UBCM resolution seeks moratorium on new private health-care clinics

The cities of Victoria and New Westminster are calling on the provincial government to establish a moratorium on the further expansion of private, for-profit surgical and MRI/CT clinics.

Backed by the B.C. Health Coalition, the two cities have sponsored a resolution set to be considered at the Union of B.C. Municipalities’ annual convention this week.

“Health Minister [Kevin] Falcon must take a leadership role in protecting British Columbians from private investors and insurance companies who are charging illegal user fees and billing patients for health services already covered by Medicare,” BCHC cochair Rachel Tutte stated in a press release today (September 27).

BCHC coordinator Lew MacDonald told the Straight the UBCM ran out of time to deal with the issue last year, so it is posting the resolution as an addendum this time around.

BCHC tenets of universal access and affordability are reflected in the resolution, added MacDonald. The resolution claims the for-profit clinics are a “serious threat to British Columbians’ health and the financial stability of the health care system”.

Aside from a moratorium, the resolution also seeks “an end to public funding for for-profit clinics, including the contracting-out of day surgeries and the provision of health authority contracts to for-profit clinics”.

Also, according to the resolution, the health ministry should “require full accountability and transparency on the part of for-profit clinics by ensuring that they submit to all oversight and regulatory mechanisms currently applied to public facilities operating under the B.C. Hospitals Act”.

In its 31-page report, Eroding Public Medicare: Update on For-Profit Health Care in B.C., the BCHC referred to a national report released in October 2008 by the Ontario Health Coalition.

The Ontario coalition found 130 for-profit health-care clinics across Canada were selling surgeries, MRIs, and access to physician care.

The BCHC report, released this month, asserts that 33 for-profit clinics in B.C. may be charging for publicly insured services or for access to these services.

It states: “Research conducted over three months (June–August 2010) by BCHC staff has revealed that for-profit clinics across the province continue to openly charge patients additional fees to jump the queue for services that are publicly insured.”

BCHC attributed its findings to clinic websites and phone interviews with clinics.

The UBCM convention takes place in Whistler from today to Friday (September 27 to October 1).

The Straight left a message with Falcon’s staff, but the minister did not grant an interview today.



glen p robbins

Sep 27, 2010 at 7:24pm

Mixing tax payer dollars with 'free enterprise' dollars is fundamentally a recipe for disaster, particularly after the most recent bail out of big business and banks by tax payers.

Coach Dobbs

Sep 28, 2010 at 9:20am

Why do we need private health care clinics ? The government is already doing a stellar job looking after health care...why, we are already paying disgusting salaries to hospital management, covering up incompetance...heck, who can do better than that?

There's no logic behind this

Sep 28, 2010 at 1:16pm

Health care is a service industry just like car repair, dental work, or legal services. We would never use the government to decide on the distribution of car repair services, so why should we do it for health care? Similarly, our dental offices are largely privately run, and are extremely similar in training and services to basic health care provision. I don't see any impending collapse of dentistry as a result of it being privately funded (in fact, I see a LOT of dental offices around), so statements that for-profit clinics are a "serious threat to British Columbians’ health" need to be qualified with some facts before I would buy into them.

It's not like people paying for private services don't continue to pay the taxes that support the rest of the system (in fact, since they can afford the services out of pocket, they probably already pay a disproportionately large amount). So how does that undermine the public system?

The only people threatened by the provision of private services are union bosses, whose monopoly on our publicly-provided services (teachers, nurses, pharmacists, etc) are destroying them faster than even the most incompetent government ever could. Want proof? Look at the structure of the BCHC. It is guaranteed to be 50% union-controlled, and I promise you that its veneer of 'community involvement' is just to solicit money from outside union coffers for activities that are a 100% pro-union agenda.

When the baby-boomers hit the medical system full-on in the coming decade or three, Canadians are going to wake up and realize that a public monopoly on health care services is doomed to fail. It's going to be too big, and too expensive to be paid for once the previous generation is out of the work force. This idea that public health care is the only model that works HAS to die, or the younger generation is going to suffer.

