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A major problem in Canada's $192-billion health-care system is accessibility: many patients face long queues and live in doctor-starved areas. Despite talk about patient-centred care, the system revolves around those who provide, not receive, treatment. But that's what you get when you have a monopoly.

The Canadian Medical Association's recent report, "Voices into Action," sought the public's view. While the vast majority favoured a publicly-funded system, they also described it as fractured, failing and needing change. One idea floated by a small minority was to have the public and private sectors work together to create a better, more efficient system.

It should not be confused with a parallel, private system. By allowing the private sector to bid on publicly-funded medical services, fresh blood could be injected into an anemic system. Today, patients are seen as a fiscal drain. With the private sector, they may very well be treated as customers deserving of excellent service.

There have been past attempts. Don Mills Surgical Unit Ltd., a private hospital in north Toronto, offered in 2007 to do knee replacements for $5,800 each – $1,082 less than community hospitals were paid per operation at the time. The pitch was rejected by the Ontario government, in a politically safe but economically baffling move. (The private hospital is one of three that was allowed to continue operations in Ontario after public health care was introduced.)

Concerns about private sector involvement include the impact on quality when large, for-profit corporations – as opposed to private, not-for-profits – move in. But those are issues to be managed, not reasons to reject private involvement. The key is ensuring the private sector faces the same regulations and high quality standards as public hospitals.

Jeff Turnbull, president of the CMA, says it's an idea worthy of further study and exploration; the dialogue will be considered by delegates attending the association meeting later this month.

"Right now is not a time for rhetoric," says Dr. Turnbull. "It's a time to be creative and courageous and stand up for a strong, publicly-funded health-care system."

It may also be a high time for a little competition.