Ash Navabi: To end lockdown excuses, allow private hospitals

Ontario Premier Doug Ford has announced another round of measures in yet another attempt to control the spread of COVID.  

In his press conference to justify this new round of the same old measures that Ontarians have been put through two times before, Ford stressed the real reason behind them: “we must do everything in our power to protect our hospitals.” 

Protecting the health care sector was the impetus for every single previous round of lockdowns as well. In a province where the number of hospitals is fixed, this is a logical policy to follow. But after two years of the same excuse being trotted out to close businesses and tell people who they can and can’t invite into their own homes, it’s time to rethink the system of a government monopoly on hospitals. 

Breaking this circuit won’t be a quick and easy fix. But a good place to start would be permitting private hospitals. 

New private hospitals have been banned in Ontario since the early 1970s, with the Private Hospitals Act. Yet attempts to repeal this act would not be unprecedented. As recently as 2018, Kathleen Wynne’s Liberal government tabled an omnibus health bill, which included a schedule to overturn the ban immediately. Intense lobbying, including by public sector unions and their allies in government-run health care, ultimately erased that provision. As a result, the same problems of hospital overcrowding persisted, and are now being used to justify Ford’s fourth lockdown in less than two years. 

While initially promised as a kind of bionic panacea to providing medical care for all, over the decades the government-owned and operated hospital sector has developed to be more like a gangrenous limb in need of amputation. 

Immediately allowing a free market in hospital construction and operation would be just the hatchet to do the trick. 

Very little attention has been paid to the fact that Ontario’s health care system, especially in Toronto, has been overwhelmed for many years before the pandemic. In fact, one can find articles for nearly every year before 2020 talking about our hospitals being overwhelmed by the seasonal flu: 

• Hospitals overwhelmed by surge of flu cases, January 12, 2011
• Surge in flu cases has some overwhelmed Canadian ERs telling would-be patients to stay away – December 30, 2014
• Surge in patients forces Ontario hospitals to put beds in ‘unconventional spaces’ – April 16, 2017
• Surgeries postponed due to severe flu cases overwhelming Toronto ICU – February 13, 2018
• Bodies left in hallways at overcrowded Ontario morgues – December 17, 2019

When the government owns the means of production and systematically under-prices its services, shortages are bound to develop as services get overused. This is the case with “free” health care in Ontario. Government decisions are not made based on profit and loss of market prices. Rather, they are made based on political expediency. 

Hospital construction should be just as easy (if not easier) as building a mall, a condo, or a factory. We can’t afford the lives and livelihoods lost otherwise. Whether they run it for profit or not, or how close they are to other existing government hospitals, or even what kind of doctors they hire, should be entirely left up to the entrepreneur taking the risk of competing with the government. We’ve tried central planning these decisions for the past 50 years, and look where it’s gotten us. 

Ontario has only built one net new hospital (not counting replacement buildings etc.) for its population in 30 years, despite 5 million new residents. During the same period, government spending on hospitals has skyrocketed, from $6.6 billion in 1990 (about $12 billion in today’s dollars) to $22.4 billion in 2019. 

Compare these stats with developments in breast augmentation, laser eye surgery, and other cosmetic procedures fulfilled by the private sector. They have drastically fallen in price while becoming more available. Perhaps those responsible for health policy should take a closer look at the market for mammoplasty for inspiration. 

Repealing the Private Hospitals Act will invite many attacks by those vested in the current system. It will require political courage. That’s why the Liberals should be commended for even trying to overturn this disastrous policy. The first step Doug Ford will have to take is to be as courageous as Kathleen Wynne. 

Too sick; too frail. That’s the Ontario government-run health care system in a nutshell. The only prescription is a radical diet of free markets: private hospitals, private accreditation standards, and the end of lockdowns.