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.

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.

That’s bad news for a health-care system that’s already cracking under the strain of the pandemic.

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.

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There are tremendous back-end pay-outs available to politicians that work to privatize healthcare. Canadian conservatives who are ideologues take their cues from the US think tanks so they actually dream of destroying Public Health Care. And those think tanks are funded by insurance companies that make tremendous money from private health care. This article is important because the real motivations of politicians are not being discussed. Plus the whole idea of for-profit healthcare being cheaper is absurd. They can do better for less and carve out a chunk of profit? It doesn't make sense.. l.but it pays.

I agree 100%. With a private health care system, the wealthy will be able to receive all the medical attention they desire but the ordinary and the poor in particular will be treated as second class or worse. The government will pay for "basic" services for most of us, basic being what is possible in a low-tax system. Can you imagine Doug Ford visiting the local clinic to get a prescription for his flu?

People from here went to Australia, to see how their "mixed system" works.
Not only are there numerous differences between how the AU system and ours are set up, but that system works really, really well for those with private insurance and lots of money; for the rest, not so much.
They don't have the pay squabbles we have, because every job, at every level, has a state-set pay-scale.
I've no idea how that works for the workers, when push comes.

All of this seems obvious to someone who was still in highschool when the people of Saskatchewan fought the American Medical Association and the public their propaganda frightened.....to prevail and establish the first single payer health care system in North America. As usual, when the rest of Canada saw what a good thing we had in Saskatchewan, everyone wanted it, and the centrist Liberals were forced to establish a national program or face the possibility of losing to 'socialists'.

At one of his last public speeches Tommy warned us the forces who like to get rich off of misfortune wouldn't give up on taking back our hospitals.......and both Liberals and Conservatives have been chipping away at helping those forces for the last few decades.

If you're among those aging baby boomers.......or one of the nations young who see no possibility of owning your own home......you'd better get political and soon. Stop hating Trudeau...urge him to withhold federal transfers if capitalist elites intend to use the money to finance any more destructive 'tax saving' schemes like privatized long term care.

We al sat in front of our tv's and listened to the grim statistics coming out of our privatized long term care homes....are we now passively preparing to hear the same grim statistics come out of our hospitals and privatized clinics???? Because the working poor AND the middle class aren't moving in a direction that suggests they can finance their health needs out of pocket..........and why the taxes libertarians allow governments to collect should go to private for profit centres, is the mystery inside this cry for privatized services.

Because we all do know, or should know, that these private centres fantasized by wanna be billionaires will be paid in 'public dollars'. Crusty Clark's assertion that private care will be cheaper.....and more 'competitive' is what ideologues call an 'idea'.

It's never held up in practice. So lets not let the illusion of lower taxes con us into thinking the private sector does anything because of their love of public service. They're never in anything except FOR THE MONEY...and its our tax dollar money they are coming for.


Great observations, and you bet I will resist. More important, I will encourage others to do the same. We need to take a stand, and we need to do it now. There is too much at stake. Thank you so much for your insights.

Yep. I remember sitting in the waiting room of our little village "doctor's office" on what is now called "well baby days," with numbers of local mothers trading numbers as to how much each of their kids had cost -- meaning how much they'd had to pay to have the baby delivered. I was very young, probably 3, maybe 4, and was quite intrigued with numbers at the time. And prices. dime icecream was two scoops, while the nickel version was but one, despite that nickels were larger.
I remember one mother saying that one of her kids had cost $100, and the next was the same, but the last was $200. There was no local hospital: locals in need travelled 40+ miles in one direction or 50+ in the other.
My grandmother was a prairie farm-village mid-wife, who'd go along with the doctor to attend to births. During the depression, doctors' services were by barter, and the local doctor there was paid in much the same manner as donations were taken at church. A chicken wasn't out of line. Grandma told of times the doctor didn't take any payment, because it would mean one less chicken available for the kids in that family.

Not only are those doctors in private clinics not willing (eVer!) to work for nothing, but they've historically been unwilling to work for the money that public insurance offers.

And there's no plan yet, as far as I can tell, to train more nurses ... or doctors ... or to require that doctors work full-time. I think ppl would be much less sanguine about the state of affairs if they actually understood how all-that-stuff works.

People generally are at a state of understanding around our healthcare system(s), comparable to those who think that the amount of money available for car loans or mortgages from a given bank, depends on how much its customers have on deposit there. (And that's actually most of the population).

On October 24, 2017, the United Nations (UN) Special Rapporteur (SR) on the right to health, Dainius Pūras, presented his report on corruption to the UN General Assembly. He told his audience, “In many countries, health is among the most corrupt sectors; this has significant implications for equality and non-discrimination “... He noted some are related to the global pharmaceutical industry and others from “institutional corruption” and emphasized the “normalization” of corruption in healthcare which includes practices undermining
medical ethics, social justice, transparency and effective healthcare provision, as well as illegal acts. Many researchers and scholars support the SR’s findings and note how the corporatization of medical practice has contributed to this situation and the loss of medical professional autonomy. Many governments now recognize that healthcare and disability costs are unsustainable and may undermine their national economies. Nevertheless, current practices regarding healthcare cost considerations are largely reduced to insurers’
quarterly earnings and governments’ annual budgets. This short-term thinking is disastrous with regards to the unsustainable healthcare and disability costs from the expanding pandemic of undiagnosed, misdiagnosed long-COVID and untreated and/or under-treated Lyme and relapsing fever borreliosis patients.

The long-term disability insurance industry doesn't want to underwrite the costs of treatment of chronic disease. Our Public Health Agency [PHAC] has decided they will no longer lead and control disease but will be cheerleaders for healthy living instead.

Our system has flaws but lets work within it. Corporations have already captured how we manage Lyme disease. They realized that if they can control the medical guidelines [poor crib sheets] they can control medicine. These corporations pay for research, medical schools and political parties. It's no wonder the CDC is in trouble and due for an overhaul from top to bottom.