Health
Opening independent non-profit hospitals would improve access to care and efficiency in Canada’s healthcare system
From the Montreal Economic Institute
Autonomous non-profit hospitals tend to perform better than government-run hospitals, shows a study published this morning by the Montreal Economic Institute.
“Interminable waits in Canadian hospitals show that our healthcare systems are struggling to deliver basic services to the population,” says Emmanuelle B. Faubert, economist at MEI and author of the study. “By allowing independent non-profit hospitals to open, our governments would help increase treatment capacity, to the benefit of patients.”
In 2023, the median wait time in Quebec ERs was 5 hours and 13 minutes, up 42 minutes from five years earlier.
It is estimated that as a result of chronic overcrowding in Canadian ERs, there are between 8,000 and 15,000 avoidable deaths each year.
The Canadian health care system ranks 10th out of 11 comparable industrialized countries, just ahead of the United States, in the Commonwealth Fund’s ranking of healthcare systems. The French, German, and Dutch systems are 8th, 5th, and 2nd respectively in the same ranking.
While the Canadian system has no independent non-profit hospitals according to the OECD’s definition, such facilities account for 14 per cent of French hospital beds, 28 per cent of German hospital beds, and 100 per cent of Dutch hospital beds.
The researcher attributes a portion of the success of these facilities to their greater managerial autonomy and to a funding method that encourages the treatment of more patients.
“One of the strengths of these hospitals is how quickly they can adapt, contrary to facilities micromanaged by government ministries, as is the case in Canada,” explains Ms. Faubert. “Since their financing depends on the type and the quantity of ailments treated, administrators see the sustainability of their facilities as being directly linked to their capacity to treat patients.”
Although Canadian hospitals generally have their own boards of directors, the management of their daily activities and their funding are subject to strict government control.
Aside from certain limited experiments, notably in Quebec, Canadian hospitals still depend largely on a global budgeting model, in which funding depends entirely on the level of activity in the previous year.
Since the annual budgetary envelope is fixed, each additional patient is seen as a cost, says the researcher.
In Europe, in contrast, hospitals are largely financed according to an activity-based funding model, whereby a hospital receives a set amount of money for each treatment carried out within its walls. With this system, each additional patient treated represents an immediate source of revenue for the facility, says the researcher.
“It’s clear that our healthcare system can and must do better, and that means changing the incentives of those who manage it,” says Ms. Faubert. “By introducing non-profit hospitals, with a better funding model, and by granting health professionals more flexibility, we will be able to provide better care to more patients, as they do in Europe.”
The MEI study is available here.
* * *
The MEI is an independent public policy think tank with offices in Montreal and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
Alberta
Province says Alberta family doctors will be the best-paid and most patient-focused in the country
Dr. Shelley Duggan, president, Alberta Medical Association
New pay model, better access to family doctors |
Alberta’s government is implementing a new primary care physician compensation model to improve access to family physicians across the province.
Alberta’s government recognizes that family physicians are fundamental to strengthening the health care system. Unfortunately, too many Albertans do not currently have access to regular primary care from a family physician. This is why, last year, the government entered into a memorandum of understanding with the Alberta Medical Association (AMA) and committed to developing a new primary care physician compensation model.
Alberta’s government will now be implementing a new compensation model for family doctors to ensure they continue practising in the province and to attract more doctors to choose Alberta, which will also alleviate pressures in other areas of the health care system.
This new model will make Alberta’s family doctors the strongest-paid and most patient-focused in the country.
“Albertans must be able to access a primary care provider. We’ve been working hard with our partners at the Alberta Medical Association to develop a compensation model that will not only support Alberta’s doctors but also improve Albertans’ access to physicians. Ultimately, our deal will make Alberta an even more attractive place to practise family medicine.”
“We have worked with the Alberta Medical Association to address the challenges that primary care physicians are facing. This model will provide the supports physicians need and improve patient access to the care they need.”
The new model is structured to encourage physicians to grow the number of patients they care for and encourage full-time practice. Incentives include increases for:
- Maintaining high panel numbers (minimum of 500 patients), which will incentivize panel growth and improve access to primary care for patients.
- Providing after-hours care to relieve pressure on emergency departments and urgent care centres.
- Improving technology to encourage using tools that help streamline work and enhance patient care.
- Enhancing team-based care, which will encourage developing integrated teams that may include family physicians, nurse practitioners, registered nurses, dietitians and pharmacists to provide patients with the best care possible.
- Adding efficiencies in clinical operations to simplify processes for both patients and health care providers.
