Private surgery clinics could help keep costs down, but beware the profits, prof says

A health management professor says allowing Medicare to cover some surgeries outside of hospitals is a good step, as long as corporations don't get free rein.

"Hospitals are big, they're expensive, they're harder to staff and they're harder to equip," Claire Johnson, assistant professor in health management at the Université de Moncton, told Information Morning Moncton. 

"The needs for staff and equipment are much higher in a hospital setting than they are at a community-based setting. So initially I was happy."

Last week, the government introduced legislation that will allow Medicare to pay for more simple surgeries outside hospitals. The bill creates a legal framework for a two-year pilot project in Bathurst that will move cataract surgeries to a local clinic.

The goal is to shorten wait times for cataract surgeries, and the program could eventually include vasectomies and colonoscopies.

Johnson said Quebec made a similar change, allowing private cataract surgery clinics to start up and address wait times. She said those clinics have been keeping wait lists short. 

However, when a corporation's mandate is to make and maximize profit, it would not discriminate between private customers and a provincial health-care system.

"If there are shareholders [and] profits are as high as they can be, then that is hugely problematic because then that completely changes the way they offer services," she said.

It's a warning New Brunswick needs to heed, she said, but it's possible for the province to keep things in control.

"The goals need to be very, very, very specific and well articulated and then regulated so that we don't fall into the same kind of traps," she said.

Green Party MLA Megan Mitton said this bill could be problematic, because it opens the doors for privatized health care subsidized by Medicare.

"[Patients] wouldn't have to pay out of pocket. But that doesn't mean that as people who pay taxes in our province, that we wouldn't be helping these corporations to make a profit," Mitton told Information Morning Moncton.

Liberal health critic Rob McKee said the project could draw even more nurses away from hospitals that are already understaffed.     

N.B. health-care system not purely public

Public and private health services exist on a spectrum, Johnson said, and the current system, even before this announcement, was not purely public.

Hospitals, for example, are considered public institutions, where everything is run and paid for by provincial funds, she said.

Then, there's family doctors and primary care providers, who operate under "fee for service." They are considered private businesses. They bill the province for services but are not provincial employee — which Johnson said is in the middle of the spectrum.

She said if this is how the new program will work, where the clinics are staffed by practitioners who charge a fee for service, then she has no concerns. 

"I'm generally comfortable with that as long as it's very clearly regulated and the rules are clear," she said.