No, operations performed in the private sector do not cost 35 per cent more, show documents obtained by the MEI
- The comparison made by the government omits several costs for the public system.
Montreal, September 30, 2026 – The treatments provided in specialized medical centres and paid for by the government do not cost 35 per cent more than they do in the public system, contrary to information transmitted by Le Devoir earlier this year, show new documents obtained by the MEI.
“In reading the analyses that led to this 35 per cent figure, we can see that this is not an additional cost, but rather a matter of different budgetary envelopes,” explains Renaud Brossard, vice president of communications at the MEI. “If the public sector seems cheaper in this comparison, it is because a substantial portion of public sector costs are excluded, whereas they are included for the private sector.”
The Devoir article was based on information transmitted in a confidential brief submitted to the Cabinet by the former health minister, Christian Dubé, in July 2025. The brief aimed to defend the adoption of a regulation on the use of private operating facilities to reduce wait times for surgery in the public system.
The brief remains confidential, but a shorter public version is available.
Thanks to a request for access to information, the MEI obtained the analytical report quantifying this gap. In it, only direct costs—that is, salaries for operating block personnel and the costs of supplies used—are considered for the public system.
For the private sector, the costs used represent estimates made by civil servants.
Direct costs are estimated to be 10 per cent lower than for the public system. According to the government, this is due to shorter operating times, more efficient procedures, and flexible negotiation and partnership with providers.
“In fact, if we compare the same costs in the public and private sectors, the private sector is 10 per cent less expensive according to the government’s methodology! But such an analysis would be very limited,” adds Mr. Brossard.
The analytical report also adds indirect costs, which is to say administrative, support, and infrastructure costs. To this amount is then added an estimated profit of 10 per cent. This is how the report establishes the estimated cost for specialized medical centres.
By comparing direct costs in public facilities with estimates costs in specialized medical centres (including direct costs, indirect costs, and a profit margin), a gap of 33.7 per cent is found.
It is on this basis that the minister states that the total cost per intervention would exceed the amounts established under patient-based funding, as indicated in the public portion of his brief.
Yet, patient-based funding (also known as activity-based funding) covers only the direct costs of a treatment in the healthcare system. Other budgetary envelopes cover costs for administration, support, and the maintenance and improvement of infrastructure.
“Administration, infrastructure, and support costs exist not only in the private sector; it’s just that in the public sector, they are in a different budgetary envelope, which is not connected to activity-based funding,” says Mr. Brossard. “After all, it would be fanciful to believe that the healthcare bureaucracy in Quebec came at no cost.”
Unfortunately, this striking—but erroneous—price gap has since been repeated by certain candidates in the context of the election campaign and by a Quebec labour union, and also used by a researcher attacking the use of private surgery centres to reduce wait times in Ontario.
You can consult the public portion of Minister Dubé’s brief here (in French only).
You can consult the analytical report obtained by the MEI here (in French only).
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The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
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Renaud Brossard
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