Quality of care, cost to taxpayers — not ideology — have to drive decisions on medical services

Opinion

Hey there, time traveller!
This article was published 06/02/2024 (615 days ago), so information in it may no longer be current.

It’s easy for politicians to be idealistic while in opposition. They don’t have to govern.

They can say whatever pops into their minds without having to deal with the consequences of what they’re suggesting government should or should not do.

Ideology almost always rules the day in opposition, whether among Conservatives or New Democrats. Opposition parties embrace their ideological beliefs with fervour because they don’t have to implement anything (with few exceptions, like the odd private member’s bill that makes it through the legislative process). For the most part, opposition days are free-wheeling ones.

All that changes once in government, as the new NDP government is learning. Nowhere is that more obvious than in the delivery of health care.

In opposition, the NDP regularly railed against “privatization” and “profits” in health care. The party insisted “profit has no place in our hospitals and health-care centres,” an absurd notion which if pursued in any meaningful way would result in the collapse of Canada’s entire medical system.

Premier Wab Kinew, while in opposition, claimed — falsely — that the then-governing Tories were hell-bent on bringing in “two-tier health care” because they were contracting out some surgical and other services, just as previous governments (including NDP) had done for decades.

Today, the Kinew government maintains, and will continue to maintain for the foreseeable future, the very privately delivered medical services they criticized while in opposition. It has to, regardless of its ideological preferences.

Canada’s universal health-care system is made up of a mix of public and private delivery. Trying to weed out all “profit” from health care — whether from the delivery of surgical services, diagnostic testing, or the supply of medical equipment — would be an exercise in futility that would ultimately harm patient care.

Which is why the NDP government recently extended for one year the private monopoly of blood tests and urinalysis provided by the Ontario-based company Dynacare. The contract, brought in by the former Tory government, was vociferously opposed by the NDP while in opposition. But now that it’s in government, the Kinew government plans to keep it, at least for now.

The private delivery of blood and urinalysis testing is not new in Manitoba. Companies big and small have been making, gulp, a “profit” by operating testing labs throughout the province for years, including many attached to medical clinics or doctors’ offices. What changed under the former PC government was the consolidation of those services under one large company: Dynacare.

Was that an appropriate move? Did it save taxpayers money compared with paying for the multitude of labs scattered around the province? Maybe. Maybe not. There’s no publicly available data on it.

Even if it did save taxpayers money, was it a reasonable trade-off for losing the convenience and comfort of having labs right in doctors’ offices and walk-in clinics? Depends who you ask.

Whatever the case, these are the factors that must be weighed when deciding what to do with blood and urinalysis testing in the future — or any medical service. It won’t, and should not be, based on ideology and the false dichotomy between public and private delivery of health care services.

The only two factors that should matter is how it affects the quality of patient care and how much it costs taxpayers.

Would it make sense for the province to establish its own blood and urinalysis testing labs across Manitoba? That would require extensive analysis and a business case to compare the status quo with a proposed public system. The province would have to buy equipment, hire staff, obtain lab space, establish a bureaucracy and administer a fairly sizable organization. The risks involved would have to be weighed against what the province is purchasing now from Dynacare, which happens to be a stable, reliable and high-quality service.

Or perhaps the province wants to return to the system of smaller labs attached to clinics and doctors’ offices. What would be the cost? If it’s higher than the status quo, can the province really afford it, given government’s limited resources and demands on the public treasury in other areas?

Maybe breaking up Dynacare’s monopoly and tendering the work out to smaller jurisdictions would inject much-needed competition into the system and drive down prices. Conversely, perhaps the economies of scale of a large provider such as Dynacare serve taxpayers and patients well.

These are the factors that must be analyzed. Ideology should have nothing to do with it.

tom.brodbeck@freepress.mb.ca