As a market and evidence-based model, it recognizes and pays for the critically important work of physicians, including the number of patients seen and patient complexity, as well as time spent providing direct and indirect care.
“Family medicine is the foundation of our health care system. This model recognizes the extensive training, experience and leadership of primary care physicians, and we hope it will help Alberta to attract and retain more family medicine specialists who provide comprehensive care.”
Additionally, family physicians who are not compensated through the traditional fee-for-service model will now receive higher pay rates under their payment model, known as the alternative relationship plan. This includes those who provide inpatient care in hospitals and rural generalists. Alberta’s government is increasing this to ensure hospital-based family physicians and rural generalists also receive fair, competitive pay that reflects the importance of these roles.
“This new compensation model will make Alberta more attractive for physicians and will make sure more Albertans can have improved access to a primary care provider no matter where they live. It will also help support efforts to strengthen primary care in Alberta as the foundation of the health care system.”
“Family physicians have been anxiously awaiting this announcement about the new compensation model. We anticipate this model will allow many primary care physicians to continue to deliver comprehensive, lifelong care to their patients while keeping their community clinics viable.”
Quick facts
- Enrolment in the primary care physician compensation model will begin in January with full implementation in spring 2025, provided there are at least 500 physicians enrolled.
- The alternative relationship plan rate has not been updated since it was initially calculated in 2002.
- The new compensation model for family doctors is the latest primary health care improvement following actions that include:
- A $42-million investment to recruit more health providers and expand essential services.
- A new rural and remote bursary program for family medicine resident physicians.
- Additional funding of $257 million to stabilize primary care delivery and improve access to family physicians.
- Implementing the Nurse Practitioner Primary Care Program, which expands the role of nurse practitioners by allowing them to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
Related information
From LifeSiteNews
By Stephen Kokx
During a free-flowing press conference at Mar-a-Lago Monday, Donald Trump mentioned the sharp rise in autism in recent decades, adding that he has experts ‘looking to find out’ if vaccines may be the cause.
Donald Trump is doubling down on his intention to study a possible link between vaccines and autism in children.
During a free-flowing press conference at Mar-a-Lago Monday, the incoming president said there are “problems” with the massive increase in autism cases in America over the past several decades and that he intends to get to the bottom of it.
“30 years ago, we had, I’ve heard numbers like 1 in 200,000, 1 in 100,000. Now I’m hearing numbers like 1 in 100. So, something’s wrong … and we’re going to find out about it,” he said.
Trump’s remarks come just days after he told MSNBC anchor Kristen Welker that his choice to lead the Heath and Human Services Department, Robert F. Kennedy Jr., will be tasked with investigating the matter.
“Certain vaccines are incredible but maybe some aren’t, and if they aren’t, we have to find out … the drug companies are going to be working with RFK Jr,” he said.
During COVID-19, Dr. Sherri Tenpenny joined a LifeSiteNews panel discussion on the science regarding the COVID shots. She warned that the experimental injections do not even qualify for the term “vaccine.”
“I refuse to call it a vaccine because it doesn’t meet any of the standards by which a vaccine is supposed to work,” she said.
In October 2022, the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) unanimously voted 15-0 to add COVID-19 shots to the U.S. childhood, adolescent and adult vaccine schedules.
Dr. Tenpenny warned about the dangers of the current vaccination schedule while attending the world premier of The Great Awakening documentary in June 2023.
“If a child gets all of the vaccines in the entire schedule, they get almost 13,000 micrograms of aluminum, and they get almost 600 micrograms of mercury, plus over 200 different chemicals,” she said. “So that’s why they’ve never been proven to be safe.”
The upcoming 2025 Immunization Schedule approved by the CDC now recommends 36 vaccinations for children from the time they are in their mother’s womb until they are two years old (four doses are given to the pregnant mother while 32 doses are injected in the child from birth to 24 months).
Dr. Simone Gold has called for an investigation into the current vaccination schedule.
“In the 1960’s children received 5 vaccine shots in total. Today, the CDC says that children should receive 72 vaccine shots, a majority of them before the age of 6. The CDC is known for corruptly advancing Big Pharma interests. This schedule needs to be investigated further,” she said on X in September.
The CDC currently advises children to receive 70 doses before they turn 18. This is a massive increase from the 1980s, when they received 24 doses. Many medical freedom activists blame the explosion in shots on the 1986 National Childhood Vaccine Injury Act which gave vaccine makers legal protection from any harm their products inflict on those who receive them.
Doctors and medical freedom activists, including RFK Jr., have long maintained that the massive uptick in autism in recent decades is likely due to the increases in vaccines for children.
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