Facts are Facts

Sep 28, 2010 at 2:28pm

Health care is not a service like any other. People are confused about the facts. Some people on this thread are distributing misinformation. Here are the facts:

There is no conclusive evidence whatsoever anywhere on the planet, that for profit health care brings in better health outcomes. The countries with the best health outcomes all have a public taxpayer funded health care system. Some of those countries have a mixed system, and we should always be open minded to new and better ways of getting better health outcomes but the fact remains, public health care is cheaper and more effective than private delivery of health care.

Our health care system is not run by the government. The Province works closely with health professionals who run the various health boards that decide the budgeting, services, etc. In a private health care system, the leaderships of scientists and doctors is subverted to financial managers and business experts, who may know how to make money but often do not have health outcomes of patients as their highest priority.

If you let the market decide, you will turn Doctors into drug dollars, as has been happening in places like California for quite some time.

Public health care works, and it's cheaper. None of the critics have facts to back up their claims that our healthcare system would be better if privately run. Actually the facts seem to indicate the contrary.

Look up the countries with the highest life expectancy, quality of life, with the least outbreak of disease, and the lowest mortality rates from these diseases. Go ahead, look them up. You will find that all the top ones have a public health care system. Countries with a private health care system are generally lower down on the list.

You can do the same thing with costs. As every reputable economist has pointed out, the high health care costs of America's private system puts their country at some huge disadvantages and is one of the major drivers of personal debt, financial deliquency and bankruptcy.

If we throw away our cherished health care system we will regret it. A lot of interest groups have been pouring money into campaigns to try and get Canadians to choose a private system. Don't go and make a decision without looking at the facts. The facts show very clearly that public health care systems and public drug plans, save money and deliver high quality care for a reasonable price. The health outcomes are high. So high that countries with public health care systems are the envy of the world.

Why would want to throw that away?

glen p robbins

Sep 28, 2010 at 4:23pm

Tnlbt - Comparing service on motor vehicle to health care is < silly imo.
Your dental care comparison is interesting. Dental care is private and only some government dollars are available to some kids who otherwise could not get dental care.

There are many adults out there who cannot afford dental care, and this leads to many other health care problems.

Because a person pays more taxes should never be the criteria for being first for health care. The high earner - wealthy person of today is seldom the old school came with an empty suitcase and earned the wealth. Many political appointments - or otherwise indirect subsidies to banks, and other businesses put them in that fortunate position.

You likely have a valid point with respect to some groups that are more covetous of access than other groups with respect to public health care and this is an unfair practice as well.

I agree we need solutions but don't agree that monies from public should be mixed with private - ever, and that is if you believe anything to do with the accounting practices in this province - and I don't.

There's no logic behind this

Sep 28, 2010 at 9:47pm

Facts are facts:

We both agree that a mixed system should be on the table. Let's start from there.

The American system is NOT(!!!!!1) a 'free market' system. There is a convoluted web of regulations and mandates in place that largely serve the third party insurance industry. I am certainly not arguing in favour of that, as I believe it destroys the proper function of the market and unnecessarily inflates costs. The largest strawman argument against opening up private medicine is that it has to look like the American system, and that's simply not true.

Of course countries with publicly available medicine have (historically) had better aggregate health than countries without. If there are people that cannot afford the service, they bring the statistics down, that's pretty obvious.

However, we are going to face an unprecedented expansion of health care costs when the baby boomers retire. I'll put this into simple terms: The size of the pie will shrink as the baby boomers leave the work force, and more people will have to eat from it as they become old and infirm. If we try to use government to socialize this burden, it is going to gobble up all of our public resources, and then some. I have never heard a good argument (and I do not consider "we must all suffer equally" to be a GOOD argument) against drawing more resources into the system by allowing private clinics in parallel of government ones.

