Who wins when provinces contract health care? | About That

There’s been a lot of discussion about private vs. public health care in Canada. How does private health care actually work? What’s being offered across the country? And is it shortening wait times? Andrew Chang speaks with CBC's Health and Science reporter Christine Birak to find out.
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[@davidh5403]

Andrew you are doing a very important job of addressing these issues!!

[@btfrost]

Maybe we should remove barriers to becoming healthcare professionals like irrelevant entry requirements to med school and make it less of a potential debt trap to get the required schooling… Why would anyone want to sacrifice a decade of their working life to come out with 400k in debt for a job they don’t know if they’ll find fulfilling in the long term?

[@tobyod]

I have yet to meet a poor doctor.

[@TipTWhip]

@@tobyod ...especially since "Covid." My cousin just bought a FOURTH house. As his father put it, "Sh____ is ROLLING in money since Covid."

[@cathymacdonald1469]

The province should not pay more for a private clinic to do this surgery than they pay a public hospital…

[@sg5720]

I don’t get how it is private when they still saying that OHIP will cover it. Maybe just have more clinics open.

[@deltaxsingh]

A private MRI clinic for example, charges upwards of $1000 per privately-funded scan. It takes about an hour. For the same scan, the government pays $300. It still takes about an hour. Guess who the clinic won't take because time = money

[@dblev2019]

Thomas Sowell has said, “there are no solutions, there are only trade offs”. That couldn’t be more true than when it comes to healthcare coverage. I would be interested to know how MAID comes into play and how it affects peoples healthcare decisions. Plus, how do the Provence’s rank when it comes to the use of MAID, and whether it’s being abused to help relieve wait times.

[@AnneBeamish]

What I like about these pieces is that you present the problem in a balanced way but also offer hope. Canada can and needs to do better.

[@BeastBishop]

The question no one seems to address is where the money comes from. If they can afford to pay private clinics almost three times the amount, why isn't our medical system better funded?

[@anelajadunandan4651]

Dont forget that in private clinics the money comes from the patient. If he/she wants faster access to a doctor/surgeon, then the patient pays from their own pocket. For example, $28,000.00 for knee replacement. What about heart surgery? The costs is astronomical as it is more complex! How many people has that kind of money sitting around? Does that answer your question?

[@susanb4816]

I am really worried for my kids under such inept government

[@daemenoth]

are you talking about the liberal federal government or the conservative provincial governments tanking healthcare in their provinces to try and drive privatization?

[@susanb4816]

@@daemenoth all of the above

[@anelajadunandan4651]

@@susanb4816 The Federal government did cut back on dollars given to provinces, but the bigger problem is when Ontario is bent on breaking the public system because Ford would like to gift his friends and CEOs with huge profits in the health care system, just like in the USA. Sad for Ontarions.

[@donnaallgaier-lamberti3933]

How embarrassing to hear this man says "When we will stop AMERICAN STYLE HEATLHCSARE from entering our country". As an American I am truly embarrassed.

[@seanmc9114]

I lived in South Korea, and I had a rhinitis surgery. It took ONLY 8 days to start surgery. And cost was 600 dollars and insurance cut half. So it was 300 around

[@angeline12345]

Nope 👎🏼. NO TO PRIVATE

[@paolotonolo1140]

Canada will never be the same again..Thanks Mr.Buck-a-Beer

[@mikev751]

How much does Social Security spend subsidizing people that have to stay home due to a waitlist. Factor that in. Add absentism from work due to illness and account for the economic impact for having that worker at home.

[@CayoFernandez-v8k]

You are doing an impressive work! The way you address each issue is perfectly on point! Very high quality journalism! Thanks!

[@TRexOne]

You don't know what the wait time would've been without outsourcing. Comparing BC to Ontario is meaningless without comparing many other factors.

[@sabrinariley848]

Don’t want to be an “Alarmist in any way” ….um no, please be an alarmist.

[@miwen9927]

Just wonder where are the private clinic doctors from? If doctors are allowed to practice both in hospitals and in private clinics, how the waiting list can be shortened? What is worse is if med graduates do their residencies in hospitals and then choose to make money in private clinics, the quality of health care will deteriorate.

