Wait time reduction "guarantee" guarantees more privatization

Canadian Health Coalition

No strategy to reduce wait times and improve access in Canada's health care system will succeed without a plan to stop privatization of delivery. Government "guarantees" to cut wait times will only guarantee more private health care.

Provinces like Alberta, British Columbia, and Qu�bec, which are already expanding private for-profit delivery, will very likely use the scheme to further contract-out to for-profit providers instead of investing in the public system.

The services that are most likely to be contracted-out are joint replacement and cataract surgeries and diagnostic imaging.

The inevitable result will not be reduced wait times, but a flourishing parallel for-profit system of providers dependent on government contracts. Profit-seeking and self-interested, they will have no desire to reduce wait lists or wait times. Similarly, since doctors earn more in the private sector, they will also have what economists call a "perverse incentive" to keep public waiting lists long. Their incomes will be dependent upon the wait list and wait times "crises" (real or manufactured).

Since health care practitioners can't be in more than one place at the same time, creating a parallel private, for-profit system will simply take much-needed doctors, nurses and radiologists out of our public hospitals. Given that we already have a shortage of doctors, nurses and radiologists, it's hard to see how transferring more of them into the private system will help alleviate wait times in the public system.

A parallel for-profit system can provide faster care-but only to those who can afford to pay. The way to reduce wait lists and wait times is through better management and coordination of the wait lists, and investment in health human resources and capital infrastructure. These approaches require long-term funding and planning.

The contracting-out approach that is the basis of the so-called "guarantee" is guaranteed to increase, rather than reduce, problems in Canada's health care system.