MYTH: Privatization will fix long wait times
FACT: Privatization makes waits worse for everyone except the healthiest and wealthiest
Privatization proponents often claim that opening a private queue parallel to the public one means opening up spots in the public system. But in reality, this does nothing to add to the number of operating rooms, equipment, or skilled professionals — it just shifts who’s at the front of the line!
In actuality, for-profit operators divert funding resources and pull surgeons, anesthetists, nurses, and other essential workers from the public system, worsening wait times for everyone else. These facilities also ’cream skim’ for the highest margin, least complex cases, leaving the most complex (and most expensive) cases to the public system. And if there are any complications? Patients again jump the queue to have those resolved in a public facility.
There is a wealth of global evidence that privatization always fails to solve wait times, in spite of decades worth of unfulfilled promises of privatization proponents who claim just that. Even in the United States, which privatization proponents often (falsely) purport is free of long waits, it’s purely on technicality: does it matter that patients aren’t on waitlists if it’s because they’re busy fighting insurers for coverage, raising money to get care in the first place, or simply live in an area too “unprofitable” for hospitals and doctors to set up?
Here in Canada, during the landmark Cambie Case in which surgeon/CEO Dr. Brian Day claimed long wait times justified his clinic’s illegal extra-billing, the BC Supreme Court found no evidence that duplicative private health care would reduce wait times in the public system, and would instead make them worse!
We should know: Alberta already has significant experience with publicly funded, privately delivered diagnostics and surgeries. The government’s Alberta Surgical Initiative, launched in 2019, was modeled after the Saskatchewan Surgical Initiative — ignoring the fact that by then, Saskatchewan’s wait times for priority procedures were already worse than Alberta’s.
But though we’ve since seen a substantial increase in government spending on these for-profit procedures (and concerning allegations of government interference in these contracts) and convoluted voucher programs to drive their use, privatization of surgeries has yet to solve our wait time problem. Sure, wait times for orthopedic and other easily-privatizable procedures have shrunk slightly, but that comes at the expense of concerning wait times for life-saving procedures like cancer and heart surgeries, which have only gotten worse.
The government’s latest scheme permits Albertans to pay for diagnostic procedures without a doctor’s referral, meaning anyone with a spare $3000 laying around can access a full-body MRI, and jump the queue ahead of someone who may actually need it. Notably, this goes against medical advice of the Canadian Association of Radiologists, who raise concern that these tests lack clinical benefit, risk harm to patients, and strain capacity, resulting in worse health inequity and system unsustainability.
If privatization solved wait times, it would have worked already! Legislated queue-jumping, like is permitted under Bill 11 and Bill 29, will only make wait times worse, while undermining the important principles of equity and universality that underpin our public health care.
The real solution?
Proven initiatives like centralizing wait lists, investing in team-based primary and preventative care, and expanding use of our public operating rooms (of which nearly 30 per cent sat unused as of 2023)! Albertans deserve health policy that actually addresses actual patient needs, and puts our public health dollars where we need them most — not in private profits.