[@Monkehrawrrr]

Private clinic doctors are from the public system, they are just paid more and lured out of the public hospitals leading to increased wait times.

[@suchawow]

if you watched the video it was explained that the reason why doctors dont do more surgeries isnt because they cant its because they arent given the money from the goverment to do it

[@natalievancouver8188]

All doctors especially surgeons have to train in public hospitals for many years before going private. No one is going to pay more for surgery from someone inexperienced but I do have experience.

[@ethimself5064]

Solution - Make the Private Providers get paid Healthcare Providers the same as regular Doctors of any kind. And how many thousands of qualified nurses and doctors from outside of Canada living here are not allowed to work at their trade? Rather shameful I believe

[@suryatkurma7466]

Wow About that provides very good information.

[@gregabbott8100]

We’ve been running this approach in BC for years and our wait times are actually longer than Ontario’s… It doesn’t work. The question is: Why is your government pushing to bring it in when it actually makes things worse? The number one challenge is lack of staff, the number two problem is provinces restricting surgeries per hospital, and the number three problem is not having a shared wait list (even within provinces) for surgeries… Fix all of that before you join BC in making things even worse and then be the example that hopefully the rest of us can follow!!!

[@daemenoth]

It's a BS approach for politicians and their friends to get rich off of healthcare money. in no universe would spending the money on public healthcare be less efficient than putting the money into a system where there are corporations/shareholders and ceo's needing to make their millions.

[@timneufeld2700]

Do you watch/ listen to the CBC exclusively. We need allot more questions answered than what is presented here. The fact that in one case we get a number from the public system and in another we don’t is so deceptive.

[@timneufeld2700]

What kind of policies does your government implement on its institutions? Find out before you trust what you are told.

[@gregabbott8100]

@@timneufeld2700 interesting comments… Anything behind them?

[@jacqueswang3722]

I love Andrew Chang

[@deltaxsingh]

This is the real bottleneck, the wait time for A DIAGNOSTIC SCAN is MUCH longer in Ontario. Without those scans, the doctor can't order a surgery. Thus when a doctor finally gets the results and orders a scan, that wait time is faster / comparable in Ontario compared to British Columbia FOR THE SURGERY. That's where this data falls short. BC has private diagnostic testing which shortens the OVERALL wait for the patient. Measuring "time to surgery" and is not the same as the entire chain "initial visit to surgery".

[@laylazer]

A centralized wait-list would be amazing. I've been waiting 1.5 years for a thyroidectomy.

[@zabd14]

@cbcnews All the provinces need to invest in significantly more residency training positions! The system of producing doctors in Canada has been rigid for way too long. It needs to be more fluid based on the current needs of the province and country. Invest in more residency training spots and allow a 5-7 year applicant graduation cut off for a couple of years and within two years you will have a huge influx of physicians, specifically family physicians which will address this issue. There is no immediate solution and this is something that will have to be addressed over the next couple of years. The backlog has been present for way too long.

[@danheuser5148]

This is another good example of where short term/quick fixes are terrible in the long term. The short term savings of not paying nurses more, not taking action on climate change, not replacing an old roof, etc will cost us dearly in the long run. Don’t vote for politicians who offer short term fixes.

[@adatabensky8381]

How do you go back once you bring this system in? Canada is making some really poor decisions lately, this is just one of them.

[@maiquanghiep9983]

No private…pls.

[@john_doe_not_found]

There are not enough nurses and doctors in the public healthcare system. Starting a parallel system that pays better wages means nurses and doctors in the public system will move to the private system. The public system will get worse. The government can stand up a private system, but that will not materialize 100,000 new doctors and nurses to staff that system. Start by encouraging family formation so Canadians have children. Then encourage those children to go to school to be doctors and nurses. In 20 years, those kids will be tax paying medical staff benefiting this country. Or bring in more immigrants with professional credentials and give them a quick path to having their credentials tested and recognized in Canada.

[@cherylsibson2529]

they are not over whelmed when a patients doctor physically faxes a requisition to the clinic for a scan and the nurses or receptionist cannot find the paperwork, so rather than email directly to the patient, when they in fact have a medical number based on the person, or to the clinic they booked the appointment to, they need a stream lined way to look after the paperwork, and reduce waiting times for the scans never mind surgery yet. In Delta hospital BC Canada. Why should I be held back due to your inadequate way of dealing with paperwork? That's apart of the muddle when dealing with two medical centers, for one appointment.

