Can we improve health care for all with only the empty public purse?

Can we improve health care for all with only the empty public purse?

Ed. note: Dr. Alykhan Abdulla’s recent article describing a day in the life of a family physician drew much reader attention. In this piece, he questions the knee-jerk reactions to any discussion of privatization after Ontario’s announcement that it would increase publicly funded surgeries at private clinics to ease pressure on the health-care system.

I run a private medical clinic in Manotick Ont. I pay rent. I pay staff wages. I pay for medical supplies. I pay for my computers. I pay if the toilet is plugged. And so on. Other than the fact that we accept all OHIP patients, there is nothing that is paid for under the public purse in my medical clinic.

Some of my medical colleagues operate private X-ray facilities, private community specialists’ clinics, private outpatient surgical clinics or private outpatient colonoscopy clinics. These are all “privatized” clinics run as businesses paid for by doctors billing the OHIP system. They all take OHIP. They all treat patients with respect. They all follow rules of egalitarian socialized public health care. This has not caused pandemonium.

In addition, most pharmacies are “privatized” clinics run in a similar fashion. There is an urgent care centre in Ottawa that accepts OHIP. There are community laboratory services that are private businesses accepting OHIP. All walk-in clinics accept OHIP. Optometrists accept OHIP diabetic patients and those over 65 years old in privatized clinics.  Do we fear any of these private companies as the slippery slope of two-tiered medicine?

Sorry to share this but hospitals accept a tremendous amount of private money from lotteries, donations and wealthy families putting their names on buildings. This does not make any hospital exclusive from public access. Hospitals need to rent space to Tim Horton’s or Starbucks or Shopper’s Drug Mart to pay for their staff or renovations or whatever. These are private businesses that subsidize our inability to sustain health care.

So here is the wicked question:

How do we improve health care for all with only the empty public purse? 

We can raise taxes (by a lot). We can continue to ration health care (so that everyone equally gets substandard care). We can keep closing emergency department and operating rooms, and spending countless hours on social media fighting about public health care.

Or we can work together and improve public-private partnerships so that services increase for everyone equitably.

The comments section is closed.

  • Pamela Fuselli says:

    What is missing from the discussion on the crisis in our health care system, public and private funding, is the solution of prevention. Investment in prevention can allow for the redistribution of funds to other priority issues. An example from my field, injuries are almost completely preventable. Car crashes, falls, poisonings, drownings, burns. All issues that show up in our ED and hospitals that don’t need to be there! Prevention MUST be part of the solutions to this enormous and complex issue of health care. Stopping something from happening is easier than treating it once it has occurred. Why isn’t this part of the discourse?

    • Alykhan Abdulla says:

      Brilliant. Hoping to tackle upstream health literacy and self management in the future. Perhaps a joint submission?

  • LE says:

    Thank you for your honest and heartfelt comments. Only through such honesty can we move beyond our rhetorical traps.


Alykhan Abdulla


Dr. Alykhan Abdulla is a comprehensive family doctor working in Manotick, Ont., Board Director of the College of Family Physicians of Canada and Director for Longitudinal Leadership Curriculum at the University of Ottawa Undergraduate Medical Education.

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