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Private Healthcare in Canada

Canada is one of very few countries in the world that does not, in any practical way, allow its citizens the option of paying privately for doctor, hospital or day surgery services if those services are insured by the government. There are some interesting exceptions built into the framework of the Canada Health Act, which forms the basis of provincial health legislation. These exceptions include people covered by Worker’s Compensation insurance who are injured at the workplace, the Canadian Armed Forces, people who have not qualified as beneficiaries of provincially insured care, and prison inmates.

Exceptions to the Rule: Understanding the Canada Health Act

The lack of private options for insured services stems from the deep national pride historically held by the majority of Canadians. The Canadian “Medicare” system became a form of cultural identity in its early days, particularly as Canadians wanted to separate themselves from their southern neighbour, who consistently performed poorly by international healthcare standards in terms of access, equity, administrative efficiency, and overall performance.

Evolving Perspectives on Canadian Healthcare

Times are changing, however. Whereas our healthcare system would likely have been the greatest source of national pride in its earliest years, it is now outranked by multiculturalism, the Canadian flag and hockey. In a 2021 report issued by the Commonwealth Fund, Canada’s healthcare system ranked 10th out of 11 high-income countries. Not surprisingly, only the U.S. performed worse. Canada ranked poorly on access to care (9th), equity (10th), health outcomes (10th), and administrative efficiency (7th). These relatively poor rankings exist despite the fact that our country is one of the highest per capita spenders on health care internationally. It’s worth noting that all of the top-performing countries have private healthcare options.

Public Opinion and Private Healthcare

Canadians are starting to take more notice of the facts. In a recent poll conducted by Ipsos in January of 2023, 59% of respondents expressed support for the private delivery of publicly funded health services. 60% of respondents were also in favour of private health care for those who can afford it. These numbers represent monumental shifts in public opinion.

Having said the above, I wouldn’t want to leave the impression that I am anything but a huge supporter of universal health care in Canada. It needs to form the foundation of any effective national healthcare system, as it is with all top-performing nations. This is why I have dedicated most of my life to finding solutions for its financial sustainability, which I believe are rooted in a highly effective primary healthcare system.

Defining Private Healthcare in Canada

Given that background, what does the term “private” really mean in Canada, when applied to a professional or an organization? How is a private medical clinic, a private healthcare centre or a private doctor defined in Canada?

First, a “private” service simply means one that is not paid for by government under a provincial health services plan. There are countless examples, including the services of mental health professionals, nurses, dietitians, exercise physiologists, dentists, optometrists, home care workers, occupational therapists, physiotherapists, chiropractors, and many others. The government may provide such services in a hospital or other publicly funded setting at their discretion, but such providers are completely free to practice for private fees. In Canada, approximately 30% of all healthcare expenses are privately funded. Interestingly, this is actually above the average of developed OECD nations (27%), despite the fact that those countries also have private healthcare options for what would be considered insured services in Canada.

Understanding Private Doctors and Clinics in Canada

A private doctor is defined in most provinces as a licensed physician who has “opted out” of the provincial health insurance plan. There are very few private doctors, and for good reason. Generally speaking, private doctors cannot bill the government for services, and their patients must pay them directly (although the patients may be able claim back these fees from government). Consequently, the demand for such private medical services is low. I suppose that strictly speaking, a private clinic would be staffed with private doctors. These are even more rare – to the point of being virtually non-existent.

Adding a little to the terminology confusion is the fact is that the vast majority of typical doctors’ offices are private, even though the physicians that work there have not “opted out” of the provincial medical insurance plan – and patients don’t have to pay for publicly insured care.

The Misconception of Public vs. Private Clinics

What do I mean by that? A doctor or group of doctors will create a practice as a private business. They must rent real estate, hire staff, pay utilities and office expenses, install computer systems, contract accountants, etc. like any other private business. The goal is to make a profit for the physician or the group, also like any other business. The fact that many Canadians see such clinics as “public clinics” and not “private clinics” is simply because the majority of their revenue comes from billing the Government under the provincial medical insurance plan. However, virtually all such private clinics supplement their revenue to some extent with services that are not paid for by government, and patients must pay for such services “out of pocket.”