[@TRexOne]

Yes, you could have the whole wack of healthcare workers if you credentialize immigrants and support health sciences education.

[@markzhao8667]

Isn't there a contradiction in that the supply of people is the limiting factor, but also that the province can fund more surgeries to lessen the backlog? Why didn't they compare BC before and after the introduction to privatization to examine the impact, in an apples to apples comparison? What is limiting the rate of new graduates into healthcare?

[@alvesa3]

Speaking for Registered Nurses- lots of new grads . The problem is retention. They work one or two years in our terribly underfunded system and realize its not worth the pay. Families are unhappy with the quality of care (so are we RNs) and we get abused , yelled at, sued, etc. So they leave to work in other provinces / countries as contract RNs making double the salary. Why not work in Alberta or USA for double the salary when Ford is taking us to court over bill 124 after we risked everything through a pandemic? We have to provide for our own families first, then our patients. Also, we can keep our registration in Ontario while we work elsewhere so when Ford says we have x amount of new grads ready to work in Ontario, keep in mind many many many of them are actually working elsewhere

[@PGcrazy6]

ANDREW, THANK YOU, GREAT VIDEO. Perhaps private facilities for purpose of operations should be banned/outlawed and hosp surgery staff tripled all with 25% wage increase but those hospitals and the rooms must be doing surgeries 24/7 ? I STRONGLY believe that private facilities and care definitely many will eventually become corrupt like in the USA , bad surgeries by amateurs or rushing, $ prices be jacked up & then hospitals outrageously jacking up theirs because private care getting away with it, Also private care Drs needlessly writing pain prescriptions to keep patients coming back and nursing homes abusing/neglecting old people etc.

[@jptrainor]

They already exist. You'd be banning something that's already used to successfully deliver many simple surgical procedures.

[@PGcrazy6]

@@jptrainor Yes Jim, thx. I do know they already exist, but in Canada the Crooked outfits/Drs not nearly as plentiful as they are in the States. My thinking was that banning private surgeries would keep the Crooked & Greedy to a lesser degree than if we let this private stuff continue over 10-50 years, it be worse.

[@jptrainor]

@@PGcrazy6 I'm referring to private clinics that offer services that are paid for using public health insurance (i.e. OHIP in Ontario). They're not uncommon today.

[@cidaliaborges370]

NDP 190 PERCENT NO PRIVATE HEALTH CARE

[@SLEMPY273]

Come on jimmy, you set him up and kept him going. You are part of the problem.

[@post2019]

very informative.. thank you CBC for spreading awareness

[@ZaheerAbbasloveforall]

Very informative program am worried about Canada and Canadian

[@franklarin8100]

excellent show.

[@j.barren3738]

We all lose with digital mandatory digital i.d's.

[@TheTeganOsmondChannel]

Thanks for sharing this

[@ryan_m_k]

As always, super informative and engaging video. Thank you!

[@teamallyracing1780]

Very insightfull

[@samgabriel2360]

How is it theat the doctors will not be available in government hospitals but will be available for same procedure in a private hospital, isnt it going to worsen the timeline of docs available in government hospitals ? Instead of alleviating the wait times wouldn't it worsen it, cos docs will focus on yheir private services more?

[@darrellginsberg1325]

Doctors don’t make more to work in privately owned clinics. In fact they make less than they make in hospital. For example at endoscopy clinics they make 30-50% less for the same work. The issue is the hospital restricts use of the procedure rooms.

[@Stella1112]

The basic idea is shorten the waiting time? I am afraid this might be a step towards private hc

[@jptrainor]

Private clinics to deliver minor surgical procedures are already common. The horse is out of the stable. The discussion now is simply about expanding the range of procedures offered by such clinics.

[@angeline12345]

I have to kinda agree with concern over that egzactly that happening. It is wrong !!

[@andreadawngilpin3054]

We are not cars that anyone can just work on! A centralized waitlist for surgery? I don't think that will work for most people.

