Do private, for-profit clinics save taxpayers money and reduce wait times? The data says no

There's a lot of talk these days about an increased role for private health-care clinics in Canada, sparked in part by Premier Doug Ford's plans to significantly increase the number of Ontario surgeries done in for-profit clinics.

Despite promises from Ford and others that it will streamline services and solve the issue of long wait times, health-care professionals that CBC News interviewed say there are nuances and that such happy outcomes are not borne out by the data.

In fact, data from B.C. and from other countries suggests private, for-profit surgery clinics will likely increase the true cost to taxpayers and could worsen wait times in Ontario hospitals.

To start, it's important to understand that every doctor is a private contractor. They bill for their services. And that figure — along with nursing staff, overhead and other costs — factors into the final bill.

"Privatization is such a broad term that it's basically useless," according to Dr. Melanie Bechard, a pediatrician at CHEO in Ottawa and president of Canadian Doctors for Medicare.

"I honestly wouldn't know how to address questions about privatization without first asking if you mean financing or delivery."

The distinction here is private, for-profit care, which means clinics that are often owned by companies who focus on bottom line earnings.

For example, data obtained from the Canadian Institute for Health Information (CIHI) shows that knee replacement surgery in a public hospital, paid by the province, costs about $10,000. The same surgery in a private clinic can reportedly cost patients up to $28,000.

When the province pays for the knee replacement surgery in a for-profit clinic, the amount is kept secret, due to confidentiality agreements. 

Andrew Longhust, a health policy researcher at Simon Fraser University in B.C., says the lack of transparency makes it challenging to understand the real costs.

"Governments are often reluctant or will actively fight the disclosure of that information and so will the clinics themselves," he said. Clinics, Longhurst added, often provide contracts with unspecific additional costs that are not easily visible or broken down, so the profit margin remains a mystery to patients and taxpayers.

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"I think what's important for people to understand is that the government is very fond of saying, 'Well, it's cheaper in for-profit facilities.' But a lot of it has not undergone any independent scrutiny."

That lack of transparency, Longhurst said, has led some health authorities to reverse course when the costs of doing some procedures in private clinics proved to be too high.