Has the Ford government hit on the ideal solution to improve Ontario’s problematic health care system? Probably not.
That doesn’t mean fixes aren’t needed, however.
The province this week announced plans to address a backlog of surgeries by having private clinics to take up the slack. That there’s a problem with wait times for the likes of cataract surgery is indisputable. That having for-profit companies in the mix is the way to go remains open to dispute.
And dispute there is, particularly from public-sector unions, though the self-interest angle mutes some of the impact from that quarter.
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Opponents argue the decision is simply a way to transfer taxpayer money to private companies, a move that will eventually lead to poorer outcomes and a weaker public health-care system.
There’s plenty to support such arguments – the COVID-19 crisis underscored the disparity in the long-term care system, for example, where for-profit homes had worse outcomes. Conversely, calls for increased spending – i.e. throwing more money at the problem – are also unhelpful.
Canadians have been spending increasingly large amounts of money on health care, and the problems have only got worse.
Collectively, health spending in this country was some $330 billion last year – more than $8,500 per person – which made Canada one of the biggest spenders among industrialized countries. Comparisons to other OECD nations puts us fourth behind the US, Germany and the Netherlands. Total spending accounts for more than 12 per cent of GDP.
In Ontario, Ministry of Health spending was more than $74 billion last year. By 2025, that number is expected to reach $78.4 billion, $14 billion more than in 2020. And those numbers reflect a slowing in annual budget increases, which in the previous couple of decades often outstripped inflation by a factor of two or three. Despite unsustainable increases, the likes of wait times, access to family doctors and so-called hallway medicine only worsened.
Studies by groups as diverse as the Wait Times Alliance (made up of doctors’ organizations) and the Fraser Institute (a corporate-interest advocate) show waiting times for the likes of referrals to specialists and medically necessary treatment reached 27.4 weeks in 2022, well beyond the 9.3 weeks seen in 1993.
Obviously, something’s gotta give.
But any changes that smack of ideologically driven motives – privatization, for instance – aren’t likely to give in the right direction.
Underlying such suggestions is the belief that the private sector can do a better job of administering health care in this country. Because we have a public system, the reasoning goes, it must be wasteful. An American-style system would trim the fat, or so proponents of privatization would have us believe.
Advocates of US-style health care have long pointed to the delays in our health system – every additional day that somebody’s mother has to wait for a knee or hip replacement, the case for a speedier alternative grows stronger. It’s the wait-time argument that is driving much of today’s debate on the future of medicare. Proponents of privatization want to put that spin on the discussion; admittedly, the issue does have weight, but is overshadowed by the real crux of the matter: emulation of the US model by default.
Americans, we’re told, have quick and easy access to medical tests and treatments. Canadians, on the other hand, have long waiting times for even basic services. They have millions of uninsured citizens who can’t afford health care, while we have a universal system.
Yes, we must do something to cope with costs. An aging population, new (high-priced) technology and rising drug costs are putting constraints on the health-care budget.
By all means, make the system better. But really better for the people who use it: all of us. Ideology has no place in our health-care system.