If you get close enough to a hospital in Canada right now, you can almost hear it straining under the pressure of the last two-plus years. The combination of a global pandemic, burned-out doctors and nurses, and an increasingly indifferent public has pushed our public health-care system to the brink — and in some cases, past it.
So far, that’s resulted in the closure of emergency rooms across the country, including in major centres like Ottawa, with the prospect of more disruptions to come. As Dr. Deepa Soni tweeted, “23 years as an EM [emergency medicine] physician and I have never seen things as bad as they have been for the last several months … with no sign of letting up.”
For most Canadians, this is an unmitigated disaster. But for some, the slow-motion collapse of our health-care system is the moment they’ve been waiting for — and they’re ready to pounce. After years of having their efforts to introduce more private activity into the health-care system rebuffed, the proponents of private medicine are now finding a more receptive audience in a general public that can’t count on the system. And make no mistake: the politicians who support private medicine intend to take advantage of it.
When asked if her province would consider allowing more private activity in the health-care system, Ontario Health Minister Sylvia Jones said, “All options are on the table.” A few days earlier, former B.C. premier Christy Clark made an impassioned plea for said options in an appearance on the Real Talk with Ryan Jespersen podcast. “If provinces were allowed the freedom to innovate in health care, to allow more private care into the system, then first of all, it would be way cheaper. And second, I think the competition would make the public health-care system better. The only thing worse than a monopoly is a government monopoly, and that’s what we have in health care.”
First, it is not at all clear that private care would be “way cheaper.” Nurses from private agencies are being used to fill vacancies in Ontario’s system right now, and they can cost as much as four times what a nurse on the public payroll earns. Private health-care enthusiasts talk a good game about reducing costs and increasing efficiency, but the actual evidence is far less compelling.
Back in 1996, Conservative premier Mike Harris justified the privatization of Ontario’s home-care and long-term care system on the basis that it would be “better, faster [and] cheaper.” Instead, as the first wave of the COVID-19 pandemic revealed, those for-profit facilities made decisions that put the lives of their residents at far greater risk than those in public long-term care homes.
But the question we need to be asking right now isn’t whether private health care can help save the public system. It’s whether those who advocate for it are trying to break the public system to make their case. After all, people won’t allow you to fix something if they don’t agree it’s broken, and conservative politicians and pundits have been trying to convince Canadians of that for years. If you want to be cynical, you could say that with COVID-19, they saw an opportunity to add even more stress to an already overburdened health-care system.
That might help explain why Canada’s provincial governments, the vast majority of which are run by conservative parties, seemed to alligator-arm the help being offered by Ottawa. A 2021 report from the Canadian Centre for Policy Alternatives suggested there were billions in unspent federal grants and spending for health care and other COVID-related supports, while this past July, Ontario’s Fiscal Accountability Officer revealed his province had underspent its forecasts by $7.2 billion.
It might also help explain why so many conservative politicians and pundits opposed mask and vaccine mandates, even as that opposition contributed to the Conservative Party of Canada’s defeat in the 2021 election. It’s hard to imagine any government bringing forward new mandates now, even if the next wave of the pandemic is particularly nasty. Public health officials may have won the battle to get people vaccinated, but they’ve lost the war when it comes to their willingness to endure other public health restrictions.
That’s bad news for a health-care system that’s already cracking under the strain of the pandemic.
Opinion: Before we change Canada's #HealthCare system, we must be sure the people in charge of solutions don’t have their hearts and their wallets in the same place. @maxfawcett writes for @NatObserver.
If we’re lucky, that strain will serve as a wakeup call for policymakers and politicians, and lead to a long-overdue national conversation about what we want out of the health-care system — and what we’re willing to pay to get it.
Being better than the United States is damning with the faintest of praise, and there are many ways that Canada’s system can and should improve. As Canadian Medical Association president Katharine Smart said, “What is clear is the status quo is not the way forward. We shouldn’t be afraid of change — we need it desperately.”
Even so, we should be wary of the people out there who are more than happy to capitalize on that desperation. As the last two years have shown, they might even be willing to add to it. Before we make any changes to a health-care system that Canadians hold dear, we ought to be sure that the people proposing solutions don’t have their hearts and their wallets in the same place.