That's an excellent question. The way that I answer it is twofold.
First, if we truly want equity in health care, we have to have public financing at its core. Studies have been done across the world: If you do not have significant public financing, even in hybrid systems, equity of access to care suffers. That's one rule of thumb that I think is easy to kind of lean on.
The second rule of thumb is to remember that the largest market mover in any economy is usually the federal, provincial or territorial government. They're the largest purchasers of goods. They're the ones who define legislation. Any single action can transform the way we practise within the health care system in the sandboxes that we live in. Having federal, provincial and territorial governments at the table as you create these rules is central in making sure the rules work properly.
Now, as far as private care goes, we are launching a national conversation around public and private care that's going to be led by the Canadian Medical Association, so that we can help folks actually realize what we're talking about. I think there's a difference between private provision of publicly funded care and pay-out-of-pocket care. Paying out of pocket in the form of copays, added fees and other barriers to access does have a negative effect on patients' utilization of services. It often makes it quite a bit more acute when they actually do apply.
Private provision of care can have a mixed track record depending on how intervention goes, but once again, the data we use to guide whether or not our assumptions are correct is going to be very important as we create these rules.