This resonates a lot with me. My cardiologist referred me to get a cardiac MRI, in order to give me a clean bill of health to start a new medication. After waiting 2 1/2 months just to get a call to schedule the damned thing, I was told that my MRI had been scheduled in December..of 2026. Not optimal.
I admit to being very fortunate in having an employer that is willing to pay for me to go the private route, but I need to go to either Buffalo or Montreal. Having more options here in Canada’s largest city would be nice…
Sorry to hear about your experience. In Alberta it's long been possible to pay for a private MRI, at the exact same clinic you'd get your MRI a year later if you waited on a public wait list. I didn't realize that wasn't possible in some other provinces. I opted to pay the $500 for one in 2017 when I tore my ACL, because otherwise it was a 3 month wait at the time. And thankfully I had a connection that was able to slip my name into another surgeon's pile for an earlier consult than I otherwise would have been able to. And then I was lucky enough to be offered a cancelation at a moment's notice, resulting in surgery roughly 4 months from injury. Had I not been willing to pay for the MRI or had a connection, it would have taken 3 months for the MRI, 3-6 months for the consult, and then another 3-6 months for surgery, wiping out the better part of a year or more of my athletic life. What a broken system we have.
The fact that I can get an x-ray for my dog same day and pay cash, and I can't for myself is outrageous and I'm honestly surprised that this doesn't get people more angry.
Maybe we should allow vets to do x-rays for humans too? I jest, but how different is it really?
If not that, I'm sure there are a millions creative ways to alleviate what ails us, even if sharing medical imaging with pets isn't one of them.
If care in the US is genuinely cheaper than here , why not cover a set of basic eligible procedures that are done across the border? Similar to a travel health insurance, but with very specific requirements.
I realize the elbows up crowd would be horrified, but I'm thinking in practical terms, not jingoistic ones.
Canadians tend to compare their outlier healthcare (public only with some exceptions wrestled tooth and nail to get) with the outlier US healthcare (user pay with some exceptions, usually trauma/ER related). There is an entire world of examples - some seem to work more efficiently and with greater coverage at a cheaper overall price - between the two, which often gets forgotten or never even considered by the Canadian public whenever our broken system is reviewed. And, let's be absolutely clear: our system is both financially unsustainable under the current regime (Drs as gatekeepers) and broken with significant and growing shortfalls (both in providers and hard point services). The false binary is the standard defence against any meaningful change.
I am for increased access to private care, but let’s be clear - same day X-rays are the norm. We’ve had many broken bones in our household and possible broken bones and X-rays have always been within hours. Imaging that takes longer is mri and CT when it’s not emergent.
A great column. This is all well known in public health care. The rationing in a monopolistic setting means patients are at the mercy of the most absurd and wasteful bureaucracy I have ever seen. My primary care provider who is excellent, moved her busy practice and was folded into a family practice unit deeply affiliated with and on the property of a large Toronto teaching hospital. During the first year a patient was unable to reach an administrator by phone, often waited several days for a return call by which time they were either better or had gone to an ER. Their "process" is improving but were there choice I would have found a new GP in a heartbeat. There's so much real or feigned sense of overwhelm in the system, much of it left over from the panic of Covid. Im thinking of the long list of questions you are warned not to ask when you attempt to reach a live person by calling a specialist. One listens to the message and realizes you're certainly not important enough to leave a number. You will not receive a return call. And many of the gatekeepers seem to justify rudeness as if every caller is just wasting their time. Clearly they are deluged. I have a strange urge to apologize and am so grateful when I am seen my a specialist it is laughable. But call a physio or an optometrist, a dentist and they answer the phone are happy to help and will fit you in when you have an emergency. Rationing health care is the biggest national insult to each one of us. And extra billing has long been misunderstood apparently even by health bureaucrats who by the way are staggering in their numbers. Yes to private and public practice, yes to geared to income annual premiums for everyone, yes to hiring more nursing staff and surgeons and running hospital OR's 24/7. Health care is not a sacred cow - it should function as a system, a well-oiled machine. Otherwise the very best and brightest surgeons will lose faith in the virtues of the Canadian system, which I know first hand was the reason some chose to stay here, and take one of the many lucrative offers they have from around the globe.
There are few things as offensive as trying to reach anything resembling a specialist medical provider in Canada. The 10-level-deep automated telephone system, the requirement to leave voice mails, getting cut off, calls not being returned, the impression throughout that you should not be trying to reach them at all. Like they are doing you the biggest favour in the world to consider you at all for an appointment sometime in the next 6-12 months.
