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Open letter re: private care

January 27, 2023   ·   0 Comments

To Sylvia Jones, Doug Ford, Marit Styles, France Gelinas, John Fraser, Michael Schriener

Greetings,

Having done so little in terms of supporting Ontarians and their need for health care, leaving covid funds unspent, with a surplus in the bank (despite attempts to hide that fact), the solution you’re proposing is to continue down exactly the wrong road:  Health Care Privatisation which means transferring public dollars into private hands. Ontario spent less per capita on health care in 2022 than any other province or territory except New Brunswick. Privatisation is NOT the way.

Yes, the idea of creating Community Surgical Centres that specialise in a single or short-list of surgeries is not new and they are working well already in at least three cities in the province of Ontario. Kensington Eye Centre is a long-standing example—though not connected to a hospital, it is a non-profit operation reporting to a non-profit board ensuring high-quality oversight and regulation. 

Here are some reasons why your proposal is not in the best interest of Ontarians (excepting of course, the health care profiteers who have your ears, sort of like developers who will somehow help out in the area of affordable housing on the Greenbelt):

1. Private means private.  Every time some government P3 or similar initiative involves the private sector, we can’t see what it is costing us as citizens and taxpayers to provide their part of the project.  Privacy.
2. Community Surgical Centres work best when they are attached in terms of quality of care, governance, oversight and financing to a hospital.  The expertise is there already and it is transparent.  How will quality performance measures be applied and reviewed in for-profit facilities? 
3. There may be, as you said on CBC Tuesday morning, 900 IHFs (Independent Health Facilities) offering testing of all sorts, diagnostics, etc., but there are fewer than a dozen offering surgeries.  It is difficult to imagine how this expansion can happen by sometime between March of this year and 2024? Presumably through private equity money—which makes sense when what you are building is for-profit.
4. When the motive is profit, profits will be paid for by patients—through their taxes or out of their pockets.  Those with means will be glad to take advantage of the extras, won’t mind the upselling frills and upgrades.  Because hospitals are funded differently—with different ‘funding pathways’, as you put it—there is lots of room for CSCs’ ‘per-unit, per-surgery’ payment to exceed that of hospitals. No surprise—when the motive is profit.
5. Though there are likely enough surgeons around, surgeons are not stand-alone practitioners; they need to be supported by the all-important nursing staff.  Nurses have worked endless hours over the last three years, and the thanks they got was Bill 124—a judgement that was superlative in its excoriation of the Premier’s actions. (And, rubbing salt into wounds, your plan is to appeal! Sigh.)  Nurses are leaving in droves, worn-out, burned out, some seeking better pay and working conditions with temp agencies (which we also pay for at inflated rates when desperate hospitals are forced to hire), better pay and working conditions in—you guessed it! for-profit IHFs!  IENs (Internationally Educated Nurses) will barely begin to make up the deficit in nursing staff across the system.  New spaces in nursing classes will not add up to more hands on deck for years.  And why would anyone want to join a system that is so broken?  So unwelcoming, so ungrateful.  Your government has starved our publicly-funded health system of nurses thanks to constitutionally-illegal wage suppression and now a private health-care system will entice yet more nurses to leave the public system.

Your interview on CBC offered up another round of dubious language that appears to sound good but is one more bit of obfuscation.  My favourite:  When Ismaila Alfa asked about why you don’t expand hospital surgical capacity, you replied:  “We’ve already done that.  There is $300M on the table for hospitals to do just that.”  On the table.  Your insistence that there is no two-tier medicine in this province does not sit well next to publicly-available data:  the public share of health financing has fallen from 75% to 66%.  Hardly makes one proud.

One could go on and on.   I have just one request of you:  Please quit telling us that we will continue to pay for health care with our OHIP card.  That is kind of true—as long as you don’t go for the frills and upgrades—but it obscures the fact that one of the things we are paying for is the for-profit privateers’ PROFITS.  So while, in a hospital, we would be paying, say, $100 for something, in profit-motivated facilities, it might be $110 or $125 or $300. Who knows?  We can’t ask.  

Sincerely,

LeeAnn McKenna

Mono, Ont.

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