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November 6, 2020

Privately funded health care: a wrong-headed approach - op-ed by Linda Silas


The following opinion editorial first appeared in the Edmonton Journal on November 2, 2020.

If Alberta’s United Conservative Party wants to improve the province’s health care, they couldn’t be taking a more wrong-headed approach.

Delegates at a recent UCP general meeting narrowly endorsed a controversial proposal to “support the option of a privately-funded and privately-managed healthcare system.” Of the 793 delegates who participated in the virtual vote, 52.71 percent were in favour of the resolution that would allow Albertans to choose between public and private health care services.

According to Premier Jason Kenney’s spokesperson, this resolution, along with others adopted at the meeting, will inform the development of the UCP’s 2023 electoral platform.

The policy resolution, introduced by the Calgary-Varsity constituency association, contends that a two-tier health care system would address soaring costs and wait times, as well as resolve the issues regarding physician salaries that have proven to be a thorn in the side of Kenney’s government. It further argues that privatizing health care will provide options for physicians and patients, cut public health costs and increase access.

The Canadian Federation of Nurses Unions and other health care advocates believe that achieving greater access to high-quality services, reducing wait times and providing appropriate compensation for health care workers are all critical objectives, but we categorically reject the idea that further privatization is the answer.

Indeed, there is significant international evidence that discredits the UCP’s approach. Wait times in the public system have not decreased in countries that permit the private payment of health care services, including the U.S., France, Australia and Ireland.

Here in Canada, we’ve seen increasing privatization result in tragedy in the long-term care sector, particularly in Quebec and Ontario. With 77 percent of COVID-19 deaths taking place in long-term care homes, governments should be rethinking the role of for-profit, private care for seniors in Canada.

If the UCP’s resolution were to eventually become law, it would result in greater choices for some physicians, along with those few Albertans who can afford to pay the high costs of private care. The vast majority of Albertans, however, would be left with limited choices, and a public health system with fewer resources and diminished capacity.

With a limited pool of health care professionals, patients who can’t afford or are ineligible for private insurance will likely wait longer for care and will be forced to compete with patients who can pay out of pocket.

Contrary to the UCP’s assertions that it would improve public health care, unfettered privatization would actually erode public health care by siphoning away much-needed doctors and resources – thereby leading to decreased access and longer wait times, and contributing to the very problem the resolution purports to address.

The UCP’s adoption of this proposal represents the culmination of several years of effort, and its timing is particularly interesting given the Supreme Court of British Columbia’s recent Cambie decision that upheld key provisions of B.C.’s Medicare Protection Act, safeguarding fair access to care for all patients in that province.

Though Premier Kenney has said that he supports public health care, his government’s recent announcement of its intention to eliminate and outsource up to 11,000 health care jobs indicates that Albertans can expect more deep cuts that will negatively affect their ability to access high-quality care. The move has been roundly condemned by labour unions, including United Nurses of Alberta.

After years of underinvestment, the Alberta government’s decision to further erode public health care capacity by eliminating thousands of jobs is not only ill-advised – in the midst of a global disease outbreak, it’s simply unconscionable. With over 1 million Canadians unemployed as a result of the COVID-19 pandemic and millions more still reeling from its enormous impact, now is not the time for austerity.

Access to quality care for everyone in Canada – not just those who can pay – will be achieved through greater investment and enhanced coordination of health care personnel and services, not through changes in how we pay for care.

Our best chance to fight off encroaching privatization is to provide stable, long-term funding for public health care and address long wait times head-on. We call on the Alberta government to act on these critical issues immediately.

Linda Silas is a registered nurse and has been president of the 200,000-strong Canadian Federation of Nurses Unions since 2003.