Some Surgeries Moving to For-profit Clinics. Is Ontario Headed Toward Two-tiered Healthcare?

Earlier this winter, Doug Ford’s PC government announced it is expanding the private delivery of healthcare. This will move some procedures out of hospitals and into for-profit clinics

The changes are slated to start with expanding the number of cataract surgeries in clinics this year, then diagnostic procedures like MRIs and colonoscopies, then in 2024, hip and knee replacements. Hospitals will continue to offer these surgeries as well.

Ford maintains that the surgeries at clinics will be covered under OHIP, so people won’t be paying out of pocket. But many health care experts along with the sector’s unions have a long list of concerns.

Clinics would be allowed to upsell patients, encouraging them to pay out of pocket for services not covered by OHIP.

Some for-profit cataract surgeries clinic already operate in Ontario, and are known to upsell patients so they are paying out of pocket. Those clinics also get paid a higher fee through OHIP per cataract surgery than hospitals receive.

For-profit clinics have the incentive to provide the easiest, least costly surgeries, leaving the more complicated surgeries to burden the public system.

The expansion of privatized health care delivery can pull workers out of public hospitals. This is the Ontario Hospital Association’s primary concern.

Ford’s government has been underfunding public health care, including not spending money the federal government gave. Ontario also capped health care workers wages so they aren’t keeping up with inflation. Nurses and others have been quitting, burned out and frustrated.

Health professionals point out that limited staffing is the main reason behind wait times, and the expansion of for-profit clinics won’t reduce those waits overall.

The College of Physicians and Surgeons of Ontario (CPSO) also opposes elements of the plan, saying “hip and knee joint replacement surgeries should remain connected to the hospital system to ensure continuity of care and patient safety.”

A number of private health care companies as well as the Ontario Chamber of Commerce, one of the province’s most powerful business lobby groups, support the privatization moves.

In the month following the government’s announcement, there were relatively few protests in opposition.

This article appears in the February - March 2023 Issue.