Privatizing health care isn't the taboo it once was. But would it help Quebec's ailing system?

It's nearly noon at the Tiny Tots pediatric clinic in Decarie Square in the Montreal suburb of Côte Saint-Luc, and there's a steady line of parents clutching little hands or pushing strollers as they check in for their child's appointment.

Tiny Tots is part of ELNA Medical's growing network of family medicine and specialty clinics, with some 96 clinics in Canada, including about 25 in Quebec alone.

Although many of the services are covered by public health insurance — in Quebec, through the Régie de l'assurance maladie du Québec (RAMQ) — the clinics are privately owned and run.

If patients need to see a specialist, they can be referred internally to someone working at one of ELNA's clinics. If tests or procedures are needed, a patient can have them done without charge at a public clinic, or have them done in-house at ELNA at an extra cost, which could be covered by private insurance.

"It's the same care, except in, shall we say, a better wrapper," said Dr. Benjamin Burko, a pediatrician and the Montreal-based company's chief innovation officer.

Support for such an approach appears to be growing.

A dearth of family doctors, long wait times for surgeries and overwhelmed emergency rooms have made the public thirsty for new ideas to improve Quebec's health-care system — and one of the main alternatives being proposed in this election campaign is opening the network up to further privatization.

Both the Coalition Avenir Québec (CAQ), which holds a commanding lead in the polls, and the Conservative Party of Quebec (PCQ), an upstart right-wing party, have laid out proposals to expand private care.

In an attempt to take pressure off nearby hospitals, the CAQ is proposing a pair of new private medical centres, in Montreal's east end and Quebec City. The privately run "mini hospitals" would be open seven days a week and include a family medicine clinic, a 24-hour emergency room for minor ailments and day surgeries. All this would be covered by public health insurance, according to the CAQ.

The PCQ wants to go farther, and party leader Éric Duhaime has said the "p-word" is no longer taboo when it comes to health care in Quebec.

Duhaime wants private companies to be allowed to operate some hospitals and believes doctors should be encouraged to practise in both the public and private health systems.

Proponents of more privatization argue it would take pressure off the public system and improve triage care, but many experts say doing so would siphon off resources from the public system, increasing inequity in the process.

"Having a private network that competes with the public system is not the solution for labour shortages in the public system," said Olivier Jacques, an assistant professor in the department of health management at Université de Montréal.

Jacques said private centres like the ones proposed by the CAQ could steal away doctors and nurses. It's unclear whether such a model would lead to a more effective use of taxpayer money, he said.