Photo by: Brenden Cowan
Ontario’s premier, Doug Ford recently announced that he will be moving 50 per cent of non-essential surgeries as well as diagnostic assessments to for-profit clinics to help with a backlogged surgery list, due to Ontario’s stressed medical system. This has been understood as just another attempt by the Ford government to use their deliberate attacks on the medical system, from capping nurse’s wages with Bill-124 to withholding funding to the system with a $2.1 billion budgetary surplus in 2021.
Ford claimed in a press conference that our system is like those in Cuba and North Korea and that it’s time to move forward. Private eye surgery clinic owners who have lobbied Doug Ford have already seen gains in the past with the government licensing private eye clinics as independent health facilities soon after their lobbying efforts. It’s no secret that Ford is for sale, however the right has to do performative backflips to make his gutting of Ontario’s healthcare system look pragmatic.
Jesse Kline, Deputy Comment Editor at The National Post and a hardline apologist of the Israeli occupation and de facto open-air prisons of the West Bank and Gaza Strip, felt he still has a reliable gage on human well being not just abroad but domestically too, having recently put out an op-ed claiming that Ford’s change was “modest” and the left was simply being hysterical about the recent announcement:
“As much as the left would like us to believe that any private involvement is antithetical to a universal health-care system, the fact remains that much of the care we receive is provisioned privately, even if it’s paid for through the public purse.”
This is true. Many walk-in clinics, diagnostic assessment centres, doctor’s offices and so on, are privately funded. However, the idea that expanding private clinics will help with a backlogged system is not a safe bet. As the College of Physicians and Surgeons of Ontario precautioned, simply diverting responsibilities and procedures to the private sector doesn’t ensure less wait-times and could even mean longer backlogs if the systems aren’t connected because of a lack of continuity with patient information between centres. The College also stated they weren’t brought into the conversation in regards to the recent decision to push certain surgeries to for-profit clinics.
Kline goes on to say that Ford ought to go further and privatize more of the healthcare system: “if ever there was a time for some premiers to stand up and say, ‘To hell with it, we’re going to stop insuring a handful of non-critical elective surgeries and allow the private sector to start charging for them, Canada Health Act be damned,’ now is it.”
This is a profoundly surface-level solution. For one, Ford plans to eventually move from currently outsourcing basic cataract surgeries, soft-tissue plastic surgery of the hands, and the likes, to more non-invasive surgeries such as colonoscopies, endoscopies, as well as MRI and CT scans. The issue is that these latter items can be preliminary procedures in discovering more serious health complications. This means that the wealthy Ontarian who doesn’t want to deal with the public system’s backlogged lists can get their MRI scan from a for-profit and so pays up front in the form of user fees, higher costs—or in Kline’s vision of a scrapping of the CHA, the full cost of surgery. Let’s say this MRI scan reveals something of serious concern, then this person is moved up the priority list in the public system. The person who is in the same position but can’t afford user fees for an MRI wouldn’t be able to skip the line.
However, this is already giving too much credit to the idea that using for-profit clinics for surgery means better care. As the highly cited (over 400) meta-analysis from the Canada Medical Association Journal which explored for-profit against non-profit hospital mortality outcomes, looking at 26,000 hospitals and 38 million patients, from 2002 demonstrated—”Our meta-analysis suggests that private for-profit ownership of hospitals, in comparison with private not-for-profit ownership, results in a higher risk of death for patients.”
Of course, critical surgeries aren’t on the docket for privatization in Ontario, yet. However, that doesn’t hinge on the point that for-profit clinics don’t have the patient’s care as a top funding priority.
One other important aspect that the study points to when considering why for-profit clinics have worse mortality outcomes is that because the clinics are beholden to shareholders, senior administrator reimbursement packages cut into funding that would go towards patient care and infrastructure. This puts for-profit clinics on unequal footing with publicly funded healthcare which isn’t beholden to anyone’s expectations for a monetary return.
Instead, public healthcare is concerned with the public’s wanting a return in the form of their health outcomes.