As some provinces turn to the private sector to address pressures in the health-care system, a new poll suggests more Canadians than ever are open to the idea of private delivery of health care.
The Ipsos poll conducted exclusively for Global News between Jan. 19 and Jan. 23, 2023 found 59 per cent of the 1,001 adults surveyed expressed support for the private delivery of publicly-funded health services.
Sixty per cent of respondents were also in favour of private health care for those who can afford it.
Darrell Bricker, CEO of Ipsos Public Affairs, says in the 30 years he has studied public opinion in Canada, he has never seen such a shift in support toward privatization.
“This is the first time I can recall in which you actually got numbers like that, where you’d have a majority of Canadians saying they’re open to considering private methods of delivery,” he told Global News.
Until now, maintaining Canada’s public health-care system has been a “cornerstone” of Canadian politics and any mention of privatization has been met with strong resistance — even repulsion — and has elicited fears of moving toward an American-style system of access, he said.
But given that a vast majority of Canadians surveyed, 85 per cent, now say they believe “drastic changes” are needed in the health system to meet the needs of the community, attitudes toward privatization appear to be shifting, Bricker said.
“Where we are now is, people are feeling that the system is so challenged that they’re open to considering other types of options.”
But when it comes to how to pay for such a shift in health-care delivery, there does not appear to be a strong consensus.
Only 48 per cent of respondents believed the needed funds should come from the introduction of new user fees for private health services, according to the poll results.
Regionally, Quebec residents were most open to private health care options, the data showed, including strong support for private care for those who are able to pay. This idea had the support of 75 per cent of Quebecers surveyed, which is 15 points higher than the national average.
Quebec residents also showed more openness to increased user fees to fund additional health-care investments at 62 per cent.
The results come ahead of a meeting Tuesday between the premiers and prime minister over health funding. The premiers have been calling on the federal government to increase their share of health costs to 35 per cent from the current 22 per cent.
According to the polling, most Canadians believe the provinces can free up more money to allocate toward health care. Three-quarters (73 per cent) of respondents said the health-care system needs more money and it should come from provincial governments cutting spending elsewhere.
The results also showed six in 10 respondents (59 per cent) believe that provinces should show the federal government a plan on how they will deliver better care to get more federal dollars, whereas 41 per cent believe provinces should decide how to spend the needed health-care funds without any conditions.
Despite high levels of concern over access to health services, only one-third of those surveyed said they would be willing to go to the United States for routine health care if they needed it, and a smaller number – 29 per cent – would travel to the U.S. for emergency care.
However, younger Canadians in the 18-34 age range were more likely to say they’d travel to and pay for care in America and those who identified as “Gen Z” and “Millennial” were more likely to support the idea of private health-care delivery options.
Bricker noted that while it’s clear younger Canadians appear to be more open to privatization, older respondents — especially those over 55 — were less supportive.
“Older people … the people who are most likely to vote, are the ones that are most firmly attached to the system that we have today,” he said.
Dr. Rita McCracken, a family physician and assistant professor in the department of family practice at the University of British Columbia, said she is not surprised to see so many Canadians wanting change in health care, given the nationwide shortages of nurses and family doctors that have led to significant wait times for care in virtually every part of the system.
But she says those who may believe privatization could address the current problems may not understand that Canada does not have an unlimited number of doctors and nurses to staff private hospitals and clinics.
Canada has a fixed number of health-care resources — a reality that is a big part of the problem in the public system, she said.
“If we go to a private model, well, those people who can afford to pay for the private access will get better access,” she said. “But we are not going to be able to manufacture more doctors, more hospitals, more health services, so the people who have trouble right now getting access to service are going to have an even bigger problem getting access to those services.”
Introducing more private delivery of health care could also present a moral dilemma for many doctors, who will have to decide which system to work in, McCracken added.
“Am I going to work in the private system, where work might be easier, I might get paid more, but I know that I’m seeing a very elite group of patients – or am I going to work in the public system where increasingly resources are going to become more difficult to access, which we’ve seen in other jurisdictions internationally where we have this public-private divide?”
After spending years researching health systems and health-care delivery, McCracken says there are “mountains of evidence” showing the most economical and fairest way to deliver health care is through a single-payer, public system.
“It shouldn’t matter who you are, how much money you have (when it comes to) the quality of health care that you’re going to get,” she said.
“That has become a value that Canadians have identified with for decades … It’s not the right way — to say if you’re richer, you can have better health.”
Meanwhile, as more than five million Canadians struggle to access primary care due to a lack of a family doctor, a majority of people support expanding virtual care.
Eight in 10 respondents said they would support more virtual care options for services provided by a family doctor.
— with files from Global News reporter Katherine Ward
Exclusive Global News Ipsos polls are protected by copyright. The information and/or data may only be rebroadcast or republished with full and proper credit and attribution to “Global News Ipsos.” This poll was conducted between Jan. 19-23, 2023, on behalf of Global News. For this survey, a sample of 1,001 Canadians aged 18+ was interviewed. The precision of Ipsos online polls is measured using a credibility interval. In this case, the poll is accurate to within ± 3.5 percentage points, 19 times out of 20, had all Canadians aged 18+ been polled.