We have a system that might be appropriate for total poverty last resort care for the financially destitute. But I don't want to be a charity case, could afford to pay more for quicker/better access to a lot of this, and I'm sorry but it helps society and the economy to prioritize the health and well-being of the economically productive over those who are net consumers of social resources.
Rather than spend internationally is possible to go to another province in Canada. As the health systems are provincially administered, if you are out of province, you are considered to be "foreign". Provinces need to cover nonresidents somehow outside their systems. In other words, it makes no sense that private services are denied to Canadians - unless of course the government prevents people from travelling!
I was surprised by this but I have a family member who is on a wait list in BC for surgery with timeline TBD, but was able to go to Alberta have a consultation followed by surgery in under 2 Months.
No idea how much they are paying and what BC is covering but still for them a viable option and they are able to stay in Canada.
BOOM! Just had a client come back from Latvia. He said he was getting a new knee for 13K. He said the treatment was outstanding and he met people from Germany, Scotland, England and Wales. I spoke to my friend about this (he is a hardworking orthopod) and he said his clinic charges 20K and he has not heard of any bad stories coming back from this clinic in Latvia. My former roommate just returned from Costa Rica, after getting stem cells injected into his working hand, $5,500 US. US clinic operating in CR. Private clinics are found when you go to see your GP. They own the office, pay the staff and charge for note and the Gov for fees. I have been to many private clinics in Calgary. I have never paid. I can tell they are private because of the furnishings and the efficiency. Just read Cale below, C-era in Calgary.
So much common sense. Unfortunately, the chicken little crowd keeps clinging to the fear of "American style" health care system as if that was the only model available and since politicians need wedge issues to control the population and win votes, this one will remain unchanged I'm afraid. I commend Premier Danielle Smith for attempting to move Alberta in the 20th century. For all of our sake, let's hope Alberta is allowed to proceed unimpeded but I'm afraid this country is stuck in fear and apathy with a federal government unable to let go of any power.
Sounds great, but this is factually incorrect. There is considerable, local/canadian evidence that when a parallel private arm opens up, all that happens is the wealthy get cared for more quickly, and everyone else waits the same, or in many cases longer. Simple laws of "supply and demand" will not magically create more nurses and doctors, or more technicians. Nursing and medical schools are taxpayer funded and have fixed enrollment. If you were a CT tech, or an OR nurse, or an anesthesiologist (already in massive under supply), would you work 9-4 M-F for higher pay, or would you work M-S on evenings and weekends, for less pay? A properly funded public system, would build more ORs, and allocate staff appropriately, to meet the health care needs. More privatization will enrich Smith and her friends, but it wont improve access for Albertans.
I ask because Alberta spent under 30% of its annual budget on healthcare as recently as 2017, but spends well over 40% of our annual budget on healthcare in the now of 2025.
I ask because spending on healthcare has been increasing year after year after year, and the only cry we hear from the Opposition is that the government is delivering "cuts" and that spending must be radically increased EVEN MORE for the system to be "properly funded"
I ask because we spend far more on healthcare (per capita) than we should, and we are still getting poor to mediocre results.
Is there ANY room in your world view to consider that perhaps, just perhaps... the spending ISN'T the issue....?
Even if your contention is correct (citing some specific reports would strengthen your assertion), my response would be, "So what?" If I (or a loved one) needs to get treatment or some scan/test and private is the only route, you can bet I'm using it. To paraphrase Matt Gurney, I have zero intention of suffering needlessly to appease the ghost of Tommy Douglas. I refuse to feel any guilt for having the means to get quicker treatment.
Good ideas. Actually, the "elbows up" crowd are making things worse for health care in Canada. All that out of country care for emergencies and urgent care snowbirds used to get in the US (and covered by insurance), now has to be provided by our already scarce resources. So repatriation of this bit of medical tourism is all cost and no investment. Would be interesting to see how much Canadians used to spend on insurance to deflect care costs away from Canada
1) The Canada Health Act does allow for Canadians from one province to pay for medical procedures in another province, but not in their own. You don't have to travel out of country. This is just making extra $$ for airlines and hotels.
2) Every new medical advance in research seems to suggest that more and more MRIs, CTs, PETs should be done to diagnose the possibility of new treatments from research. This is just adding to the geometric increase in costs and further reductions in access.
None of this seems to point to a sustainable end point?
Alberta currently prohibits the purchase of private health insurance for health care provided by the public plan. Hence the proposed change will have little impact on the province's health care waiting lists.
This resonates a lot with me. My cardiologist referred me to get a cardiac MRI, in order to give me a clean bill of health to start a new medication. After waiting 2 1/2 months just to get a call to schedule the damned thing, I was told that my MRI had been scheduled in December..of 2026. Not optimal.
