In Ontario, some doctors are beginning to offer “pay-to-play” health-care services. Patients can pay a subscription fee of $30 to $60 a month for around-the-clock access to a nurse practitioner. The doctors using this policy are framing it as a makeshift solution for the extreme burdens faced by primary care providers. With this program, subscribers can receive an immediate virtual appointment for their children, and a next-day in-person appointment if necessary. The doctors argue that this is “not ideal”, but say it will “increase access”. Whatever these doctors’ intentions, this is continuing the marketization of Canada’s health-care system, in this case, towards a two-tier, pay-to-play health system.

Who does pay-to-play benefit? Families deserve free, universal health care with better access than is available today. Likewise, doctors deserve to work in a system that provides equitable and accessible services for fair wages with safe working conditions. Unfortunately, these measures do the exact opposite. By giving better and faster service to those who can pay the fee, the attention and time of health-care workers will be taken from those who cannot pay. The wealthy have no problems shelling out cash for health care. Working families are often not so fortunate. Combined with more private surgery clinics, the tendrils of private health care are infiltrating the cracks in our public system. 

Despite the arguments that pay-to-play will “increase access” or remove clogs in the health-care system, all evidence points to the fact that privatization, or marketization, of health care has the opposite effect. When the market is involved, someone has to pay for the bosses to profit, killing the efficiency of the system.

As Fightback wrote in January 2023:

The reality is that giving public money to private clinics is a waste of health-care funding. Instead of the government paying for just the cost of delivering health-care services, it will have to pay for the cost of these health-care services and profits for the owners on top of that. That is money that would be better spent on solving the staff shortage by hiring more nurses and doctors and paying them well. We can look to our neighbours to the south to see how expensive health care can get when it is in private hands. A 2020 study showed that U.S. hospitals charged an average of $417 for every $100 of costs they incur! The more we expand the role of the private sector in health care, the less care we actually get for each dollar of public money spent. The only people that stand to gain from privatization are the health-care profiteers that own these private facilities.

Access to free, quality health care in Canada is a source of pride for many Canadians. This vital social reform was zealously fought for by workers’ struggles of the past. As the recession looms, the bosses sacrifice these reforms to pay for the crisis. Long gone are the days of the postwar boom which afforded workers these programs. If we do not stop the bosses, they will continue to cut our health care until there is nothing left. The movement to a two-tier system will pave the way toward single-tier, fully privatized health care. 

Canadian public health care is under attack! Our health-care system has been suffering for decades as the bosses decide that the upkeep of workers’ health is no longer worth the investment. Relentless budget cuts, understaffing and overworked providers are festering. As our health-care system suffers, so too do the workers! As emergency departments, family clinics, and hospitals collapse, Canadians are no longer receiving quality health care. Capitalist politicians are using this outrage as fuel for the privatization flame. They use long wait times, poor outcomes, and dissatisfied patients to bang the drum for the private sector. Workers must stand up to these austerity measures dressed up as “innovation”.

The labour movement is capable of fighting back against these attacks. We need the trade unions to boldly mobilize workers in this fight. The individual “solutions” of a handful of doctors, like this “pay-to-play” system, only empower the private sector. Instead, we must band together. Collectively, the workers are not only capable of fighting back, but of pushing forward! We must courageously turn the defence of public health care into an offensive for genuinely universal health care! For dental, pharmaceutical and mental health treatment, free at point of use. To expropriate the parasites profiting off of people’s health. The struggle for public health care has the potential to bring the entire working class to its feet! A militant campaign in defence of public health care led by the labour movement would attract massive support and sympathy. This would build momentum for a movement which could turn the tide against the destruction of the public health-care system.