That, given that, (i) during the 2021 federal election campaign, the prime minister was harshly critical of the Conservative Party of Canada proposal to encourage “innovation” in the health care sector by expanding for-profit provision of publicly funded services, (ii) the prime minister has now dramatically changed his position and has lauded as ‘’innovation” Ontario Premier Doug Ford’s proposed expansion of for-profit clinics, (iii) for-profit clinics would poach workers from the public system and lead to longer wait times, (iv) there are multiple public reports of two-tier health care in Canada, where people are charged for faster access to care, such as family doctors or surgery, the House call on the government to: (a) express disappointment that the prime minister has promoted Ontario’s for-profit health plans as “innovation”; (b) ensure that recently announced health care funding is not used for the expansion of for-profit health care, but instead used to rebuild and innovate within the public system by hiring more staff and reducing wait times; and (c) enforce the Canada Health Act and immediately move to close loopholes that allow for the growth of two-tier health care in Canada.
Mr. Speaker, Canada's health care system is based on the principle of access to care based on need rather than ability to pay. A well-designed, well-funded single-payer system can provide fair, effective and high-quality care to make this a reality.
Our public health care system is certainly facing some challenges, but the solution lies in strengthening our public health care system, not weakening it.
If we introduce private funding, then need will come second to ability to pay. That would result in less accessibility, longer wait times and higher costs in the public system. It would also lead to increased administrative costs, in other words, more money for insurance companies and less money for health care.
Introducing private payment prioritizes care based on ability to pay, not need. It leads to worse access and wait times, as well as higher costs in the public system. It also leads to higher administrative costs, which means less money for patient care.
There is not only little evidence that private, for-profit investor-owned corporations can provide better quality care or reduce costs. In fact, there are many examples that show precisely the opposite. Those seeking to improve the quality, equality, access, efficiency and equity of health care services in Canada can do so by focusing on strengthening our public system rather than dismantling it.
Proponents of privatization claim that increasing private pay and/or private for-profit delivery will reduce wait times, either overall or for those in the publicly funded system specifically; reduce costs to the public system; and lead to better health outcomes. There is perhaps no more serious and dangerous myth in Canadian politics today than that statement. I want to review the situation today and some of the factors that show this is not the case.
Everyone deserves health care when they need it, no matter the size of their wallet. No one should need to wait in pain because there are not enough health care workers or because the wealthiest jump the queue.
However, under successive Liberal and Conservative governments, today people are waiting in pain for hours, days or weeks, and sometimes months or years. Folks are losing their quality of life while they wait for surgery. In addition, health care workers are run off their feet, burned out and exhausted in every corner of this country.
The Prime Minister could make things better for patients by hiring and rebuilding the public health system. Otherwise, he can contribute to making the crisis even worse by helping to fund for-profit schemes that will poach staff from the public system.
We are not surprised the Conservative Party loves for-profit care. It will make billions for corporations and rich CEOs. This is right out of the Conservative playbook: starve a public service and use that as an excuse to hand it off to the private sector.
A condition of federal health care funding should be investing to fix public universal Canadian health care, not funnelling funds and staff into for-profit facilities. New Democrats want health care to move towards more public delivery, not farther away from it.
If new bilateral health agreements do not result in thousands of new health care workers in our public system, it will fail. Ottawa urgently needs to partner with the provinces and territories to help provinces train and hire more health care workers, respect current health care workers and pay them better, and recognize the international training of thousands of health care workers who are already in Canada and ready to work.
During the 2021 election, the former Conservative leader said that “he would support provinces in introducing privately led health care ‘innovations’”. At that time, our current Prime Minister told Canadians this was evidence that a Conservative government would threaten Canada's public health care system, saying that the Conservative leader “believes in a for-profit, private health care system and he will not tell people what exactly he wants to do with that.”
My, how things change once one is in office. The Prime Minister recently reversed his position by calling Ontario premier Doug Ford's private for-profit clinic scheme an example of “innovation”.
Let us just quickly review the privatization plans by Conservative premiers across the country. Doug Ford has said that he wants to divert funding from his province's hospitals towards for-profit surgical clinics.
His plan includes an expansion of private cataract surgeries, MRI and CT scans, minimally invasive gynecological surgeries, and knee and hip replacements. Ontario's plans to contract out to private for-profit clinics for cataract surgeries is expected to cost the government 25% more per surgery. Moving only hip and knee replacements to for-profit clinics will benefit owners, with an estimated windfall of half a billion dollars annually. The owners of Herzig Eye Institute, one of the top private surgery clinics that lobbied the Ford government to expand private cataract surgeries, have donated thousands of dollars to the Ontario Conservatives.
In a recent throne speech, Manitoba premier Heather Stefanson announced her government's intention to seek out private partnerships to deliver health care.
Saskatchewan is moving forward with plans to reduce its backlog of surgeries by privatizing certain procedures.
In January, Alberta announced that it is contracting Canadian Surgery Solutions to perform more than 3,000 orthopaedic surgeries covered by the provincial medicare plan.
Why are they doing this, and how are they getting away with it?
There are several loopholes here, but I want to itemize one of them. There is a serious loophole in the Canada Health Act. As we speak, private clinics across Canada are advertising to prospective patients that within weeks they can get surgeries that typically take six months or more under provincial health plans. All the patient has to do is pay them $20,000 to $30,000, depending on the clinic.
CIHI estimates that the average cost per joint replacement operation in public hospitals in Canada is $12,223, which means that the private clinics are charging patients roughly double what the surgery costs the provincial medicare system.
To those who claim that private surgery is cheaper, one can tell right away that when one adds profit and extra administrative costs, diverting money to the private system will cost our public system more.
Doug Ford says, “Oh, that is okay. We are still paying for it with public dollars”. Why would Canadians ever tolerate paying twice as much for surgery in a private system than they would in the public system?
The Canada Health Act prohibits extra billing. This means that doctors are banned from charging patients more than the medicare rate for an insured service. However, private clinics are getting around that by operating only on patients from other provinces.
Imagine the loophole in this country where, if one is in Manitoba, one can sell a private surgery to someone from Ontario but not somebody in Manitoba.
This violates the fundamental principle of the Canada Health Act. It is a gaping loophole in our system. We are calling on the government to close that loophole right now if it truly cares about public health care as it says.
It is not only those kinds of surgeries, though. Maple, a Loblaws-funded virtual care business based in Toronto, is charging patients $69 per doctor's visit or $30 per month for 30 visits per year if one wants to go bulk. In-person service would be covered by Ontario's public insurance plan.
Ontario has insured virtual visits under OHIP, but Maple has found a way around the province's rules by connecting patients with a nurse practitioner or physician outside of the province. This is another gaping loophole.
That is not to mention the odious practice that has been going on in this country for years, where people appear at private clinics only to be upsold. They come for cataract surgery but are told that if they want a better lens, they have to pay more. That kind of introduction of private pay and access to health care is a fundamental violation of the medicare system that Canadians hold so dear in this country.
Let us talk about the evidence against privatization. A recent study led by Dr. Shoo Lee, a professor emeritus at the University of Toronto and former pediatrician-in-chief at Mount Sinai Hospital, looked at international experiences to determine what impact private financing would have on Canada's health system. That study found that private financing, both private for-profit insurance and private out-of-pocket financing, negatively affects the universality, equity, accessibility and quality of care.
It is not just that study. A recent study of England's National Health Service found that as outsourcing to the private for-profit sector increased from 2013 to 2020, so did the rates of death from treatable conditions.
I look forward to hearing any questions. Let us stand up for public health care in this country and make sure that every dollar of public funding goes to public health care in Canada.