Public Pay Public Benefits

The new graphic beside this post features logos from five corporations delivering essential medical services in Canada. The represent the reality of a broad range of for-profit companies benefiting from public payment for health services:the new focus of this blog.

For the last year I have written on for-profit delivery in Canada’s medical laboratory services. While this interest will continue, example after example illustrate the continuing threat of private laboratory companies to accessibility and sustainability of health care, they are only part of the problem. The companies depicted in the new graphic indicate the breadth of the private threat.

CML Health Care is one the three multinational corporations that take a billion dollars a year from our public health care system for medical laboratory services. CML was founded by a pathologist who made his initial wealth from the expansion of health services after the introduction of medicare.  Through a strategy of mergers and acquisition his company grew to include pharmaceuticals and a wide range of other diagnostic services.  CML currently provides over 20% of the community radiology and ultrasound services in Ontario.

The Cambie Surgical Center is one of Canada’s most infamous health care facilities.  The corporation was founded by an orthopedic surgeon and past president of the Canadian Medical Association, Dr. Brian Day, known for his ongoing clashes with the public health care system.  Dr.  Day’s clinic is being investigated for extra billing in contravention to the Canada Health Act and he is currently involved in court challenges to the validity of universal health care. Cambie brags that it has more operating rooms than most hospitals, six, and provides a range of surgical procedures, including eye, dental, orthopedic and plastic surgeries, to private pay patients and those insured by British Columbia`s universal health insurance.

The three remaining logos are from for-profit primary care chains.   The AIM Health Group: Integrating Health and Wellness runs a broad range of primary health facilities, including 11 family medicine clinics, 35 infusion therapy centers and 14 rehabilitation clinics.  It was a publicly traded company that was purchased in 2011 by Imperial Capital, a Toronto based private equity firm. AIM’s revenues in 2009 were over 54 million dollars. MCI: The Doctors’ Office, the logo that looks like a Swiss flag, in a privately held corporation that runs a chain of 36 family practice clinics in Ontario, Alberta and B.C.  The red apple is the logo of Appletree Medical Group, a healthy primary care chain with 14 locations in Ottawa and 21 around Toronto.

Sadly CML, Cambie, Appletree, MCI and AIM are a small sample of an expanding number of for-profit firms reaping the benefit of public payment. Even though many provincial governments, including Ontario’s call for moving more services out of hospitals into Independent Health Facilities, favour more private clinics their use is relatively unstudied.  I hope that more discussion and research on these for-profit providers will help in a critical evaluation of their impact.  When the public pays the public should benefit.

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