I admit to being very fortunate in having an employer that is willing to pay for me to go the private route, but I need to go to either Buffalo or Montreal. Having more options here in Canada’s largest city would be nice…
Sorry to hear about your experience. In Alberta it's long been possible to pay for a private MRI, at the exact same clinic you'd get your MRI a year later if you waited on a public wait list. I didn't realize that wasn't possible in some other provinces. I opted to pay the $500 for one in 2017 when I tore my ACL, because otherwise it was a 3 month wait at the time. And thankfully I had a connection that was able to slip my name into another surgeon's pile for an earlier consult than I otherwise would have been able to. And then I was lucky enough to be offered a cancelation at a moment's notice, resulting in surgery roughly 4 months from injury. Had I not been willing to pay for the MRI or had a connection, it would have taken 3 months for the MRI, 3-6 months for the consult, and then another 3-6 months for surgery, wiping out the better part of a year or more of my athletic life. What a broken system we have.
The fact that I can get an x-ray for my dog same day and pay cash, and I can't for myself is outrageous and I'm honestly surprised that this doesn't get people more angry.
Maybe we should allow vets to do x-rays for humans too? I jest, but how different is it really?
If not that, I'm sure there are a millions creative ways to alleviate what ails us, even if sharing medical imaging with pets isn't one of them.
If care in the US is genuinely cheaper than here , why not cover a set of basic eligible procedures that are done across the border? Similar to a travel health insurance, but with very specific requirements.
I realize the elbows up crowd would be horrified, but I'm thinking in practical terms, not jingoistic ones.
Canadians tend to compare their outlier healthcare (public only with some exceptions wrestled tooth and nail to get) with the outlier US healthcare (user pay with some exceptions, usually trauma/ER related). There is an entire world of examples - some seem to work more efficiently and with greater coverage at a cheaper overall price - between the two, which often gets forgotten or never even considered by the Canadian public whenever our broken system is reviewed. And, let's be absolutely clear: our system is both financially unsustainable under the current regime (Drs as gatekeepers) and broken with significant and growing shortfalls (both in providers and hard point services). The false binary is the standard defence against any meaningful change.
I am for increased access to private care, but let’s be clear - same day X-rays are the norm. We’ve had many broken bones in our household and possible broken bones and X-rays have always been within hours. Imaging that takes longer is mri and CT when it’s not emergent.
A great column. This is all well known in public health care. The rationing in a monopolistic setting means patients are at the mercy of the most absurd and wasteful bureaucracy I have ever seen. My primary care provider who is excellent, moved her busy practice and was folded into a family practice unit deeply affiliated with and on the property of a large Toronto teaching hospital. During the first year a patient was unable to reach an administrator by phone, often waited several days for a return call by which time they were either better or had gone to an ER. Their "process" is improving but were there choice I would have found a new GP in a heartbeat. There's so much real or feigned sense of overwhelm in the system, much of it left over from the panic of Covid. Im thinking of the long list of questions you are warned not to ask when you attempt to reach a live person by calling a specialist. One listens to the message and realizes you're certainly not important enough to leave a number. You will not receive a return call. And many of the gatekeepers seem to justify rudeness as if every caller is just wasting their time. Clearly they are deluged. I have a strange urge to apologize and am so grateful when I am seen my a specialist it is laughable. But call a physio or an optometrist, a dentist and they answer the phone are happy to help and will fit you in when you have an emergency. Rationing health care is the biggest national insult to each one of us. And extra billing has long been misunderstood apparently even by health bureaucrats who by the way are staggering in their numbers. Yes to private and public practice, yes to geared to income annual premiums for everyone, yes to hiring more nursing staff and surgeons and running hospital OR's 24/7. Health care is not a sacred cow - it should function as a system, a well-oiled machine. Otherwise the very best and brightest surgeons will lose faith in the virtues of the Canadian system, which I know first hand was the reason some chose to stay here, and take one of the many lucrative offers they have from around the globe.
There are few things as offensive as trying to reach anything resembling a specialist medical provider in Canada. The 10-level-deep automated telephone system, the requirement to leave voice mails, getting cut off, calls not being returned, the impression throughout that you should not be trying to reach them at all. Like they are doing you the biggest favour in the world to consider you at all for an appointment sometime in the next 6-12 months.
We have a system that might be appropriate for total poverty last resort care for the financially destitute. But I don't want to be a charity case, could afford to pay more for quicker/better access to a lot of this, and I'm sorry but it helps society and the economy to prioritize the health and well-being of the economically productive over those who are net consumers of social resources.
