Simon Fraser University, Burnaby, British Columbia, Canada.
The University of British Columbia, Vancouver, British Columbia, Canada.
Healthc Manage Forum. 2023 Sep;36(5):293-298. doi: 10.1177/08404704231182260. Epub 2023 Jul 27.
Ensuring access to primary care is a persistent challenge in Canada, and the COVID-19 pandemic exacerbated existing gaps. Public policy reform that only partially addresses these access issues, technological opportunities, workforce desires, or patient preferences creates an opportunity for private, investor-owned corporations to take ownership of primary care delivery systems. This article summarizes the history of the "public-private" conversation as it pertains to primary care, with a particular focus on investor-owned corporations. We outline how profit-driven, corporate healthcare impacts equitable access to care, increases spending on low-value services, and undermines the underlying values of Canadian healthcare systems. All of healthcare delivery requires rapid regulation and oversight by policy-makers, which would increase transparency of corporate care. There also must be parallel efforts placed on addressing the long-standing issues in publicly funded delivery of primary care that created the space for corporate care to grow.
确保初级保健的可及性是加拿大面临的一个持续挑战,而 COVID-19 大流行加剧了现有差距。公共政策改革仅部分解决了这些获取问题,技术机会、劳动力需求或患者偏好为私营、投资者所有的公司提供了机会,使其可以拥有初级保健服务系统。本文总结了与初级保健相关的“公私对话”的历史,特别关注投资者所有的公司。我们概述了以利润为导向的、公司主导的医疗保健如何影响公平获得医疗保健的机会,增加了对低价值服务的支出,并破坏了加拿大医疗保健系统的基本价值观。所有医疗保健服务都需要政策制定者迅速进行监管和监督,这将提高公司护理的透明度。还必须同时努力解决公共资金提供初级保健方面长期存在的问题,为公司护理的发展创造空间。