Key Takeaways
- Alberta’s proposal to allow private billing for surgery may create new business opportunities for some providers, but it is unlikely to increase the overall capacity of the healthcare system.
- The plan may lead to a shift of resources from the public system to private care, potentially leaving those who cannot afford private care waiting longer for treatment.
- The lack of regulation on fees in the private system may result in patients paying tens of thousands of dollars for an operation.
- The proposal may not attract many new physicians to the province, as surgeons are not highly mobile and may not be enticed by the opportunity to work in a private environment.
Introduction to Alberta’s Proposal
The provincial government of Alberta has introduced a bill that would allow surgeons to bill both public insurance plans and patients directly. This change would create a new model in Canada, where physicians can operate in both the public and private systems. The United Conservative Party government believes that this change will attract more physicians to the province and increase the availability of services. However, physicians who study the province’s healthcare workforce are skeptical about the impact of this proposal.
Lucrative Opportunities for Some Providers
According to Stephen Kwan, a Lethbridge-based orthopedic surgeon and president of the Alberta Orthopaedic Society, the proposal could be lucrative for some providers. Dr. Kwan stated that it is "exceedingly attractive" for surgeons to have operating time in both the public and private systems. However, he also cautioned that there are serious resource constraints, particularly among other healthcare professionals who are essential to operations. Fees for private services are unregulated, and patients may pay tens of thousands of dollars for an operation.
Limited Resources and Capacity
Braden Manns, a physician at the University of Calgary who has studied the province’s workforce challenges, believes that the proposal is unlikely to increase the overall capacity of the healthcare system. Instead, resources in the public system may shift toward care paid for out of pocket, leaving those who cannot afford private care waiting longer for treatment. Dr. Manns stated that "the people that are forced to stay in the public system, those people who need the supports of a hospital, those people who can’t afford to pay that – they’re going to wait longer."
Government’s Response and Recruitment Efforts
The government has been working to recruit more physicians to the province, with registration numbers showing an increase of 643 people this year. However, Dr. Manns noted that this increase is in line with population growth in the province, and the number of registrations may not match the number of practicing physicians in Alberta. Dr. Kwan expressed concern that new surgeons coming into the province may only stay temporarily, leaving follow-up work and complications to be handled by permanent surgeons.
Challenges and Concerns
Dr. Kwan’s organization is suggesting that itinerant surgeons should also provide call coverage for hospitals. David Urbach, the head of the department of surgery at Women’s College Hospital in Toronto, noted that most opportunities for private providers have been in specialties such as cataract surgery or orthopedic surgery. He stated that the number of physicians who would be most enticed by Alberta’s offer is likely to be limited, as surgeons are not highly mobile and may not be enticed by the opportunity to work in a private environment.
Conclusion and Future Implications
In conclusion, Alberta’s proposal to allow private billing for surgery may create new business opportunities for some providers, but it is unlikely to increase the overall capacity of the healthcare system. The lack of regulation on fees in the private system and the potential shift of resources from the public system to private care may have significant implications for patients who cannot afford private care. As the proposal moves forward, it is essential to consider the potential consequences and ensure that the healthcare system prioritizes the needs of all patients, regardless of their ability to pay.