defund & privatize just kinda going along at pace
Hospitals did nearly 139,000 joint replacements in 2019-2020, according to the Canadian Institute for Health Information (CIHI). Its research puts the average cost per operation at $12,223, which means the private clinics are charging patients roughly double what the surgery costs provincial medicare systems.
Perfectly normal, legitimate health services:
The Canada Health Act prohibits extra-billing. What that means is doctors are banned from charging patients more than the medicare rate for an "insured service" — any medically necessary procedure that is covered by provincial health plans.
A medically necessary non-emergency surgery such as a hip replacement is an insured service when you're in your home province. When you visit another province, non-emergency surgery is not insured.
"Unfortunately, due to government regulations, you are unable to have private surgery in your home province. You would need to travel to Calgary for the procedure," said the email, which also priced the surgery at $28,000.
The people perpetrating this are criminals who are literally going to kill I don't know how many patients by sabotaging our system and need to be dragged into the streets before they've done irrevocable damage.
The fastest, most total fix for the ongoing push toward privatisation:
Dismantle the infrastructure of privatisation.
Bearing in mind the fact that healthcare is constitutionally a provincial area and not a federal one, the feds should nonetheless buy out every private healthcare provider which is unwilling to commit to complying with the proper expense and billing rules, justifying it as a peace/order/good government use of their residual powers if required, and then use this as a channel through which to initiate the implementation of a new organisational structure. This should probably include:
- First of all, we need several times more doctors and nurses, which means expanding our med schools as far as possible, and paying people's tuition and living expenses throughout med school and the residency process.
- Every medical professional and other such worker should be a civil servant, employed by public bodies whose leadership is ultimately at least in part accountable to elected officials, but with an organisational structure that is resistant to interference via short-term efforts by parliaments or legislatures, and which, critically, is free of any levers for input or interference by shareholders or other investors.
- Insurance-based billing should be replaced with a system where there are no invoices, no bills, no payment processing — medical establishments should pay whatever is required to treat patients, not even have the infrastructure to engage in per-patient billing, and then bill the cumulative costs of patient care to the public body that they are owned and operated by.
- Optical, dental, and cosmetic services should be placed under such a model. No more luxury bones, no more "buying contacts", no more "having to pay for completely elective cosmetic procedures that aren't even gender-affirming". If it's important enough that people are willing to Do A Surgery to achieve it, it's important enough to make it universally available.
- "but what about medical tourism" That's an edge case that can be resolved and responded to as needed.
Would this be a mess, jurisdictionally? Probably. There's a good chance it'd be spicy to actually get it implemented in a manner that manages to stick and would survive constitutional challenges, but it's not as if it'd be impossible.
Do we need to do this? Basically, more or less. The best way to prevent privatisation is getting rid of all the lines along which capital seeks to divide our public services.