SUN NEWS COLUMN: MRI choice for patients has grown substantially

Should you be allowed to use your own money to try to improve your health?

A quarter century ago, it was a controversial decision for the Alberta government to say “yes” to that question when it came to allowing private MRI scans.

At the time, patients could either wait ages for the government to provide an MRI scan or leave the country and pay for a faster scan; private clinics were not allowed to sell scans to the public in Canada.

But all that changed when the Alberta government decided to allow a private MRI clinic to open in Calgary. Some critics, many of whom had a comfortable monopoly on health care, fearmongered about the policy change, arguing that giving patients choice would “undermine” the government’s health care system.

Well, that was 1993. SecondStreet.org decided to see where things are at today in Canada.

What we found was that a majority of provinces now allow patients the same choice Albertans have had for over a quarter of a century – wait for the government’s health care system to provide an MRI scan at no charge or pay out-of-pocket at a private clinic.

British Columbia, Saskatchewan, Quebec, Nova Scotia and New Brunswick now allow private clinics to sell MRI scans to the public. (Note: The current B.C. government is in court trying to clamp down on private health care options in the province.)

Ontario outright bans private MRI scans, while Manitoba, Prince Edward Island and Newfoundland do not yet have private clinics that sell scans to the public (proponents would need to apply for approval).

In the case of Ontario, restrictive health care policies are still pushing patients – as well as some doctors and capital investment – from Canada to outside the country.

For example, one Ontario resident, Jocelyn, described to SecondStreet.org how she has taken her son and a parent to Buffalo for MRI scans in the past. Why? Because the procedures are provided much more quickly.

According to the Ontario government’s own data on MRI scans, less than 40 percent of patients are scanned within the target time frame set by specialists and health care administrators.

Jocelyn is not alone when it comes to leaving the country for faster health care. Statistics Canada data obtained by SecondStreet.org shows that Canadian patients made over 217,000 trips outside the country in 2017 specifically for health care.

And each time a patient leaves the country for health care, their money helps create jobs and opportunities in other countries – not that you can blame a patient for trying to improve their health.

It should also be pointed out that each time a Canadian patient visits a private clinic for an MRI scan, they’re one less person waiting in line in the government’s system – shortening the waiting list for everyone else.

There are many countries with universal health care systems that perform better than Canada. For example, Australia, New Zealand and Norway all provide better results according to the progressive Commonwealth Fund’s 2017 study on health care systems. What do those countries have in common? They operate public health care systems alongside private health care clinics. 

It should be clear that private health care doesn’t “undermine,” public health care. Not only does it provide patients more choice, it reduces the strain on the public system.

 

Colin Craig is the President of SecondStreet.org, a new Canadian think tank.

This column was published in the January 7, 2020 edition of the Toronto Sun, Ottawa Sun, Edmonton Sun and Calgary Sun.

Share on Facebook
Share on Twitter

Other Canadians Share Similar Experiences:

Play Video

Don and Jackie, Winnipeg

Play Video

Jerry and Becky, Calgary

Play Video

Troy and Erika, Victoria

Play Video

Jim Jones, Toronto

You can help us continue to research and tell stories about this issue by making a donation
or sharing this content with your friends. Be sure to sign up for our updates too!

Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.