Rob Leone: The future of Canadian health care is private

Governments are simply not capable of doing the job as quickly or efficiently
NDP Leader Jagmeet Singh speaks during a rally to demand Canada's public health care system be protected and expanded, on Parliament Hill in Ottawa,Tuesday, Feb. 7, 2023. Spencer Colby/The Canadian Press.

When NDP Leader, Jagmeet Singh, says that he wants to take the profit out of health care, he’s not talking about your family doctor being a private actor in a single-payer health-care system. He’s talking about rich CEOs and corporate profits siphoning money that might otherwise go to the public system and into the pockets of shareholders.

It sounds good. I mean, by the very nature of having a profit going to a corporation, we can very cogently see that the money isn’t going to hire a nurse or more doctors.

Here’s the problem though: the government—by itself—is incapable of solving the world’s wicked problems. The government actually needs the private sector to help.

If we stop to think about how we got out of the pandemic, could we have done it without the private sector? Could vaccines have been as effective, and developed as quickly, if we left government scientists to do the work? Could we have done as many diagnostic tests for COVID-19 if we didn’t have private community laboratories running millions of COVID tests? Could we have built enough supply for PPE and hand sanitizer if the private sector didn’t adjust its production to focus on these items? 

Even where governments should have had a solid grasp on operations, say procuring vaccines or the logistics of getting vaccines in arms, they were woefully slow. One could legitimately argue that a patchwork network of for-profit pharmacists, armed with the online savvy Vaccine Hunters sourcing available vaccines, aided what otherwise was a catastrophically slow rollout of the vaccines. 

That was one case study of the past, but if we look to the future, we are confronted with major problems with our frail health-care system. Under the current and outdated thinking, we now have insufficient infrastructure (e.g. not enough ICU beds), a health human resource shortage exacerbated by funding caps in publicly assisted higher education, and a health-care system that is currently facing unreasonable wait times for most medical procedures. 

To illustrate the point, most readers would not believe that the only industry that is still primarily relying on the fax machine to function is the Canadian health-care system. The fax machine is used for referrals, booking appointments, and more. A medical office administration takes a form from a doctor, faxes that form to a specialist, and it will sit on that fax machine until another medical office administrator picks it up and sits next to a computer to figure out when the appointments will be made.  This causes unnecessary delay, and it is happening across Canada every minute of every day. Not only is there excess delay, but there are also excess costs associated with this waste.

It’s not that the technology does not exist to get rid of the mess. It does exist. It exists because there are enterprising companies that have figured out ways to make health care more efficient. You see, many for-profit companies are popping up to innovate and sell their innovation to make system improvements. These system improvements will solve the wicked problems of the future in health care and beyond.

We are at the precipice of understanding that the root cause of our health-care system crisis is founded on an antiquated system, built in the 1960s, reaffirmed in the 1980s, and is severely strained today. The old design has also led to antiquated thinking. When it came to building electronic medical records, for example, many provinces decided to build their own beast. Today, we’re faced with massive interoperability problems for no other reason than governments thought they were better at designing their electronic medical records than leaving them to private entities that could have provided off-the-shelf solutions cheaper and quicker.

What will happen over the next 10 years is entirely predictable if we take a few moments to think about it. All of these smaller for-profit entities will be consolidated into massive health conglomerates. As these conglomerates grow, they will become more skilled at defining health-care problems and developing health-care solutions than governments will. They will do so much quicker and of a higher quality than governments can ever imagine. Think of how Microsoft or Google have now become technology giants. In the same way, the future of Canadian health care, and health care around the world, frankly, will be about the private sector becoming super proficient at solving health-care problems. 

This is inevitable because governments are simply not capable of doing the job. Governments have long ceased to have the in-house technical skills to create these solutions to massive problems that are ailing the health-care system. And, if they did for some reason have the technical skills to do it, they are prone to taking historical, antiquated approaches to fixing future problems, as exemplified with eHealth across the country.   

The future of health care is private. Delaying the inevitable will only make our present system worse. Sorry, Jagmeet. 

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