LETTER: New Brunswickers oppose moves towards private delivery of health care

Editor’s note: This letter by long-time public health care advocate Jean-Claude Basque and signed by almost 100 people was sent to Premier Blaine Higgs and all Members of the New Brunswick Legislative Assembly on October 21, 2022. Days later, on October 26, the government of New Brunswick introduced legislation to allow Medicare to pay for more surgeries and medical procedures outside hospitals.

Dear Premier Blaine Higgs,

We are very concerned, as we are convinced you also are, about the ongoing situation in our public health care system. We will not list the various challenges it faces, as you, as Premier, are surely as familiar with them as we are. However, we would like to stress our deep concern about the government’s tendency to turn more and more to the private or non-profit sectors to solve the present difficulties of our public system.

As you know, the government has already subcontracted to Medavie Blue Cross, the full management of certain health services (Ambulance New Brunswick, the New Brunswick Extra Mural Program, Tele-Care-811). Recently, it has concluded very costly contracts with private companies, including the virtual care company, eVisitNB, and the Acadie-Bathurst Ophthalmology Centre.

The announcements of these agreements by the government and the Health Authority have made much of the fact that we will not have to pay out of pocket for these services and will be able to use our Medicare card. You may ask then why we oppose such arrangements; let us list the reasons.

Loss of control: By turning to private or non-profit companies to deliver health services, we lose control of our public health system. We lose control over the direction we want the system to take, the staff, the infrastructure, the equipment, the technology, the dollars invested, etc. Increasingly turning to the private sector means that in fact we are creating a two-tier system.

Accountability: The public health system needs to be accountable to the MLAs, and to the Legislature. That way we can all know what is going on and have a say. When we give management or pay private companies for health care services, we lose access to the information altogether because they claim confidentiality and protection of their business interests to deny us access. Non-profit companies are not accountable to the public, but to their boards of directors, and they too make claims of confidentiality.

Competition: Private and non-profit companies need staff (doctors, nurses, technicians, managers, trainers, etc.). As you know, there is currently a significant shortage of staff in the public system. In order to operate, the private system must then “steal” employees from our public system, reducing its ability to deliver services to the entire population. The private sector focuses on the more profitable services (cataract, virtual care, etc.) and leaves the more expensive (cancer, dialysis, mental illness, etc.) but essential services to the public system.

Costs: The purpose of private companies is to make money. They need to recoup their capital costs for renting or buying space, for equipment, for attracting staff with better salaries than the public system and, most importantly, to make a profit. These additional costs are included in the contracts granted by government. These services cost us more than if they were provided by our public system. This money is being diverted from the public sector to enrich private investors. As for not-for-profit companies, while the motivation is not profit per se, executive compensation and benefits are major drivers; they are far from being altruistic enterprises.

Accessibility in the regions: Private and not-for-profit companies are locating in areas of high population density, i.e. Moncton, Fredericton, Saint John. Increased private arrangements will reduce services in the regions and will result in additional travel and accommodation costs for rural populations.

Services in one’s own language: Access to services in the official language of choice will be compromised. Privatization of health care undermines language rights and will force citizens to fight in court for vested rights.

Quality of service: In our public health care system, we have quality standards that must be followed by all and are monitored. Unless we drop quality standards, transferring to the private sector will require the establishment of a monitoring system and therefore will result in an additional cost to the taxpayers.

Large corporations: When we increasingly outsource the management or delivery of health care services, we create the ideal conditions for concentration in large corporations. The best example is Medavie/Blue Cross which manages AmbulanceNB, the Extra-Mural Hospital, Tele-Care-811, and the New Brunswick Drug Program. These large for-profit and not-for-profit corporations are then well positioned to decide the direction of our health care system. They have the staff, the expertise, the money to lobby our public decision-makers, to advertise and to influence future directions that will serve their private interests rather than the common good.

Loss of support: Our public system is expensive, but it is accessible to everyone, regardless of their ability to pay. To maintain and improve it, ongoing public support is needed. Increased privatization undermines public support for our public system and sets the stage for its collapse.

