This week, private MRI (magnetic resonance imaging) services became available in Saskatchewan.
To hear proponents speak of it, you would think the Sask Party has come up with a panacea to solve all the problems of the health care system.
Detractors, of course, decry the slippery slope to complete erosion of the public system.
The truth likely lies somewhere in between and we are unlikely to know the true impact for several years to come. There are just too many ifs.
Let’s look at a few things it definitely is and definitely is not, however.
The right-wing Frasier Institute is praising the Sask Party saying this is a case of “putting patients before ideology.” That is laughable. Privatization is the Sask Party’s ideology. Liquor stores, new school builds, the Regina Bypass are all examples of ideologically-driven privatization of traditionally public sector activities that offer dubious benefit to the public.
The one thing the private MRI scheme definitely does do is help wealthy people improve their position of privilege in society. That is certainly contrary to the spirit of universal health care, which is care according to need not according to ability to pay. Tommy Douglas is likely turning over in his grave.
Some unions, for example the Canadian Union of Public Employees (CUPE), are taking aim at the legislation, even perhaps to the point of legal opposition. CUPE sought a legal opinion that states private MRIs are “unlawful under the Canada Health Act.”
Perhaps we can’t afford to be slavish to the traditional public model with health care costs eating upwards of 40 per cent of provincial budgets.
There is some pretty good evidence, however, that private MRIs is not going reduce wait times or help the government’s bottom line. The Saskatchewan Medical Association is against them saying it is “hasty policy.” Alberta, which has had private MRI clinics for several years, has wait times that far exceed Saskatchewan wait times and they have actually increased since that province started allowing the practice. In fact, several studies have shown wherever this has been tried, wait times increase, except for the people who can afford to pay.
Saskatchewan is not Alberta, but there is no guarantee our experience will be any different. Private clinics are for-profit businesses. For-profit businesses thrive by increasing demand for their product or services. Furthermore, a lot of wealthy people are already jumping the queue by going out-of-province or out-of-country. Now that these people can get it at home, won’t that increase demand?
Stephen Lewis, an expert in health policy, says the only way the province will benefit from this move “is if demand stays constant while you’re increasing capacity—and that never happens.”
The trend in public health care, on the other hand, is toward reducing demand. Healthy living and preventative medicine are the watchwords of the day.
There is also the danger that cash-strapped governments will further reduce public funding of services in the presence of private options.
There is one clever aspect to the Saskatchewan scheme. For every paying patient private providers take on, they must also accept a patient from the public queue. In essence, if you want to, and can afford to jump the queue, you have to take one of your less fortunate fellow citizens along with you.
And then there is public perception. Is the message here not that private is better than public? Does this not erode public confidence making it even easier to make the case for further privatization?
We need creative solutions to the health care crunch. Whether private MRIs is one of them is highly questionable.
