Iris Gorfinkel: How Doug Ford’s health plan costs taxpayers billions — and privatization is making it fail - Toronto Star

To save universal health care, Ontario must reverse its path. Funding private clinics drains our public system, poaching staff and siphoning taxpayer dollars from front-line care.

“As the Ford government diverts funding to private facilities, Ontario’s public operating rooms are underutilized. Many sit dark on weekends; others become storage rooms, a monumental waste of an expensive resource,” writes Iris Gorfinkel.

Iris Gorfinkel is a family physician and clinical researcher in Toronto.

Half of Ontario’s family physicians plan to retire or exit practice within five years. This mass retirement is expected to add another 1.74 million to the 2.5 million Ontarians already lacking a family doctor. It could leave 1-in-4 people in this province with minimal preventive medicine, unmanaged chronic conditions and nowhere to turn but emergency rooms.

In response, the Ontario government allocated $2.1 billion to build interprofessional health teams. Yet the Ford government is undermining its own strategy: Teams are forced to offer salaries far below those of public hospitals to the essential staff required to run them. Worse, the province is funding private clinics that compete for this already scarce workforce. The Ford government is sabotaging its own plans.

One consequence of this underfunding is the fast growth of “concierge” medicine. Private corporations exploit the scarcity of primary care physicians and nurse practitioners by recruiting them away from the public system.

By charging out-of-pocket membership fees ranging from $3,000 to $12,000 annually, these networks fast-track medical services for the wealthy — while everyone else waits.

“But these are medically necessary services!” you respond incredulously, “Aren’t they covered under the Canada Health Act?”

They are, but concierge care thrives on loopholes. The Canada Health Act makes no mention of “membership fees.” While physicians are legally barred from charging for medically necessary care, nurse practitioners are not.

In response, Ottawa issued an “interpretation” to close this loophole, but the Ford government blew past the federal deadline. Ontario’s refusal to fund medically necessary services provided by nurse practitioners is deepening the province’s primary care crisis.

The consequences of corporate medicine can be lethal. During the COVID-19 pandemic, Ontario’s for-profit long-term care homes had 78 per cent more resident deaths than non-profit facilities. For-profit homes were more likely to pack vulnerable seniors into outdated, multi-resident ward rooms, while relying on a transient, part-time workforce to avoid paying benefits. Maximizing profit means cutting costs, putting patient safety in the back seat.

This systemic sacrifice of public safety for private wealth sets the stage for the government’s next major corporate pivot — surgical outsourcing.

“Private clinics will bring the province’s surgical backlog to normal levels,” Ford promised in 2023. Yet past experience says otherwise: Ontario funded nearly 1 million cataract surgeries between 2017 and 2022. A 2024 Canadian Medical Association Journal study found that when the province shifted funding to private, for-profit cataract facilities in 2020, operations for the wealthy surged 22 per cent, but fell 9 per cent for the lowest-income patients. Far from clearing the backlog, the shift to private facilities resulted in 93,000 fewer cataract surgeries than expected.

Ontario’s Auditor General warned that private eye clinics exaggerated public wait times, upsold expensive lens upgrades and misled patients into paying out-of-pocket fees even though public options were fully covered.

Shifting funds to private clinics is a proven policy failure, but the damage extends beyond eye clinics.

Private equity firms like Persistence Capital are now reshaping Ontario’s health care. Almost one-third of Ontario’s fertility clinics are tied to investor-backed networks. These firms value dermatology and eye clinics as well because of their high volumes and add-on fees.

As the Ford government diverts funding to private facilities, Ontario’s public operating rooms are underutilized. Many sit dark on weekends; others become storage rooms, a monumental waste of an expensive resource.

This waste is compounded by a massive price premium. CBC News found Ontario paid Clearpoint’s for-profit facilities 2.5 times more for cataract surgeries and 3.1 times more for knee arthroscopies than public hospitals.

To save universal health care, Ontario must reverse its path. Funding private clinics drains our public system, poaching staff and siphoning taxpayer dollars from front-line care. If interprofessional health teams are to succeed, the province must guarantee competitive salaries to staff them. Nurse practitioners need immediate provincial funding. 

The corporate promise of “pay more, get more” is a lie. Private clinics cost Ontario more, threaten patient safety and increase public wait times. They erode equity, accessibility and universality — the very foundation of the Canada Health Act.

Doug Ford’s two-tier medical vision is transforming a universal Canadian right into an unaffordable corporate luxury.

Error! Sorry, there was an error processing your request.

There was a problem with the recaptcha. Please try again.

You may unsubscribe at any time. By signing up, you agree to our terms of use and privacy policy. This site is protected by reCAPTCHA and the Google privacy policy and terms of service apply.

Opinion articles are based on the author’s interpretations and judgments of facts, data and events. More details

Iris Gorfinkel is a family physician and clinical researcher in Toronto.