Privatization can strengthen the universal healthcare mandate

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There are few words more cursed in the Canadian lexicon than “privatization,” especially when it comes to healthcare.

This is of course no surprise to the chief purveyors of the public-or-bust approach to healthcare, the NDP.  Ontario NDP leader Andrea Horwath played to Canadians’ ironclad grip on medicare last week in leaking a draft government bill that appears to open the door for further outsourcing of some healthcare services, among other changes.

Progressive Conservative Health Minister Christine Elliott says the document is actually from the non-partisan public service and that she hadn’t seen it before the leak.  Horwath maintains the bill has PC fingerprints all over it.  Either way, the bureaucrat responsible for sharing it with the NDP has been fired.

Despite the PCs’ insistence that this is a big nothingburger, which it may well be, Horwath played the politics well.  She riled up her base and more moderate Ontarians by playing to people’s worst fears about Premier Doug Ford and his government.  These fears are more rooted in public sector union spin than fact, but still, it was an effective political attack.

The instant and vicious reaction to even a whiff of privatization talk underscores why it’s long overdue to shift the discussion about healthcare in Ontario.  Not only is private-sector delivery of some health services a good idea, but it’s already being done in numerous areas.

From laboratory testing to some medical clinics, there are myriad examples in Ontario where private companies are tasked with giving care as part of — not outside of — the public system.  These services are still covered by the Ontario Health Insurance Plan, but are administered by private companies who frankly work more efficiently than government does.

Even most family health practices are privately-owned professional corporations, run with a business mindset but still contributing to Canada’s universal healthcare mandate.

Governments should always be looking for the most cost-effective way of delivering services, provided quality is not compromised.  It shouldn’t matter whether the Ministry of Health or Health Inc. is doing that.

But Medicare Fever, which has infected the NDP for years, is more rooted in ideology than facts.  Horwath and her colleagues have no interest in even entertaining a discussion about whether patient care would improve under a modified system.  Results and efficiency are less important to them than protecting what they still believe is a government monopoly on healthcare.

Nothing we’ve seen about Ford’s and Elliott’s plans involves disrupting the universality of healthcare.  Nor would they allow patients to pay out of pocket to jump any lines.

Healthcare is not a Canada-United States dichotomy.  It’s possible to tweak our system without adopting America’s.  Universal coverage can exist with greater efficiency and lower costs; there are several European countries who manage this much better than Canada does.

No one — not even Horwath and the NDP — argue that Canada’s healthcare system is adequately working.  The NDP and PC agree that hallway healthcare must end, and that the front lines of Ontario’s healthcare system are under-resourced.

It’s particularly fruitless to shame a government for trying to find solutions.  Had the NDP won the election, its approach would have been to pump more money we don’t have into the system that caused the problems in the first place.

Political parties would rather clutch their pearls and trumpet the success of public healthcare than confront the reality that our system is far from optimal.

The PCs were elected in no small part on their promise to do away with hallway healthcare.  It’s impossible to do this without at least looking at shaking up the fundamental DNA of how healthcare services are delivered.

This is a far cry from the Horwath’s dystopic view of wounded souls dragging their bloodied bodies through the streets only to be turned away at Sunnybrook because Joe Amex got there with his gold card first.

As for consolidating the Local Health Integration Networks into a super agency, it’s laughable the NDP finds this objectionable considering it was leading the charge against the LHINs during the Dalton McGuinty-Kathleen Wynne era, during which time these bloated and bureaucratic offices became money traps, preventing millions from getting to the patient level of the healthcare system.

I understand the NDP’s role, as official opposition, is to oppose.  But it would do well to be a part of the solution considering its caucus doesn’t disagree that there’s a problem.

Andrew Lawton is a fellow at the True North Initiative and a Loonie Politics columnist.

More from Andrew Lawton.     @andrewlawton

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