Back in the day, when things were tight, people helped cover the mortgage payments by renting out the spare bedroom to a boarder. Well, the country’s health-care providers are under financial pressure right now — maybe it’s time to consider taking in a “paying guest” and renting out excess operating room capacity.
What excess capacity? Surely the region’s hospitals are crammed to their limits, resulting in lengthy wait times and postponed procedures. Yes and no. Whatever the constraints facing health facilities, they do not result from the absence of physical infrastructure. Operating rooms exist in quantity but are frequently out of commission. Some may be outdated, but even quite new emergency facilities are routinely closed before midnight. Health authorities cite staffing issues — a lack of qualified physicians, nurses and ancillary professionals. In reality, those are manifestations of a single phenomenon — budgetary pressures.
That there is enough demand for operating facilities and enough resources to staff them is evident in the proliferation of for-profit surgical clinics across the country. These units provide diagnostic services such as MRIs, fertility treatments, gynecological and urological procedures, bariatic (weight-reduction) and vascular surgeries, neurosurgery and ophthalmology, plus a wide range of sports-related remediations and an array of cosmetic and plastic procedures. These services are provided to well-heeled patients from around the world — and to Canadians who can afford to leap-frog the creaking public delivery system.
Defenders of Canada’s single-payer public system decry these developments. The stark reality is that, whatever one’s values, there is no reversing the tide. Those Canadians dissatisfied with the existing structure, and willing to pay to circumvent it, will continue to do so. The global market in medical tourism is worth close to $100 billion annually — and by some estimates, Canadians account for as much as seven per cent of buyers.
It is time to recapture some of that drain — and do better: actually profit from the country’s high standard of medical service, ability to attract qualified practitioners, and perceived political and individual security — and actively encourage inward-bound medical tourism. Montreal currently has the highest concentration of private medical establishments in the country. There is no reason why Atlantic Canada could not be competitive — provided that public policy becomes more supportive.
What about opening up some of those underutilized operating theatres in public hospitals for rental by private operators prepared to treat fee-for-service patients? It is not such a fantastic idea. The previous B.C. government contemplated such a strategy and even began negotiations to treat Saskatchewan residents under contract with that government. The rationalization works both ways — one Montreal public hospital leases facilities and services from a private hospital in the city.
What would be the benefits of fostering a medical tourism industry in Atlantic Canada? Among them would be the generation of a direct revenue source for public facilities. If the private patients were Canadian, space on the public waiting list would be freed up — or if they would otherwise have travelled outside the country for treatment, the revenue drain would be replaced with a local income gain. Properly managed, there is a potential for real economic advantage by creating a viable medical sector serving an international clientele seeking safe, secure, high-quality medical services at reasonable cost.
Taking in a lodger out of economic necessity is one thing — creating a viable, internationally recognized, high-paying industry is another. But we have to start somewhere.
Don McIver is a Senior Fellow at the Atlantic Institute for Market Studies, an independent economic and social policy think tank based in Atlantic Canada.