Rather than spend internationally is possible to go to another province in Canada. As the health systems are provincially administered, if you are out of province, you are considered to be "foreign". Provinces need to cover nonresidents somehow outside their systems. In other words, it makes no sense that private services are denied to Canadians - unless of course the government prevents people from travelling!
I was surprised by this but I have a family member who is on a wait list in BC for surgery with timeline TBD, but was able to go to Alberta have a consultation followed by surgery in under 2 Months.
No idea how much they are paying and what BC is covering but still for them a viable option and they are able to stay in Canada.
And the UK, India, Latvia, Mexico, etc. There are also some private hip clinics in Quebec that Albertans and others favour.
Trying to understand how and why Govts ration health care.
BOOM! Just had a client come back from Latvia. He said he was getting a new knee for 13K. He said the treatment was outstanding and he met people from Germany, Scotland, England and Wales. I spoke to my friend about this (he is a hardworking orthopod) and he said his clinic charges 20K and he has not heard of any bad stories coming back from this clinic in Latvia. My former roommate just returned from Costa Rica, after getting stem cells injected into his working hand, $5,500 US. US clinic operating in CR. Private clinics are found when you go to see your GP. They own the office, pay the staff and charge for note and the Gov for fees. I have been to many private clinics in Calgary. I have never paid. I can tell they are private because of the furnishings and the efficiency. Just read Cale below, C-era in Calgary.
So much common sense. Unfortunately, the chicken little crowd keeps clinging to the fear of "American style" health care system as if that was the only model available and since politicians need wedge issues to control the population and win votes, this one will remain unchanged I'm afraid. I commend Premier Danielle Smith for attempting to move Alberta in the 20th century. For all of our sake, let's hope Alberta is allowed to proceed unimpeded but I'm afraid this country is stuck in fear and apathy with a federal government unable to let go of any power.
I worry that most Canadians are too vindictive and petty to support policy like this. In fact, I'm certain they are. I believe this can change.
Sounds great, but this is factually incorrect. There is considerable, local/canadian evidence that when a parallel private arm opens up, all that happens is the wealthy get cared for more quickly, and everyone else waits the same, or in many cases longer. Simple laws of "supply and demand" will not magically create more nurses and doctors, or more technicians. Nursing and medical schools are taxpayer funded and have fixed enrollment. If you were a CT tech, or an OR nurse, or an anesthesiologist (already in massive under supply), would you work 9-4 M-F for higher pay, or would you work M-S on evenings and weekends, for less pay? A properly funded public system, would build more ORs, and allocate staff appropriately, to meet the health care needs. More privatization will enrich Smith and her friends, but it wont improve access for Albertans.
Noticing the number of likes to your post....
Ah, there's the rallying cry of the NDP...
"A "properly funded" healthcare system would...."
So what does "proper funding" look like , friend?
I ask because Alberta spent under 30% of its annual budget on healthcare as recently as 2017, but spends well over 40% of our annual budget on healthcare in the now of 2025.
I ask because spending on healthcare has been increasing year after year after year, and the only cry we hear from the Opposition is that the government is delivering "cuts" and that spending must be radically increased EVEN MORE for the system to be "properly funded"
I ask because we spend far more on healthcare (per capita) than we should, and we are still getting poor to mediocre results.
Is there ANY room in your world view to consider that perhaps, just perhaps... the spending ISN'T the issue....?
Even if your contention is correct (citing some specific reports would strengthen your assertion), my response would be, "So what?" If I (or a loved one) needs to get treatment or some scan/test and private is the only route, you can bet I'm using it. To paraphrase Matt Gurney, I have zero intention of suffering needlessly to appease the ghost of Tommy Douglas. I refuse to feel any guilt for having the means to get quicker treatment.
Good ideas. Actually, the "elbows up" crowd are making things worse for health care in Canada. All that out of country care for emergencies and urgent care snowbirds used to get in the US (and covered by insurance), now has to be provided by our already scarce resources. So repatriation of this bit of medical tourism is all cost and no investment. Would be interesting to see how much Canadians used to spend on insurance to deflect care costs away from Canada
Excellent article. Thank you.
It should be noted that:
1) The Canada Health Act does allow for Canadians from one province to pay for medical procedures in another province, but not in their own. You don't have to travel out of country. This is just making extra $$ for airlines and hotels.
2) Every new medical advance in research seems to suggest that more and more MRIs, CTs, PETs should be done to diagnose the possibility of new treatments from research. This is just adding to the geometric increase in costs and further reductions in access.
None of this seems to point to a sustainable end point?
Alberta currently prohibits the purchase of private health insurance for health care provided by the public plan. Hence the proposed change will have little impact on the province's health care waiting lists.