[@moomagpie4265]

Canada has Not tried to train Canadians. They bring in health professionals, and save all that 'schooling' money. During the pandemic Ottawa could see we were sadly short on medical staff however did nothing to educate our own young people.

[@bobmorane4926]

It seems like the private healthcare was a sneaky way to retain Canadian specialists in Canada with US like salaries. Those clinics were not meant to shorten the long list burden but to pay the doctors more so that they stay in Canada instead of heading South.

[@CK-fh8ny]

From my understanding, surgeon's that want to do surgery can have trouble getting enough operating time. We just dont have the staff and adequate space to be able to do more surgeries.

[@aleksandrekaterinanfilov8983]

You should have discussed how healthcare system works in Germany and in Netherlands.

[@TheOneAndOnlyTeknocat]

When it comes to the people problem, if you actually pay them well and treat them like they are valued, then they won’t bugger off to the private clinics. Even now there are plenty of nurses that cross the border to work in the US because they not only get better pay, but more importantly they are treated like they are highly valued. That means they are not over worked and forced to do more than they can handle just to keep things going. If the public healthcare system in Canada was more compelling to work for then more people would be interested in working for them. More people might become qualified health professionals if that was the case, thus increasing the pool.

[@MarianoCiancone]

End rotating shifts for public medicine Most clinics are open during day only Easy for nurse and doctor to go home to family and have life

[@shawneevee7490]

Yet our government allowed tens of thousand of business majors into the country to work at Tim Horton’s rather than recognizing foreign credentials within the healthcare profession and incentivizing new students in high demand fields. Canada is its own worst enemy. We have such an amazing country and the potential to create an awesome life for all but our policy makers are internally incompetent.

[@Zilong09]

Private healthcare becomes a nightmare in areas you dont want them to be. They always use areas like "I need this one surgery...or scan.. have to wait hakf a year. I paid for it, got it in 6 weeks" But what about the situations where your elderly parent needs ICU, or your loved one ends up in a fatal accident? And for both cases you have to let those people go and palliate them? Their care dueing those moments would still cost something and the bill ends up on families' lap. Yes its a broken system and I work on jt. We gotta fix what we got. Because it is in fact rhere for us when we need it the most. You may argue "but i needed it now not 6 months from now", again somethjng we need to work on and also realize its very hard to get to everybody. You arent the only one waiting 6 months, we all are. I have lots of examples of people ridiculously complaining in the ER because the ER team is busy with a cardiopulmonary resuscitation.

[@flailmail7069]

Not Alberta?

[@timneufeld2700]

Leave it to CBC to cook the numbers and muddy the water.

[@johncasey5594]

I am not knocking on immigration, we have an aging population and we need immigration, there is no denying that. In the same breath, we have to acknowledge the issues with immigration that are not being addressed. For starters, Trudeau wants to bring in 1.4 million immigrants in 3 years I believe was his quote. Fine, assuming average 3 people per immigrant family, that means we will need over 450 thousand new housing units in 3 years. Failure to accomplish that leads to the housing/rental price increases we are experiencing. Furthermore most immigrants choose to come to Vancouver, Toronto and Montreal, so each of these cities will need average 150 thousand new living units each to cover the influx and I don't think that is happening or is doable. Same goes for healthcare. Immigrants get free healthcare basically from day one. Canadians have paid into OHIP for their entire working life. Many immigrants have poor health and require services from day 1. This is what is leading to the healthcare system failing. Poorer people may not like a public/private option, but Canada may have no choice or risk the system falling apart all together.

[@markzhao8667]

"Many immigrants have poor health and require services from day 1." Got a source on that? Immigrants skew younger and healthier than the general population. They also pay taxes on day 1. Everything else you said was spot on though. Massive immigration is a scheme to enrich property and capital owners at the expense of everyone else.

[@traceymagee976]

Where this money is being spent seems to be an issue as well. My father in law died during covid but before he died he was given an experimental drug that they told my mother in law had a cost of 1 million dollars and were foing to give him a second dose which she asked whether this will give him more time which they said no, so she refused, meanwhile I know people being told they need to pay to have a simple lump removed or my little granddaughter broke her wrist which was set incorrectly and there was an issue with giving her an anesthetic so they broke that child's arm without it. Her mom cried and couldn't believe they did that as did I when she yold me. I can't even believe this is canada anymore.

