Nadeem Esmail and Mackenzie Moir are analysts at the Fraser Institute. The Smith government’s recent announcement — that it plans to allow physicians to work in both the public and private sectors — has made headlines, both favourable and unfavourable, and sparked debate across the country. But the Smith government also recently announced it will soon allow Albertans to purchase diagnostic screening and testing services (e.g. MRIs, CT scans) from private clinics.Opponents argue this plan will lead to the wasteful delivery of services that patients don’t need. Others bemoan on principle any option where patients can purchase faster or more advanced care than the public system provides. While others simply oppose allowing doctors and other healthcare workers to work outside the public system.But these predictable arguments simply underscore how broken our system is today.Let’s be clear. Despite having one of the most expensive universal healthcare systems in the world, Albertans endure some of the lowest availability of advanced diagnostic machines and remarkably long wait times for diagnostic services, with median wait times reaching nearly six months for an MRI scan and three months for a CT scan in 2024. Canada’s diagnostic situation has actually become so concerning that the Canadian Association of Radiologists has been ringing alarm bells about the economic and personal consequences of delayed access to medical imaging in Canada.If the Smith government’s plans come to fruition, patients in Alberta will be able to access services from innovative entrepreneurs and the faster-moving private sector, which will increase the overall availability of services and subsequently reduce wait times for everyone. By allowing people willing to pay for services to leave the public queues, the government will help reduce wait times for patients in the public queues..Of course, private clinics must be staffed, and some have raised concerns that this will attract workers away from public hospitals. But many healthcare workers are leaving the public system due to burnout and other reasons, and they may want to work in private facilities that may have more flexible employment arrangements and better working conditions. And incidentally, the solution to the monopolistic public system’s limited ability to respond to the concerns of its employees is not to prohibit a more attractive alternative. The answer is to resolve why so many workers are leaving in the first place. And what about the argument that private providers will needlessly expand diagnostic testing and waste resources? In today’s reality, healthcare providers make greater use of diagnostic testing than they have in the past, following advancements in both diagnostic and treatment technologies. This greater volume of testing data allows physicians to track changes in patients over time and more precisely target treatments. More information can help avoid more costly invasive treatments in the future or help catch problems earlier when they can be less expensively and more effectively treated. Patients also sometimes just want to know what’s going on in their bodies. That knowledge and information — whether it brings a sigh of relief, discovers an abnormality that turns out to be insignificant, or points to a potential developing concern — clearly has personal value to them. While some may want to deny patients greater access to this information to somehow “protect” the public system, they ignore the personal nature of healthcare and the desire for knowledge about one’s own health. Clearly, when patients have greater access to MRI machines and CT scans, they can take better control of their healthcare in a manner currently denied to Albertans.Finally, the predictable arguments that this latest move is tantamount to the “Americanization” of healthcare, or that this “two-tier” option will somehow damage universal access in Alberta, ignore a very important reality: private alternatives exist in every universal healthcare system in the developed world. Other countries such as Switzerland, Germany, the Netherlands, and Australia all provide better and faster universal access to healthcare while spending a similar amount of money (or less money) than Canada because of — not despite — the private options available to patients. The naysayers want the government to retain a policy approach that’s clearly failed Albertans. Hopefully, the Smith government stands firm and implements this reform, despite ill-informed objections, and keeps patients top of mind.Nadeem Esmail and Mackenzie Moir are analysts at the Fraser Institute.
