Privatizing health care is no panacea

Alberta’s UCP government is looking to privatization as a cure for what ails Alberta’s public health care system.

Bill 30 allows for-profit corporations to bill the government directly for medical services and 30% of surgeries conducted in Alberta will be done in private facilities by 2023.  Despite ample evidence suggesting the opposite, the Kenney government believes that private health care will cut costs and decrease wait times without compromising quality.

The Canada Health Act legislates that all Canadians should have equal access to publicly-funded, medically-necessary physician and hospital services. Health care is to be provided on the basis of need and not ability to pay. To receive federal health transfer payments, provinces have to abide by the principles of the Canada Health Act.

But several provinces are allowing a private health care system to exist alongside the public one and turning a blind eye when private clinics charge patients user fees in blatant contravention of the Canada Health Act

Private health facilities are not the cheaper alternative.  When Alberta contracted with the private Health Resources Centre to perform orthopedic surgeries under the Stelmach government, Albertans paid more per surgery than for procedures delivered publicly, and were left with outstanding costs when the business declared bankruptcy. Private businesses tend to take the profit but leave the risk with taxpayers. 

Private clinics can also choose less complicated patients to serve, leaving more complex (and costly) patients to be looked after by public facilities.  Private clinics further add burden and cost to the public system when patients who develop complications from privately delivered surgery have to be admitted and cared for in public hospitals. All these factors do not add up to cost savings for governments.

The primary obligation of for-profit businesses is to maximize profits for their shareholders.

Private health care does not decrease wait times.  Health care professionals for public and private facilities are draw from the same finite pool.  Moving surgeons from the public to the private sector does not mean that procedures will be done faster. 

Cataract surgeries have been performed in private clinics in Alberta for many decades, yet wait times are higher than the national average and less than half of Albertans receive their surgery within the 16-week national benchmark. 

Also, training physicians and surgeons comes at a considerable cost to the public purse.  Allowing for-profit businesses to siphon valuable human resources from the public system amounts to providing them with generous subsidies to erode the public workforce.

Private health care does not encourage quality care. The primary obligation of for-profit businesses is to maximize profits for their shareholders. If private facilities are paid no more than public facilities, in order to turn a profit, they have to reduce their expenses by cutting corners or increase their revenue by charging patients.

There is evidence that both these strategies are used. During the COVID-19 pandemic, we have seen higher death rates in private long-term care facilities that cut corners with lower staffing levels and over-crowding of residents. Private clinics often charge patients overhead or facility fees up to two times higher than overhead costs incurred by private hospitals in order to increase their revenue. 

How then can we strengthen the health care system in our province? 

We can encourage our government to adequately fund upstream efforts in health promotion and disease prevention because we know that prevention costs less than cure.  We can insist that our governments look closely at publicly-funded medical services and cover only necessary and effective therapies.  Finally, we can encourage the government to collaborate with physicians to implement fair and efficient models of physician compensation.  

Albertans are fiercely proud of our world-class publicly funded health care system. We need to make sure that it endures for future generations.

By Vamini Selvanandan © 2020. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on November 19, 2020. Photo credit: Karolina Grabowska on

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