while canadians tend to think that equality is one of the bedrocks of the canadian healthcare system, there’s nothing like a pandemic to uncover the disturbing inequalities that exist in the ways different people receive care for their health.it’s been more than a year since covid-19 began its creep across borders, and ever since, the spotlight has been on the failings of long-term care, the lack of resources in mental health, and how income and where you live often determines the quality of your health outcomes.take covid-19 testing as an example.in october 2020, ontario covid-19 assessment centres switched to an appointment-only model to cut down on lengthy wait times and ease backlogs. and while the government has
provided additional support for increased testing options, some people are still left waiting several days for covid test results, prompting those with the means to go elsewhere.
a two-tier system once such place is
medcan, a toronto-based company that offers antibody testing anywhere from $200 to $400anyone who was able to afford it had access to antibody testing through medcan as early as july 2020 for anywhere from $200 to $400. today, it’s offering polymerase chain reaction (pcr) tests — which are free in the public system for those with symptoms — for $250 a pop, with guaranteed next-day results.memberships that “ensure that you and your family (grandma and grandpa, too) receive unparalleled care for acute and ongoing health concerns — through the covid-19 crisis and beyond.” that includes year-long memberships which boast same or next-day appointments, a team of physicians at your disposal, next-day prescription delivery and 24/7 on-call assistance, just to name a few of the benefits.medcan is offering this in partnership with switch health, which operates four clinics in toronto, charges patients $160 per test, and is actively expanding as demand for testing rises.
meanwhile, elsewhere in canada… in alberta, there’s
ichor blood services, a private lab company, which charges $120 for covid-19 tests, while in winnipeg,
pure lifestyle, a test will run you $450.most are offering special employee or “corporate packages,” and are branded as “premium” services. so if your workplace administers them regularly, odds are good they’re being provided by a private company like one of these.aside from the exclusivity they reek of, there are other cons to consider when it comes to private treatment during a pandemic.in a press briefing in october, health minister patty hajdu said, “generally no, we prefer that there isn’t a two-tier public health system. in fact, the
law says explicitly that that should not exist and we have a number of measures that we can take under the canada health act if that’s happening.”she went on to explain that clinics should only be using tests approved by health canada, as others can lead to false negatives and a lack of accuracy in reported data.one might ask, then, ‘well, doesn’t private health care offer better services?’if you ask claudia chaufan, a professor of health policy at york university, that’s the wrong question entirely.“if the services you’re offering make someone feel like a queen or a king, then you could say that individual will be receiving ‘better’ treatment, but there’s no reason in the world why that would be,” she says. “if you fund a public system well, nobody will care for a private system because why would you pay for something you can get for free? you’ll pay your taxes and that’s the end of the conversation — no premiums, no deductibles, no this, no that.”
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chaufan points to concierge medicine in the u.s., which functions much like medcan, and focus on making people feel like “royalty.”“it’s like going to get a manicure, what’s better than that? except this is not a manicure,” she says. “it’s very important to canada to have a healthy population. but profit is not compatible with maintaining a healthy population, and the pandemic doesn’t give a damn about whether your coverage is private or public.”she also cautions against creating hierarchies.“you will automatically push millions of people away from the access to those services,” she says. “it takes a toll and can lead to higher maternal mortality, lower life expectancy, and much more.”as it is, it’s lower income people who are facing the brunt of the pandemic, and who also have the least access to healthcare services. with private companies becoming increasingly popular —
in the u.k, too — the divide between the health have and have-nots is only growing, to the detriment of those on the lower part of the food chain. it’s a trend that threatens to decimate what canada’s universal healthcare system has come to be known for.even politicians have been taking advantage, most notoriously conservative leader erin o’toole who,
after being turned away from an at-capacity public testing site after waiting in line for several hours in september, received a covid-19 test at a private clinic in quebec. that clinic was privately arranged and specifically for mps. o’toole later said he had “no idea” that it was a private clinic and that he does not believe there should be a “special clinic where people get superior access.”with our own politicians opting to go private, it’s no wonder why the belief that private care is not only faster, but better, lingers, as does the fear that the vaccine rollout, which has been moving at a glacial pace in canada, will lead to a similar dynamic. right now, vaccination priority is for the elderly, front-line healthcare workers and those in long-term care homes. it could be months before the roll-out broadens, and odds are that could lead to private vaccinations, too.
concern over private vaccine sales the moderna and pfizer vaccines have contracts with the federal government, which is allocating the doses to the provinces and territories. the latter, according to
a global news report, says its current focus is on selling to governments and not private corporations, including the nhl,
which recently expressed interest in “securing vaccine when and if it’s available for private purchase.” moderna did not comment on private sales.still, there are reasons to worry. in a briefing in december, hajdu said the canadian government doesn’t have “mechanisms to block corporations from purchasing” a vaccine “on a contractual basis.”it’s clear, then, that the pandemic has brought the many pre-existing inequities of canadian health care into the light. perhaps the next step when it comes to stemming any possible tide of private healthcare, is regulated costs and sales, along with oversight when it comes to treatment and tracking.chaufan, who is an advocate for
a universal pharmacare system, thinks “private healthcare is a nightmare.”“a pandemic is both a terrible and fabulous example to show the unmitigated disaster that you can create if you start seducing people who have a big salary and telling them, ‘you’ll be treated specially, you’ll be getting all these bells and whistles, we’ll take care of you,’” she says. “well, they won’t, because you don’t take care of people in a pandemic unless you take care of everyone. a commercial system cannot take care, by definition, because only the people who can access it will get the services.”not only are there moral and economic considerations but, she says, private systems can motivate the political interests of those who are privileged enough to take advantage of them. and that’s a massive risk as the pandemic continues.“anything that is not an absolute luxury that you could live a healthy life without is a disaster to put in the hands of commercial insurers and vendors,” she says. “if you don’t like your nose and you want to change it and you decide to buy commercial insurance at that point, that’s okay. but for anything that your average public health professional considers a medically necessary service, that’s the last thing i can recommend as a policy person.“because the moment you offer these essential services to the privileged, they will lose interest in supporting a very strong public health system for everyone. it’s an ‘i can’t save the world, i’m going to save myself’ dynamic…and it’s growing.”
sadaf ahsan is a toronto-based culture writer, editor and stereotypical middle child. she can be reached here.
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