Despite these facts, Canadians hear the term “private clinic” often, usually with the suggestion that such organizations are doing something wrong by Canadian social standards. Rounding out the reasons to be befuddled is that the media (and others) use the term “private clinic” to describe surgical centres and diagnostic imaging facilities as well.

If you’re not completely confused yet, we need to discuss the difference between a “private medical clinic” and a “private healthcare clinic”. The terms “medical” and “healthcare” are often interchanged in our community, but it is generally accepted that a healthcare centre or a healthcare clinic is focused on holistic and preventive care of a person versus the episodic treatment of the symptoms of injury or illness that generally takes place in a medical clinic. Because holistic and preventive care invariably involves private inter-professional services, and often the majority of their revenue comes from those services, they are labelled private healthcare centres or private healthcare clinics. It is more uncommon to hear the term private medical clinic, because a typical medical clinic receives most of its funding from government insured services, as mentioned earlier.

Harrison Healthcare: A Model of Private Healthcare Excellence

Harrison considers itself to be a private healthcare centre using the above rationale alone. It does not charge for insured services, nor does it charge for access to any insured service. The Harrison Healthcare model simply combines the services of publicly funded expert physicians with a complete team of other professionals – all with an unwavering focus on disease prevention and optimal health management. The organization charges an annual services fee that covers the cost of mental health navigators, nurse practitioners, registered nurses, dietitians, exercise physiologists, specialist referral coordinators and others that are not funded by government. The annual fee also covers non-insured administrative services, technology tools, and important 3rd party services. A significant portion of the annual fee can often be offset with private healthcare insurance or employer health benefit programs, so the actual “out of pocket” cost is generally less than the annual fee.

Harrison Healthcare’s Role in the Canadian Healthcare System

Harrison Healthcare is indeed a private healthcare centre by any Canadian definition, minus any suggestion that we exist for any reason but to be an important and meaningful part of the Canadian healthcare landscape. One of the great motivations for us is the heartfelt belief that our service contributes significantly to the long-term sustainability of the Canadian public healthcare system. With our dedicated focus on prevention, we reduce the costs of the most expensive elements of public healthcare, namely specialist referrals, chronic disease management, emergency room visits and hospital stays. Read more here about Harrison Healthcare’s social philosophy.

Harrison Healthcare’s Commitment to Canadian Health

We operate with sincere compassion for all people that truly care about their health. We are very proud of the exceptional outcomes we deliver for our clients, and equally proud of how we work within the existing legislative framework in Canada to be a meaningful force in the continuous improvement of the quality of healthcare in our country. The organization has a 17-year legacy of preventing disease, effectively managing disease (when already present), and optimizing the health and well-being of its clients. It is “healthcare” in every sense of the word. Click here to learn more about our signature program, Premier.

Harrison Healthcare currently serves clients from its three private healthcare centres in Calgary and Vancouver at Burrard St and West Hastings St, with plans to expand to more communities across Canada.

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Locations:

Calgary

: Suite 910 – 517 10th Ave SW

: 403-879-7000

Vancouver (Burrard)

: Suite 500 – 1280 Burrard St

  : 604-753-6000

Vancouver (West Hastings)

: Suite 800 – 900 West Hastings St

: 604-206-8000

All services offered by Harrison Healthcare Inc. are for Canadian residents, and information provided on this site should not be considered solicitation for residents of other countries.

We would like to acknowledge with gratitude that we operate on the traditional, ancestral, and unceded territories of the Musqueam, Squamish, and Tsleil-Waututh Nations in Vancouver, and of the Blackfoot Confederacy (Siksika, Kainai, Piikani), the Tsuut’ina, the Mountain Nakoda Nations, and the Métis Nation (Region 3) in Calgary. With appreciation, we recognize that these lands have been stewarded by them since time immemorial.

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