Private clinics could help Alberta reduce health-care wait times
Health-care reform is a topic of endless discussion by Canadian politicians. But action on health care is much rarer. The Kenney government recently introduced Bill-30, which contains a number of significant reforms including and perhaps most importantly reducing regulatory hurdles for private clinics, allowing them to be more fully used as partners in the delivery of publicly-funded health services.
The use of private clinics has already drawn criticism from defenders of the status quo, but there are several reasons why this type of collaboration benefits both patients and taxpayers.
First, Alberta’s current approach isn’t working, and hasn’t for years. The province already spends more on health care per person ($5,187) than any other province (except Newfoundland and Labrador). And yet, despite this high price tag, Albertans faced a median wait time of 28 weeks for treatment after a referral from a family doctor last year—significantly longer than the national average (20.9 weeks).
And remember, Canada has one of the most expensive universal health-care systems in the world yet reports fewer doctors and beds, and longer wait times than its international peers. Clearly, more spending on health care doesn’t necessarily produce more timely access.
Second, the use of private medical clinics to perform publicly-funded surgeries was a key component of a four-year initiative in Saskatchewan, which helped reduce surgical wait times from 26.5 weeks in 2010 to 14.2 weeks in 2014. Notably, contracted clinics delivered procedures at 26 per cent lower cost (on average) compared to their public counterparts.
Third, Alberta recently postponed thousands of elective surgeries while the province dealt with the COVID-19 outbreak. During this time, an estimated 22,000 cancelled elective surgeries were put on hold, adding to Alberta’s existing long wait list. By partnering with private clinics, Albertan has an opportunity to expand its system’s capacity to tackle this backlog. This strategy is also in line with provinces such as British Columbia, which recently announced limited partnerships with private clinics to help clear its own backlog.
Finally, a collaborative attitude towards the private sector better aligns Alberta’s approach to more successful universal health-care countries such as Australia, Germany, Switzerland and the Netherlands, which all spend similar amounts on health care (as a share of their economy) but generally have more doctors, beds and diagnostic imaging equipment (MRIs, CT scanners) on an age-adjusted basis.
Each of these countries embrace the private sector as a partner in the delivery of universal care. For example, governments in Australia routinely contract private hospitals to provide universally accessible services. In Germany, nearly one-third of the total number of hospital beds are in private for-profit hospitals but 99 per cent of all beds are accessible to individuals with public health insurance. Incidentally, while 18 per cent of Canadians reported waiting four months or more for elective surgery in 2016, only 8 per cent reported waiting as long in Australia. In Germany, that number was zero.
The Kenney government’s decision to streamline the approval of private clinics represents an important step in Alberta’s attempt to replicate the success of Saskatchewan’s experiment. It also follows in the steps of more successful universal health-care countries. But much more is needed for Albertans, and indeed Canadians more broadly, to receive the value-for-money in health care that people in other countries already enjoy. Alberta’s efforts to increasingly collaborate with private clinics to deliver publicly-funded care is a good first step.