Accepting the Dirty P-Word

 

Lack of competition among providers has burdened our healthcare system with overcrowded emergency rooms, long waitlists for critical services, and poor quality of care1. Our system gives healthcare providers a financial incentive only to focus on serving a high volume of patients. But imagine having a parallel “private” system where innovation, performance and patient satisfaction matter more. The model is simple: by allowing public and private providers to “compete” over the government’s healthcare dollar, both will have incentives to practice effective and low-cost care, and not just focus on volume. To cite journalist Pooley, “the cure to our ailing system is a dose of competition1,” and privatization would provide that.

So then, what’s holding us back from implementing competitive practices? Mostly, it’s the P-word: Canadians have a negative view of privatization.

However, economists who critique Canada’s current system say that it’s possible to mix healthcare solutions financed by both public and private providers. These mixed solutions exist in countries such as France, Switzerland and Germany, where social justice values are not compromised by privatization.

While it may be difficult initially to convince consumers—patients—of the need to privatize, they are ones who experience firsthand the deficiencies of our healthcare system. If we can catch them when they are most negatively affected by our system, as well as educate them about the opportunities that can arise out of privatization, it will be a win-win for all. But the difficulty lies in how we reach consumers effectively in times of frustration and poor health. In the following strategy, I propose four recommendations to support the adoption of privatization.

First, privatization lobbyists need to publicly debunk myths about privatization. Several health coalitions have entrenched negative perceptions of privatization in our consumers’ minds, and we need an alternative representation to give privatization a fighting chance. For example, the Council of Canadians reinforces these myths through protests and various meetings to defend the public health system2. No council currently exists to defend privatization. We need to counter the myth that universal healthcare is the best option by showing consumers that a publicly funded healthcare system is monopolized and has little incentive to increase efficiency and delivery of care while lowering costs. The myth of “Americanizing” can also prevent public action against this monolithic structure. Thus, we must reassure the public that privatization would improve services while maintaining Canadian social justice values of universality and fairness.

Second, we need to use social media platforms to raise awareness of the deficiencies in public healthcare. For example, highlights of the Chaoulli case (Quebec’s failure to deliver healthcare in a reasonable manner while preventing Mr.Chaoulli from purchasing private insurance3) could be shared via Twitter to publicize the shortfalls of our public system. Lobbyists need to provoke other Canadians to share their horror health experiences to enhance solidarity for privatization. The hashtag #HCprivatization could be implemented to monitor and link various public opinions.

Third, privatization lobbyists should invite health professionals to stand in solidarity to increase public confidence in privatization. For instance, having Dr. Brian Day (Canada’s unofficial champion for privatization4) speak to Canadians about his own for-profit surgical clinic and its effectiveness in providing competitive care will instil credibility for this purpose. Due to his role as a physician, Dr. Day would be better able to advocate for privatization than a lobbyist, and encourage public dialogue.

Lastly, to help Canadians see the potential for privatization in healthcare, lobbyists with the support of Dr. Day and his colleagues should implement trials where some healthcare services are contracted to private providers. Private clinics should offer publicly funded medical services for a grace period of two months to let consumers “sample” privately delivered health services. Consumers could then compare the wait times and quality of care offered by both providers. This would be a trial run for privatization because now both providers would compete to offer the best service. Regardless of whether consumers choose public or private care during the grace period, they will see positive changes in their care because the private clinic would reduce patients in the public system.

While the recommendations outlined above would be ideal, I acknowledge that there are limitations, which include: potential legal action taken against health professionals who support privatization, and violations of the Canada Health Act due to the trial. My solution is to have political officials, like the Honourable Deb Mathews (who supports cutting services from local public hospitals and contracting them to private clinics) to assist in ensuring that health professionals who support this cause are not viewed as legal threats and to support the trial run for privatization. Lobbyists’ efforts to educate and inform the public of alternative opportunities will be understood better with the combined efforts of open dialogue and trial.


References:

1 Pooler, Erin. “The Cure to Our Ailing System: A Dose of Competition.” Canadian Business, October 01, 2007. Health care: Medicare Inc.

2 Brent Patterson, “Council of Canadians Demands Dr. Day be Held Accountable for Overbilling”, in Council of Canadians, September 30, 2014, http://canadians.org/blog/council-canadians-demands-dr-day-be-held-accountable- overbilling.

3 Daniel Cohn, “Chaoulli Five Years On: All Bark and No Bite?,” Concordia University, (2010), 2.

4 Pamela Fayerman, “Dr. Brian Day vs. the BC Government and Anti-privatization Foes: Legal Case Twists, Turns,” The Vancouver Sun, March 10, 2014, Medicine Matters.


 Thrmiga Sathiyamoorthy

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Thrmiga Sathiyamoorthy is completing her Bachelor of Health Sciences at Western University. She is interested in pursing a career in medicine with hopes to be involved in health policy and administration. Her focus remains on inter-professional collaboration and equitable healthcare for all.