As Ontario pumps millions into private health care, public health will continue to suffer

Toronto Star

a day ago

Patient: 'How long is the wait?'
Family doctor: 'We'll have to see.'
The truth? Typical wait times for MRI scans and hip replacements jumped by 30 per cent in Ontario over the decade leading up to 2023.
Bad as these trends are, waits are about to get worse. But rather than focus limited resources on the public system, Ontario plans to more than double the funding for private surgical and diagnostic facilities.
The new budget will add another $280 million over the next two years to the $275 million already spent on investor-owned facilities. The grand total amounts to well over half-a-billion taxpayer dollars paid into the pockets of private facilities over five years for cataract surgeries, joint replacements, and CT and MRI scans.
That leaves half a billion dollars less to make sure that every Ontarian has access to a family doctor. Where does that leave the 1-in-4 Ontarians expected to lose access to primary care by 2026? Yet the funding slated to connect 300,000 people to primary care health teams this year is a relatively paltry $235 million. It's a sum that barely scratches the surface, given that 4.4 million Ontarians won't have a family doctor by next year.
The pool of qualified health professionals is limited. A worker hired by a private facility leaves one less available to work in the public system. Consider Alberta — as funding increased for surgeries performed in private facilities, the workforce shifted to for-profit facilities.
The Alberta Surgical Initiative was started in 2018-19 and shifted funding toward private, for-profit surgical facilities. As public dollars were pumped into investor-owned facilities, the number of surgeries performed in public hospitals declined and wait times for everyone increased.
It also proved far more expensive: The average cost of outsourced procedures rose by 79 per cent since they began contracting private surgical services in 2019, far outstripping inflation. As Alberta's costs swelled, so did public wait times for most priority procedures, including knee replacements and cancer surgeries. The Alberta Surgical Initiative also failed to improve total surgical capacity.
Their experience isn't unique. Ontario paid one privately owned facility (Clearpoint Health Network), 2.5 times more than its public hospitals to perform cataract surgeries and 3.1 times more to perform knee arthroscopies.
It's impossible for Ontarians to gauge if they're getting value for the money because of Bill 60. Since its passage in May 2023, agreements made between the Ministry of Health and private providers are not disclosed to the public. Bill 60 blindfolds Ontarians from seeing which private facilities provide what services, how many, and at what cost.
ARTICLE CONTINUES BELOW
ARTICLE CONTINUES BELOW
Governments get ensnared into a vicious cycle of their own making: The longer waits grow, the more pressure builds for them to deliver services. Private facilities seem like a quick fix, but it leaves the public system with fewer health-care workers, which only further exacerbates public wait times. It's a domino effect that's difficult to stop.
But stop it must. Longer-term strategies are needed. Ontario's decision to fund primary care teams is a major step in the right direction, but simultaneously funding private facilities will only further erode access to public ones. It's a downward spiral that Ontario continues to actively fund.
It's time for Ontario to phase out for-profit staffing agencies altogether and replace them with a publicly funded alternative that ensures the availability of temporary staff when required. This would prevent ER closures and surgical cancellations. Funding public facilities must be prioritized.
Half a billion dollars spent on private health facilities leaves half a billion dollars less to pay for public ones. The result? Ontarians wait longer for essential health services — or worse — are denied access to them altogether.