[@fredrickolsen838]

My father had a workplace related injury. The provincial NDP government at the time sent him to a private clinic for his surgery and recovery because the public system had a wait list of more than 4 months. He had a beautiful room with excellent care, clean, edible food, helpful nurses and doctors, etc. It was more expensive than a public hospital, but the money saved on Workers Compensation costs meant that we as taxpayers saved much more in return because he got back to work sooner. That was 30 years ago. Anyone who thinks private health clinics are a new thing has been living with there head in the sand. And I certainly think these CBC commenters have absolutely no clue how the real world works.

[@TheOneAndOnlyTeknocat]

People just have to look at how pretty much EVERY OTHER COUNTRY with universal healthcare makes it work successfully. The UK is not a great example. Their NHS has a lot of issues. Why not take a look at some other European countries that have made it work really well and find out how and why it works there?

[@JenniferJane78]

Both public and private care for elderly has higher mortality rates than in pediatric care due to neglect. While pastors were thrown in jail during the pandemic the deadliest spreaders got bonuses from their employers. Cannot compare private hospital to private long term care and assisted living as it is socially acceptable to neglect the active employed person in central care.

[@maksymkovalchuk7468]

Let's face it: the solution is pretty apparent but it might be a bit uncomfortable for a group of people. The main problem is the stuff. But instead of simplifying the path for International Medical Graduates, Ontario just invent another smoke and mirrors solution. They could fulfill nursing jobs or assistant positions. Look at the statistics: 2740 internal applicants were matched for a residency last year which is 87% of all Canadian applicants. At the same time, 437 IMG matched (27% of international applicants). There is no shortage of doctors in Canada, there is a shortage of licensed ones. No wonder they say: “The best spot to have a heart attack is the Uber, with a high degree of probability the person who drives is a cardiovascular surgeon from overseas”. No one gives a damn that the average waiting time in ED in Ontario is more than 8 hours. But at the same time, the fewer doctors working- the lesser money spent by the government and the bigger waiting list have working doctors which grants them further work for years.

[@jp4431]

DoFo and friends win, obviously

[@raylenemacdonald2417]

I am 3/4 of the way through this report and I see holes in this reporting. While having more OR time would help, you alos have to have the hospital beds to put the patient in if they need it, even in the case where they might need it. I was prepped for surgery one day from 7:00 am and waited until 1:30 to be told my surgery was cancelled because the previous case went longer than necessary (an argument for longer days in the OR). When the surgery was rebooked I almost got cancelled again because of lack of a bed. They put me on a maternity floor after thyroid surgery and I was glad to get the surgery over with. Lack of beds is an issue owing to underfunding. Also I object to having a single waitlist for surgery. I have had 2 orthooedic surgeries and will need another in future. I certainly want to go back to the same surgeon as it gives me trmendous peace of mind. Do you want to take that away as well? Is the patient not entitled to some choice? This is not Jiffy Lube where you get the next available technician. There is trust and care involved.

[@jptrainor]

I got to 5:54 and saw what looks like a major hole. Huge error, actually. See my top level comment.

[@codelessunlimited7701]

Private healthcare do a better job in a sound system, while government run healthcare is nothing about healthcare it's about taking care of that emotional damage.

[@nibblesd.biscuits4270]

How about private health care for non elective surgeries only. And doctors can only work 20% of their time in private clinics. Also 20% or more of all private clinic profits flow into funding public health care. Finally make dental and eye care free for all Canadians born in the country.

[@cullin4waystarceo203]

Hospitals should pay nurses more. Benefits are better at hospitals. Pay isn’t better. Cost of living is more. What do u expect.

[@nasseq]

nope

[@XYZ-nz5gm]

Are there really private clinic in canada

[@ethimself5064]

Also sounds like mass confusion at Provincial levers - WTF next??

[@jptrainor]

5:54 misleading. It excludes the substantial annual operating budget of a public hospital. A large hospital in a mid size city in Canada has an annual budget of well over $1 billion. That budget amount is amortized over all services provided by the hospital. In addition to that there are per procedure fees, including the doctors' fees. This example only appears to present the hospital's per procedure fee. The private clinic fee would incorporate all expenses.