Mr. Higgs, before the 1960s, we had a private health care system; we got rid of it because much of the population did not have access to it. We are convinced that you agree with us and do not want to go back to those times.

Please accept our best regards.

Signatories

Chantal Abord-Hugon, Moncton
Greg Allain, Dieppe
Anne-Marie Arseneault, Moncton
Samuel Arseneault, Moncton
Maurice Aubé, Ste-Rosette
Alex Bailey, Fredericton
Albertine Basque, Tracadie
Jean-Claude Basque, Moncton
Ron Batt, Moncton
Jean- Luc Bélanger, Dieppe
Steve Berube, Riverview
Léo Blanchard, Moncton
Denis Boulet, Haut-Madawaska
George Bourgeois, Grande-Digue
Hélène Branch, Moncton
Alphonse Breault, Tracadie
Roland Brideau, Moncton
Fernande Cantin, Dieppe
Daniel Caron, Dieppe
Louis Caron, Campbellton
Michele Caron, Dieppe
Leslie Chandler, Moncton

Hilaire Chiasson, Balmoral
Jules Chiasson, Moncton
Omer Chouinard, Moncton
Auréa Cormier, Moncton
Hector Cormier, Moncton
Irma Cormier, Bathurst
Monique Cormier-Daigle, Moncton
Pierre Cormier, Dieppe
Denise Cyr, Tracadie
Alain Deneault, Shippagan
Jean-Eudes Doucet, Pointe-Verte
Suzanne Doucet, Moncton
Suzanne Doucet, Balmoral
Rhéal Drisdelle, Dieppe
Yolande Drisdelle, Dieppe
Thérèse Duguay, Tracadie
Lise Éthier, Moncton
Liliane Ferguson, Dieppe
Lise Gagné-Losier-Tracadie
Marie-Gabrielle Gagnon, Fredericton
Pauline Gallant, St-Louis de Kent
Huberte Gautreau, Moncton
Julie Gilet, Moncton

Yvette Godin, Dieppe
Dirk Groenenberg, Rusagonis
Louise Guérette, Edmundston
Rose-Marie Haché, Moncton
Léoline Hétu, Dieppe
Nicolas Kalgora, Moncton
Sarah Kardask, Sackville
Bernadette Landry, Dieppe
Georgette Landry, Moncton
Romain Landry, Dieppe
Serge Landry, Moncton
Nicole Lang, Edmundston
Jeanne Lanteigne, Pointe-Verte
Marcelle Lanteigne, St-Sauveur
Lucienne Lanteigne, Moncton
Rose-Hélene Lanteigne, Ste-Rosette
Brigitte Lavoie, Moncton
George Leaman, Riverview
Gladys LeBlanc, Dieppe
Armand LeBlanc, Dieppe
Simone Leblanc-Rainville, Moncton
Claude Léger, Shediac
Daniel Légère, Memramcook
Raymond Léger, Bertrand
Ginette LeGresley, Bathurst
Claire Levesque, Campbellton
Julien Massicotte, Edmundston
Yvon McGraw, Pointe à Tom
Robert McKay, Moncton
Rosella Melanson, Fredericton

Jean-Marie Nadeau, Moncton
Simon Ouellette, Fredericton
Jean Pereira, Grande-Digue
Johanne Perron, Dieppe
Serge Plourde, Allardville
Denise Boucher Pineault, Moncton
Rachelle Poirier, Shédiac
Susie Proulx-Daigle, Fredericton
Maurice Rainville, Moncton
Jeanne Renault Moncton
Noëlla Richard, Dieppe
Rosemonde Richard, Losier Settlement
Lise Savoie, Moncton
Marc H. Savoie, Moncton
Marie-Thérese Séguin, Moncton
Louis-Marie Simard, Cocagne
Claude Snow, Caraquet
Gérard Snow, Moncton
Alice Thériault, Moncton
Paul Thériault, Dieppe
David P. Thomas, Sackville
Odetta Vienneau, Pointe à Tom
Christopher Wanamaker, Saint John
Elizabeth Weir, Saint John