Evidence from Denmark shows that mixed public-private practice doesn’t reduce hours in public hospitals and increases overall care time
MONTREAL — The Alberta government’s leaked plan to allow doctors to work in both the public and private health systems would be a win for patients struggling to access care, lauds the Montreal Economic Institute (MEI).
“It is well documented that in countries where doctors have the option of practising in both the public and private sectors, patients have better access,” said Emmanuelle B. Faubert, economist at the MEI. “The Alberta government’s draft proposal is welcome news for patients who have struggled to get treatment within the government monopoly system.”
News reports on Nov. 18 revealed a leaked draft plan from Premier Danielle Smith’s government that would introduce a hybrid system allowing physicians to work simultaneously in both sectors. Current regulations prohibit this dual practice, forcing physicians to choose one system over the other.
Under the proposed framework, “flexibly participating physicians” would be permitted to offer services under both the public system and privately for a fee, without having to notify the government in advance.
“The Danish model is a success that should and is being replicated,” said Faubert. “Alberta is taking inspiration from European countries that once faced similar access problems and chose to open the system to mixed practice.”
Faubert cited evidence from Denmark showing no significant difference in the number of hours worked in public hospitals between doctors in mixed practice and those working solely in the public system. In fact, doctors engaged in dual practice added hours in the private sector without reducing their public commitments.
Canada ranks seventh out of 10 countries studied by the Commonwealth Fund in terms of access to care. The six countries ahead of Canada all have universal health systems that allow fully private medical practice alongside public provision.
“The Alberta government understands that universal and government run are not synonymous,” said Faubert. “Successes abroad demonstrate this, and we are glad Alberta is prepared to take an evidence-based approach to addressing the chronic wait times facing patients.”
Emmanuelle B. Faubert is available for interviews and commentary on health system reform, mixed practice models and international comparisons in health care access. Commentaries.
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About the Montreal Economic Institute
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, 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.
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