Mark my words: if we don't start considering a mixed system now, discussing how to do it right, we will inevitably eff it up in 15 years when it becomes a necessity.

same argument over and over

Sep 29, 2010 at 1:49am

Turning the system into a mixed system won't necessarily address the waste that happens in health care.

1) The electronic medical record software system. Millions of dollars have been wasted in poorly implemented the system into Vancouver Coastal Health. Its been over two years and it still isnt been properly utilized.

2) Product waste. Everything is thrown away or burned.

3) Focus on treatment and cure rather than prevention.
Until this is changed are health care system is always going to be expensive. In a report by the canadian health coalition they found the number one driver of costs was the use of diagnostic/medical technology, prescription drugs and health interventions. They recommended that health consumers start mediating their own use of the health care system to drive down costs and start investing in health promotion tactics ie diet, exercise..

Read the fact sheet here and find other resources here: http://medicare.ca/main/the-facts/9-sustainability-of-health-care/langsw...

What you'll find there is the health care spending hasn't gone up in terms of GDP over the last 20 years. What has increased is the amount people are spending on items not covered by medicare: dental, pharmaceuticals and home care.

Facts are Facts

Sep 29, 2010 at 1:38pm

Only if private delivery is incentivized to produce better health outcomes can a private health care system begin to approach the quality of public health care.

That's the problem though. In a private system how do you create incentives for practicioners to improve health outcomes? There is little monetary incentive for a doctor to improve health outcomes holistically. Even if you could incentivize it through bonuses, we could see doctors drop patients in an effort to game the system. The only doctors who are practicing and have financial incentives to produce better health outcomes, work in public funded, government regulated health care systems such as Britain's NHS.

As for the demographic deficit argument, first of all, I haven't seen the debt and data projections but if it is true that our costs will outstrip our current revenues going in, I still don't see how that's any argument for privatization. If the US is a straw man example please educate me on others. Because the US is the private health care model I am familiar with. It is driven by the insurance industry and I have no reason to believe that privatisation in Canada would produce results differently than the United States. And health care in the US is very inefficient. They spend pointlessly high amounts of money on administration, even spending significant amounts of money trying to figure out who they can take off their health plans, or other ways to make money that have nothing to do with improving health of the individual. In fact, they still manage to make money even when they make people sicker. To me, that is a completely broken system.

As far as mixed plans go, I have an open mind. I've been to many countries, and among the best health care systems which are overwhelmingly public there are countries experimenting with private delivery innovations such as in France.

Whatever system you want, it doesn't change the fact that health care is a human right. The laws of the market do not extend to violating human rights. Even in the States, a hospital has to treat a life-threatening illness, whether the person has money or not. This ends up sometimes bankrupting the patient and the unpaid costs have to be covered by the state. That's a wasteful system that needlessly creates a disincentive for people without health care to not seek/receive treatments.

What should Canadians do to address the projected demographic deficit of babyboomers retiring? This is a very good question. I think we should look at who has benefitted most and who can afford to perhaps have their taxes increased. I know it's a dirty word, tax. But, the gap between rich and poor has widened greatly in this country and we have some of the lowest business taxes in the world. Maybe it's time to ask people who can afford to step up. It seems like privatization is likely to benefit the few who can afford better care and it puts everyone else at risk of getting passed over by other, sometimes transnational interests.

Also, often the drive to privatize is short-sighted. What is the true cost of bad health outcomes for a nation? When I think about the fact the majority of diseases affecting Canadians are primarily lifestyle diseases, I am even more skeptical that a health care industry that is privatized can produce better results. A lot of the reasons people are overweight and contracting diseases like diabetes has to do with a lifestyle promoting by private capital: car-ownership, high sugar additives in food, fast food, a sedentary lifestyle, inadequate access to affordable produce. The problems created by these market driven forces are not properly costed in.

We are right to be cautious about any changes to our public health system. If people want to introduce private delivery, let's see some evidence that it will produce desirable outcomes. Only then should it be considered.