[@carlyar5281]

It is not entirely misleading. There are many situations where the provincial government did not pay for procedure, and the hospital charges either the patient directly, or a third-party (for example the Canadian Armed Forces). The hospitals absolutely do include overhead charges with the fees. It would be better for CBC to check what is charged for an out of province or uninsured patient (For example, it’s easy to check what hospitals are charging the Canadian Armed Forces/DND because CAF members are not covered by provincial health insurance).

[@jptrainor]

​​@@carlyar5281She used the term "the province pays the hospital for that knee surgery". I viewed that as the procedure fee paid for a public health insured patient, exclusive of the separate annual budget amount since she says nothing about that. But I'll accept that it's not clearly presented, and the hospital fee paid by an uninsured patient would presumably roll in overhead too. The example also excludes the cost of capital to build the hospital to begin with, which will also be present in a fully private fee. Overall, I give CBC a C for this reporting. The comparison is a good idea, but it's too poorly executed to provide a meaningful result.

[@oldmanlearningguitar446]

Hospital administration costs 12.9% of Canadian healthcare spending. So unless private clinics are paid just 12.9% more to adjust for that separate funding in hospitals then private will cost more.

[@jptrainor]

​@@oldmanlearningguitar446What does administration cover? The annual budget of a hospital covers alot more than the admin expenses. It includes the staff nurses salaries, the cleaners, the kitchen staff, etc, etc.

[@jimc9516]

so private healthcare is bad, great, how do i get my knee surgery in Ontario in less than 8 months??

[@MisconceivedPancit]

Simple answer....look at what the surgeon drives....and consider what a politician drives, then think about the car repairs a taxpayer can't always afford. As well, consider the mistakes in surgery that all that money pays for.... through OHIP. 🤔

[@TS-00]

Confucius Says: War no determine WHO Right, War determine WHO Left

[@timneufeld2700]

Get a representative from a private clinic in the room and ask them how it works. I just will not take anything our government agencies say on this as an absolute given.

[@williaml3300]

They also could hire all the doctors and nurses back that were fired because they wouldn't take the clot shot.

[@analogieswithg7398]

DING DING DING we have a winner.

[@Stella1112]

❤the hospitals are not overwhelmed they are sort of stuff! Maybe they should be looking to hire more doctors and nurses!

[@justinventela]

We can't just think of Canada as a closed system. Doctors aren't just leaving for higher pay in private clinics in Canada they're leaving around the world for higher pay, and it would just be more that did so if they didn't have a private option in Canada. Same with International students, we train them to be doctors only to lose them once their degrees are done. If doctors choose private clinics in Canada to work at its still better that losing them to the to another country.

[@angeline12345]

It will it does take away from average joe. He now ☝️😡has to wait longer because most doctors go private see we than wait for ever until we have an available doctor under ohip. Wth. Makes no. No sense

[@shauncameron8390]

Makes perfect sense. Just about anything government-run is inefficient and costly.

[@sg5720]

Canada needs to provide both. Keep it simple. One schedule for those who want to pay private and one schedule for those who go public. Eg, private Care is available Tues and Thurs and sundays - something like that. Each clinic and hospital can set their hours and days. I think Canada can definitely provide both, cause in some ways we do anyways. 🤷🏽‍♀️

[@jjintheflesh]

I know someone in health care getting charged $80 day for care- can't leave, needs to stay, and pay-terriable! Even though other's pay nothing..there's already private costs to services..so bring on private. Then people who can pay will pay and taxpayers don't need to pay for them! Because you pay anyway.

[@JJUnohu]

Privatize everything....name one thing the government does well...

[@SmilingBakedBaguette]

You're living in the wrong country my dear

[@thesweetone]

Ford will win

[@kerrybarratt6298]

Greed again

[@bobbieforseth7027]

she's wrong about being able to go to another province for the surgery, Dr's won't accept an out of province health care number I'm from AB and when visiting BC had to go to emergency they wouldn't accept me because I was out of province !!!!!!!!!!!

[@oldmanlearningguitar446]

Private clinics in other provinces…

[@gregwilson8503]

FJS