Converting doctor's offices to premium clinics could spawn a new health-care crisis

News that a Calgary medical clinic has solicited "member" fees from its patients will no doubt shock many Albertans, regardless of their ability to pay for enhanced care.

But the believers in an equitable, fully public health care system should understand this challenging reality: some Alberta clinics have been charging patients thousands for premium services since well before Premier Danielle Smith's tenure.

The trend predates UCP predecessor Jason Kenney. And the NDP's Rachel Notley. In fact, you can go back five premiers into the Tory dynasty, to the latter days of Ralph Klein in 2006, to find a government and health ministry reckoning with a new private health clinic offering a boutique or "concierge" service for willing residents.

And similar clinics have existed in other provinces like Ontario, Quebec and British Columbia.

But there's something that seems to set the Marda Loop Clinic apart, that many Albertans will reasonably find unsettling.

What appears to be different or novel in this case is that Marda Loop is an existing clinic that's switching over to premium-pay service.

Dr. Sally Talbot-Jones' clinic in an inner-city southwest Calgary neighbourhood recently sent existing patients a letter about what it called a "transformative health care initiative." It offered reduced wait times, longer appointments and an array of other perks, through membership that costs up to $4,800 for families.

Clinic patients who opt not to become paid members could still receive care from their doctor, but only one day a week.

The long-controversial but long-sanctioned Copeman Healthcare Centre chain of private clinics set up as new operations seeking a new list of patients. For patients at Marda Loop, the doctor and clinic they'd relied on for years transformed beneath their feet.

The switch from a public doctor's clinic to a (mostly) private boutique seems like the health-care equivalent of a condominium conversion — in which a landlord evicts the apartment renters to renovate and sell the units as condos.

Shifting apartments to higher-cost condos pushes tenants out of their existing units and makes them seek units elsewhere. That's a big problem when vacancy rates are low and affordability is scarce.

Marda Loop Clinic's conversion comes during a similar scarcity crisis in health care.

It's gotten harder to find a family doctor. And that will do two things in this case: leave people who cannot afford membership fees either scrounging or unable to find a family doctor; and add pressure on existing patients to pay up, rather than lose access to their physician.

This development also stands to make countless other Albertans wonder: will my doctor's clinic do this, and will I be faced with the same choice Talbot-Jones imposed on her clinic's patients? Will I have to reckon with the consequences of either adding $400 to our monthly family budget, or losing the physicians and nurses who understand our medical histories?