Textes d'opinion

Service matters most in health care

When you think about health care, what’s the most important thing to you? Is it the fact that care must be provided in government-operated facilities, or that care should be accessible to all, regardless of income level?

In my view, the latter should be prioritized, as timely access and quality are much more important determinants for our health than the ownership structure of the place where services are dispensed.

That’s also what Doug Ford’s government has recognized with its recent proposal to use privately-owned clinics to help reduce the backlog for some surgical interventions and key medical treatments, with the cost of care covered by the province’s health insurance plan.

And what a backlog it is. At the moment, approximately 206,000 Ontarians are waiting for surgery.

For those 206,000 Ontarians currently on surgical wait-lists, it’s fair to say that health care is not accessible. As former chief justice Beverly McLachlin famously put it in the Chaoulli case, “Access to a waiting list is not access to health care.”

What Ford is doing by making treatment in private clinics accessible under Ontario’s universal health insurance plan is adding extra capacity to the province’s public system.

Bold as this is, including privately operated facilities within universal health care systems is not exactly unprecedented.

Just look at France or Sweden. Both countries benefit from a universal public insurance program that covers the cost of medical treatment for individuals. Both also leverage privately operated hospitals and clinics to increase their universal system’s capacity. For instance, nearly 40 per cent of French hospitals and clinics are run by private-sector partners.

Within Canada, one can look at the province of Quebec, where the government-run Sacré-Coeur hospital has had a deal for a number of years with the privately owned and operated RocklandMD clinic to provide operating rooms and support staff for day surgeries.

That clinic alone fulfilled over 2,000 interventions per year for the Sacré-Coeur hospital, equivalent to more than half of the hospital’s load of eligible day surgeries.

While the deal is now discontinued, the Quebec government is still looking at ways to leverage private-sector partners within its health care system, with the current governing party having campaigned under a promise to open up two privately operated mini-hospitals, with services covered by universal public insurance, before 2025.

Or, even closer to home, Ontarians can look at some of the private hospitals covered under OHIP that already exist within their province and help bring greater access to health care.

These are places like Thornhill’s Shouldice Hospital, which has been able to keep operating as a private hospital thanks to a grandfather clause and is currently a world leader in hernia surgeries.

This health facility alone accounts for roughly 7,000 hernia surgeries per year, helping to dramatically reduce the load on the province’s government-run hospital system. All that without Ontario patients having to take their credit cards out of their wallets to pay for treatment.

Whatever bogeyman its opponents might want to bring up, Ford’s approach is nothing new, nor is it untested. His plan to involve privately owned and operated facilities in delivering care within Ontario’s universal health system builds on well-documented success stories.

And for the 206,000 Ontarians who are suffering on waiting lists for surgeries, it offers a beacon of hope that they can get more timely access to the care they need. Isn’t that what our health care debate should really be about?

Emmanuelle B. Faubert est économiste à l’IEDM. Elle signe ce texte à titre personnel.

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