As you know, Canada has a universal health care system, largely funded by the federal government via the Canada Health Act with services largely provided by each of the provinces under their provincial health acts. However, in recent years, provincial governments have been considering more delivery of health care services through private outlets. This occurrence became increasingly an issue in light of the fact that provinces have to be careful not to violate the Canada Health Act by requiring people to pay for medically necessary procedures. Otherwise, they could loose funds that they receive annually from the federal government for health care. The issue has once again arisen as result of a severe lack of family physicians in many provinces, long wait times for some surgeries and in emergency rooms, and hospital closings because of staff shortages. Some have described the situation as one reaching crisis levels.
Now, this is not to say that numerous health care services are not now provided through private means. These include such services as medical testing, drugs, dentistry, physiotherapy, audiology and optometry. According to one expert, such privately delivered health services already make up about thirty percent of the total health services in most provinces. They further include the supply of nurses for home care or to cover hospital staff shortages, building of new hospitals in partnerships with governments, and the operation of costly equipment like M.R.I. machines. Some provinces, such as Ontario, have recently announced that more services will be allowed to be provided through private sources. These would include a number that initially had been performed only in public hospitals, such as medical imaging, cataract surgeries and hip and knee replacements. To date, most such clinics have been owned by groups of physicians, and they are relatively small businesses. The primary caveat for this expansion is that patients will continue to be covered by public health plans. The last thing that they want to see is move to a two-tier health care regime such as exists in the U.S.
Katherine Fierlbeck, a professor of political science at Dalhousie University in Halifax, is the author of a recent report on the issue. In it, she predicts that as the private clinic business grows, large health care companies based in the U.S. will take a keen interest in the Canadian market. Professor Fierlbeck also notes that these American companies don’t have that much political clout, and they’re not interested in behaving aggressively. However, if you open the door and allow these huge corporations to come in from the States, then they are going to act aggressively, the same way that pharmaceutical companies act aggressively. As a result, you would have to fend off interests who really want to expand the parameters of private business through constant lobbying or lawsuits.
Some observers argue that allowing for more private clinics to operate could lead to more medical practitioners moving from the public hospitals to private clinics, thereby impacting on the services normally provided by public hospitals. A further loss of staff would only increase the waiting times in emergency wards and operating rooms for patients without access to private clinics, particularly in rural areas.
All in all, the increased use of private clinics is considered as being only one aspect of dealing with the health care crisis in Canada. It must be accompanied by increases in the number of doctors, nurses and other medical staff through more subsidized training in medical schools and facilitating and speeding up of the licensing of foreign medical practitioners. As with other occupations, the number of medical practitioners retiring in Canada will only increase in the near future.
Polls indicate that the vast majority of Canadians continue to support a universal health care system. There is no doubt that both federal and provincial governments will have to be very cautious in how they deal with this politically-hot issue!
FROLITICKS 