New data shows for-profit clinics charging significantly more for surgeries

New data from Quebec shows the government has paid more for medical procedures in for-profit clinics as concerns grow that the Ford government plan to move more surgeries out of public hospitals could cost taxpayers.

The details obtained through an Access to Information Request by independent Quebec research institute, IRIS, have revealed stark differences in surgery costs depending on where they occur.

Cataract surgery costs the government an average of $800 at a public hospital but almost $1,200 at a for-profit clinic, representing a 45 per cent increase. The cost of carpal tunnel surgery averaged under $500 publicly but $900 privately, an 84 per cent increase.

“We have a lot of issues with the health systems in every province in Canada so that people are worried and, rightly so,” said the researcher who made the data public, Guillaume Hébert.

The findings were similar for three other procedures, and Hébert wants governments to use this information.

“We shouldn’t use solutions that are worse than what we actually have,” said Hébert. “When we have such a good comparison, such a clear result … we should use it.”

Unknown how much Ontario will pay for surgeries in for-profit clinics

University of Toronto assistant professor in family and community medicine, Danyaal Raza, said there are better ways to deliver the highest quality at the lowest cost.

“Investor-owned care is not the answer. There are better ways to do that,” said Raza. “It’s to invest in not-for-profit services that either operate as extensions of hospitals or standalone community clinics.

In Ontario, it’s unknown how much the province will pay for surgeries in for-profit clinics, as confidentiality agreements make it impossible to know the actual costs.

Raza tells CityNews clarity should be necessary in this instance. “When we’re spending public dollars, transparency is essential, so we know we’re getting value for our money.”

However, health policy researchers tell CityNews there is a growing body of evidence across Canada and worldwide about the higher cost of for-profit healthcare delivery.

“I would expect there’s no reason to believe we would see costs lower in Ontario,” shared Andrew Longhurst with Simon Fraser University.

“I think it’s pretty telling that at a time when the Quebec government and other provincial governments are looking to increase for-profit delivery of surgeries, we have compelling evidence suggesting this is not the right policy direction.”

Some national examples of higher costs include hip and knee replacement at a hospital in Canada, anywhere from $10,000 to $12,000, while for-profit clinics charge as much as $28,000.

“If we want to move towards a more cost-effective system … we should be focusing on improving the public system,” Longhurst said. “We can ramp up if we want to. But what’s happening now is now the policy focuses on increasing for-profit delivery. So, a big shift in resources will go to a private for-profit system, where you’re essentially building things from scratch largely.”

The Ford government’s main selling point has been that private delivery will help clear the surgical backlog and reduce wait times. Still, research from the Canadian Institute for Health Information shows Ontario has substantially better wait times for joint replacement than provinces outsourcing those surgeries.

Seventy-three per cent of Ontarians received a hip or knee replacement within six months, compared to 70 per cent in B.C., 53 per cent in Alberta, and 48 per cent in Quebec.

“The biggest issue is the workforce … and it’s under tremendous strain, so what happens when you pull that workforce into the private, for-profit sector, it means you’re impacting your ability to deliver those same services in the public system,” explained Longhurst.

CityNews contacted Ontario’s Minister of Health for comment but has not received a response.