Independent Health Facilities and For-Profit Delivery: Reassuring Words, Troubling Results

Who said these words and when?

We have three broad objectives: to develop a more community-based health care system to ensure that patients receive quality medical care as close to home as possible; that the procedures are carried out in a safe, effective manner; and to regulate facilities so that they are appropriately located and established in a planned way.

What we want to see is the freeing up of hospitals to do what they do best: provide the patient care and the patient care services that require a hospital setting. As a result, our institutions will be free to direct their expert care to those most in need, which in turn will result in substantial savings and efficiencies in our hospital sector.

For community-based facilities, the Ministry [of Health] will give preference to Canadian and not-for-profit groups. (minor editing was done to improve word flow)

You could be excused if you guessed Deb Mathews, Ontario’s current Minister of Health, or Dwight Duncan, the Minister of Finance. Either could have used these exact words when describing the 2012 changes in funding to health care.  But you would be wrong.

Elinor Caplan, Minister of Health in 1988, made these comments when she introduced the Independent Health Facilities Act (IHFA).  The IHFA legalized and structured the market for non-hospital facilities that provide medically necessary procedures, much the same as the Laboratory and Specimen Collection Center Licensing Act did for private laboratories.

Both of these pieces of legislation created separate silos for private providers further dividing health care provision.  A fact reinforced by Ontario’s recent initiatives to move more hospital services into the community.

I know that Caplan, presaging recent comments by Minister Mathews, said that preference would be given to non-profit providers, but what is the result of her government’s actions?

Twenty-five years after the introduction of the IHFA the ten largest for-profit chains governed by the IHFA account for 2% of all the providers yet hold 38% of all the licences and control 24% of the locations.  Two companies, CML Healthcare and Medical Imaging Centers have 23% of the licences. Limitations on public data provided by the Ministry of Health make more interesting comparisons, like income, corporate interlinks, volume of patients and quality records, of these publicly funded health care providers difficult, if not impossible, to obtain.

The words that Caplan and Mathews use are reassuring but the outcomes of their actions are troubling. One consistent fact has been the disconnect between what they say and the continued expansion of the for-profit sector to the detriment of public services and patient care.

Explore posts in the same categories: Ontario Government Policy

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