A part of the "Don't Swallow Everything You Hear About..." fact sheet series by the Canadian Women's Health Network.

Don't Swallow EVERYTHING You Hear About
Private Clinics and Wait Times

HERE'S WHAT WE NEED TO CONSIDER:

Private For-profit Clinics Actually Lengthen Wait Times

Parallel systems do not cut public waiting lists. Research evidence on for-profit health care from England and New Zealand shows that both countries in fact have larger waiting lists and longer waiting times in the public system than countries, like Canada, where most health care is provided through the public system with a single payer (the government). ¹

Why have their wait times increased? Among a number of reasons, private systems take younger, healthier patients who have conditions that are easier and cheaper to treat, leaving the expensive cases to the public system. In addition, if doctors work in both the public and private systems, but earn more in the private sector, they have a  “perverse incentive” to keep public waiting lists long to encourage patients to pay for private health care. ² However, the strongest argument against for-profit health care is the most obvious; a parallel private system simply takes badly needed doctors and nurses out of our public hospitals and clinics. As the Canadian Health Services Research Foundation says, “it's hard to see how removing them from the public system will help alleviate public waits.” ³

Private Health Care Costs More

For-profit care tends to be more expensive than non-profit care. In Sweden and Australia, for-profit care has reduced equity in access to care, lengthened public-sector wait times and has substantially increased administrative overhead and overall costs. ⁴ The evidence on direct patient care shows that when surgery is contracted out it tends to cost more. ⁵ Whereas for-profit facilities have to generate profits to satisfy shareholders, not-for-profit facilities can spend that money on patient care. ⁶

The cost of privatized health care is a particular issue for women because women on average earn less than men. Women are less likely to have supplementary health insurance that would cover the costs of privatized care. Also, because women have higher rates of chronic conditions and disability ⁷, they are less likely to qualify for private insurance.

Mounting Evidence Shows that Quality of Care is Better in the Non-profit System

For-profit centres need to make a profit to stay in business. One way to do that is to reduce quality. According to a review and analysis published in the Canadian Medical Association Journal ⁸, for-profit hospital care results in a higher risk of death for patients compared to public hospital care. Other studies show that contracting out health services leads to poorer quality. ⁹ For-profit facilities are also less likely than non-profit health services to provide continuing education and training programs to their staff. ¹⁰ The bottom line is that when quality is cut, women feel the impact more because we are the majority of health care receivers. ¹¹

Profits Matter, Not People

For-profit centres need to cut labour costs to increase profits. How do they do this? By paying their employees less, by hiring fewer people to do the work, and by lowering benefits and eliminating job security. ¹² When the focus is on cutting labour costs, women feel the impact first because 80% of paid health care workers are women, many with children. These work conditions can be unacceptably harsh, impacting women's workers' health, well-being and family life. ¹³

“We're not going to have a two-tier health-care system in this country. What we want to do is strengthen the public health-care system.”
-Former Prime Minister Paul Martin

Get the full story!

• Access to health care services in Canada, 2005
  Statistics Canada, 2006
  
  
• Getting to the heart of the private hospital debate
  Canadian Women's Health Network, 2000
  
  
• Health care privatization: women are paying the price
  Canadian Women's Health Network, 2002
  
  
• Myth: a parallel private system would reduce waiting times in the public system
  Canadian Health Services Research Foundation, 2005
  
  
• Myth: for-profit ownership of facilities would lead to a more efficient healthcare system
  Canadian Health Services Research Foundation, 2003
  
  
• October 2005: Supreme Court jeopardizes women's right to health
  Canadian Centre for Policy Alternatives, 2005
  
  
• The pains of privatization: how contracting out hurts health support workers, their families, and health care
  Canadian Centre for Policy Alternatives BC Office, 2005
  
  
• Private care is no cure
  National Union of Public and General Employees, 2006
  
  
• Private funding of medical and hospital services: opinion
  Conseil de la santé et du bien-être, 2003
  
  
• Public solutions to health care wait lists
  Canadian Centre for Policy Alternatives, 2005
  
  
• Taming the queue II: managing health care waiting lists
  Canadian Policy Research Networks, 2005
  
  
• Waiting in the wings: how for-profit health corporations are planning to cash-in on the privatization of Medicare in Canada
  Polaris Institute, 2002
  
  
• Without foundation: how Medicare is undermined by gaps and privatization in community and continuing care
  Canadian Centre for Policy Alternatives BC Office, 2000
  
  
• A woman's guide to health care debates
  Canadian Women's Health Network, 2002
  
  
• Women and health care reform
  National Coordinating Group on Health Care Reform and Women, 2002

NOTES

Written by:
Ghislaine Alleyne, Web Site Manager and Barbara Bourrier-LaCroix, Information Centre Coordinator
Copyright © 2006 The Canadian Women's Health Network
Posted: March 8, 2006