People across the political spectrum agree that Ontario’s healthcare system is in crisis, but what are the causes and what are the solutions? For the Ford government the cause is public healthcare, and the solution is private healthcare. This is based on a series of old myths that predated the current crisis, and that continue to be reused every time governments want to push further privatization. Here are 7 myths used to justify healthcare privatization, and how to bust them.
Myth #1: public healthcare doesn’t work
As Ford said, “we just can’t as a province keep doing the same thing and expecting a different result.” This implies the public healthcare system is inherently in crisis because of its own failings and a dogmatic refusal to consider privatization. But the public healthcare system is not failing of its own accord, it has been bled dry. Through years of Liberal and Conservative government cuts, Ontario has the lowest public healthcare spending per capita of any province. Ford has continued to underfund public healthcare even through the pandemic, with plans to withhold billions more. It’s true we can’t continuing to do this and expect a different result, so the solutions is not to keep cutting and privatizing but to reinvest in public healthcare.
Myth #2: private clinics are needed to clear the backlog
“We’re taking action to reduce wait times for surgeries,” Ford said. The government claims private clinics are needed to clear the surgical backlog, which implies that publicly-funded surgeries are at full capacity. But while hospital bed capacity is overcrowded, operating rooms are below capacity – both because of underfunding. The Auditor General report found that more than a third of hospitals across the province were operating at less than 90% capacity. As Ontario Health Coalition executive director Natalie Mehra explained, “Instead of using their operating rooms, that we paid for, they want to rebuild them in private clinics. All over Ontario, there is all kinds of hospital capacity if we chose to open it.” There is also much more capacity in hospitals than in the smaller number of private clinics, so if the government really wanted to efficiently clear the backlog they could simply invest in public healthcare to maximize the capacity that already exists. Privatization can also increase wait times, by encouraging unnecessary imaging: when Saskatchewan expanded private MRI clinics, the wait list doubled.
Myth #3: private clinics complement public hospitals
The Conservative government also claims that procedures done in private clinics will complement public hospitals, explaining: “These procedures will be non-urgent, low-risk and minimally invasive and, in addition to shortening wait times, will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries.” But this illustrates exactly why private clinics are not helpful. Hospital wards are not overcrowded by patients waiting for non-urgent knee replacements or minimally invasive cataract repairs. Hospitals wards are filled with patients admitted with complex medical issues, including those who can’t be discharged because a lack of longterm or home care, resulting in emergency department overcrowding with admitted patients who can’t be transferred to the wards. Non-urgent and minimally invasive surgeries in private clinics will not free up hospitals to focus on complex issues, they will siphon away funds and staffing to focus on the simplest cases – leaving public hospitals with less resources for more complex cases.
Myth #4: private surgery clinics relieve the pressure on healthcare workers
A related myth is that private clinics will relieve the burden on healthcare workers, but this makes even less sense. There is only one pool of healthcare workers, so siphoning some away from public hospitals into private clinics will make the staffing crisis in public healthcare worse. As Dr. Nancy Whitmore, head of the College of Physicians and Surgeons of Ontario warned, “”We emphasized our ongoing concern about creating further strain on the present health care provider crisis particularly in skilled operating room nurses and anesthesiologists.” This also doesn’t address factors contributing to the staffing crisis, like Ford’s Bill 124 that freezes the wages of healthcare workers—which government documents admit have made the crisis worse.
Myth #5: privatization is good for patients
An embedded assumption in the privatization agenda is that for-profit healthcare is at least as good for patient health, if not better. But it’s worse. Death rates in Ontario long-term care homes were higher both before and during the pandemic. For-profit hospitals in the US also have higher death rates. To maximize profits, private clinics cut corners – like healthy wages and working conditions, paid sick days and infection control measures. So privatization costs lives as well as resources.
Myth #6: private clinics don’t cost more
Because of historic and ongoing opposition to private healthcare, Ford has even tried to avoid the word: “I don’t even like the word ‘private’ because it’s really not. No Ontarian will ever have to pay with a credit card. They will pay with their OHIP card.” But this illustrates how parasitic the privatization agenda is, funneling public healthcare funds to support private healthcare profits. For-profit clinics are by definition designed to make profits, which they accomplish in a variety of ways including upselling or double billing. Just because this can be paid for using the provincial health card doesn’t make this better, it just confirms that private clinics are leeching off the public system in order to drive up costs.
Myth #7: privatization enhances patient choice
Ontario health minister Sylvia Jones admitted that private clinics will be upselling patients, but is trying to sell this as giving patients options: “I wouldn’t call it upselling, I would call it patient options,” like for cataract repairs, “upgraded lens as an option that patients can choose, but are not obliged to.” This confirms that the government’s plan is to transform healthcare from a public right into a private commodity. This is the same attitude as underfunding education and saying that students have the “option” of paying for private school, or underfunding public transit and saying that people can “choose” to drive a Mercedes but are not obliged to. But wealthy patients have never had a lack of options, it is lower income and disproportionately racialized patients who lack options—and undocumented workers without an OHIP card don’t even have the option of accessing basic public healthcare. The solution is not further privatization, but public OHIP for all.
Fight for public healthcare
Ford claims that public healthcare is failing of its own accord and that privatization will clear the backlog, complement public healthcare, relieve the pressure on healthcare workers, and support patient health and choice at no cost. But these are all myths that will lead to the further erosion of public healthcare, costing resources and lives. Fortunately, workers fought for public healthcare in the first place, and can fight to defend it. A majority of people across Ontario blame Ford for the current crisis, and five major healthcare unions across Ontario have called on the Ford government to stop privatization. They are are taking on the privatization myths and calling for a public solution, as OPSEU president JP Hornick summarized:
“The claim that this move will relieve the burden from public hospitals is a blatant lie by Premier Ford and Minister Jones. To improve access to care, public hospitals require staff and funding; both of which will be even further depleted with increased reliance on private clinics. The claim that patients will never pay out of pocket for health care under this sell-off scheme is another lie. Whether they’re upselling or double-billing, private clinics put profits first – and this move will undoubtedly hurt patients and the public healthcare system we all depend on. In these difficult times, we should be taking care of one another, not corporations and their shareholders.”
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