued on Thursday afternoon, Ontario minister of health Sylvia Jones announced that the province would be investing $300 million into a “surgical recovery strategy” which includes increasing the number of OHIP covered surgical procedures performed at “independent health facilities” and increasing surgeries provided at existing private surgical clinics.

Health care advocates are concerned that the reliance on private, for-profit facilities will not only fail to address the staffing challenges facing the health-care system, but will actually exacerbate these issues.

“The pressure right now is that there is not enough staff,” said Ross Sutherland, co-chair of the Kingston Health Coalition and board chair for the Ontario Health Coalition, in an interview with the Whig-standard. “If they move these surgeries to private clinics, where are these places going to get the staff? It’s going to be from the public system. That is just going to increase the pressure on the system.”

The concerns about the increasing commodification of the health-care system were echoed by the Ontario Nurses Association in a media release issued on Friday.

“This is a blatant move that will line the pockets of investors, nothing more,” said ONA President Cathryn Hoy in the media release. “The evidence is clear: health-care privatization provides worse health outcomes to our patients, and has much higher overhead costs which will be paid by taxpayers. Ontario is deep-diving into privatization that will only benefit shareholders.”

Concerns about the creeping privatization of the Ontario health-care system are not new, and advocates have long been clear that publicly funded and publicly run health care is more cost effective and produces better outcomes for patients.

Sutherland points to a 2008 study published in the Canadian Medical Association Journal compares the differences between the private health-care system in the United States and the largely public system in Canada and found that health care costs were higher and outcomes were worse in the United States.

Study author Marcia Angela is clear that privatization is not an effective solution to long wait times or staffing issues.

“The notion that partial privatization in Canada will shorten waiting times for elective procedures is misguided,” Angela writes. “Partial privatization would draw off resources from the public system, increase costs overall and introduce the inequities of the U.S. system. The best way to improve the Canadian healthcare system is to put more resources into it.”

In the current context of the staffing shortages, Sutherland points out that investing more public money into private clinics will not increase the availability of staff, but will fragment it as the public and private system compete to hire from the same pool of staff.

The division of health-care staff between the public and private system, Sutherland says, makes it impossible to prioritize efficient and effective care for people. He points to the example of the home-care system.

“We have a few large companies that provide home care here in Ontario. Say there are two people on the same street who need home care. You can have one nurse from one company going to one house, and one nurse from another company going to another house on the same street, in the same day. Think about the waste of time and driving! Whereas, if you had one integrated system, the same nurse could go into four houses on that one street and save a ton of time and money,” Sutherland said.

While advocates of privatization argue that competition and profit motive inherently produce more cost-effective systems, Sutherland points out that competition and cost-effectiveness do not work in the health-care setting.

“The motive of private companies is to make money—that’s what businesses do! What that means with health care is that they are going to increase the charges they can put onto patients where they can, they’re going to direct profit for dividends for stakeholders and share buybacks, rather than reinvesting all that money into improving the system,” he said.

In addition to being less cost-effective, Sutherland says these companies often become permanent features of the health-care system.

In reality, you can’t have competition in health care, because it’s too technologically sophisticated. It involves too much co-ordination between systems. So once (a company) gets set up, you can’t have another company bidding in and say ‘oh, we can do it cheaper’ because these companies need to somehow build up their laboratories, or build up their their surgical capacity so they can compete with (the other) facilities. So, it doesn’t happen. These companies are there forever. They just become a part of the public paid system,” he said.

With increasing privatization currently on the table, Sutherland wants to be clear about what that means for the health-care system in Ontario.

“There is no evidence that shows that using for-profit companies and privatizing the health-care system works. There is no logic in it. It is just a way of taking public money that could be used to improve our health-care system, and giving it to private companies, which end up paying stakeholders,” he said.

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