Surgeries performed at a private clinic cost up to two and a half times more than at public facilities, government data obtained through a freedom of information request shows. These conclusions contradict the advocates of two-tier medicine in Quebec.
In 2016, Gaétan Barrette, the Minister of Health at the time, launched a pilot project in three Montreal clinics. The Chirurgie Dix30 clinic, the Rockland MD Surgery Center and the Opmédic Group received exceptional authorization to be able to carry out day operations while earning a maximum profit of 10%. “The private sector has been saying for a long time that it is more efficient, we will find out if it is true”, the minister then pleaded.
We have to admit that this is not the case, according to the financial results of this pilot project analyzed by the Institute for Socioeconomic Research and Information (IRIS) and cross-checked by The duty.
For example, in 2019-2020, the cost of a carpal tunnel operation was on average $908 in the private sector compared to $495 in the public sector, a difference of 84%. That of a short colonoscopy was $739 in the private sector, which represents two and a half times the cost of the same intervention in a public establishment, which was $290. In all cases, Quebec reimburses the entire invoice.
“What this pilot project demonstrates is that the private sector is not a good use of public funds”, concludes Anne Plourde, researcher at IRIS. “The conditions of this pilot project are extremely advantageous for private clinics. These clinics do not take any financial risk, because all costs are insured [par le gouvernement]. She also notes that the profit margin guaranteed by Quebec encourages these same clinics to increase their prices.
The government has spent a total of nearly $80 million to carry out this pilot project, phased between 2016 and 2020. The initial bill was to amount to $4 million per year.
Cheaper to the public
Conversely, physicians working in the public were able to gain in efficiency in three of the four interventions for which data are available. The bill for “day surgery” decreased by 11% for cataract operations, 38% for long colonoscopies and 13% for short colonoscopies.
This pilot project also does not allow us to conclude that the private sector improves the efficiency of the health system. “We are not at all certain that by privatizing operations, we will improve access to services,” criticizes Anne Plourde. “There’s nothing at all that backs that up. Nothing in the pilot project made it possible to verify this. […] We are in the process of generalizing a practice without taking into account a pilot project for which we paid dearly. »
Currently, about 20% of health care is provided by the private sector, Premier François Legault recently revealed. This proportion is expected to grow even more, as Quebec plans to build two private mini-hospitals in Montreal and Quebec.