Wednesday, June 02, 2010

On competitive destruction

Leftdog has already discussed the Wall government's inexplicable determination to privatize the delivery of CT services in Regina - and my previous posts on other privatization efforts also cover some of the problems with the latest move, particularly given Don McMorris' eagerness to jump at every possible "opportunity" to push delivery into private hands. But let's note an extra issue with the CT scan plan in particular.

Here's the supposed rationale for putting public resources into private CT scan delivery:
The region currently has two CT scanners at Regina General Hospital and one at Pasqua Hospital that are running at maximum capacity doing 75,000 scans a year.

If one new CT scanner is added to the region, it will be able to provide 10,000 more scans, officials with the Regina-Qu'Appelle Health Region said.
But those estimates come with an important "all else being equal". And there's reason to think that for a privatized form of service delivery in particular, that assumption won't hold up.

After all, in order to operate a new scanner, a private firm will naturally need to recruit staff with the technical expertise required for the job. And the most obvious source of trained local staff will be...the Regina-Qu'Appelle Health Region. Which will presumably lose the ability to operate its scanners at full capacity if enough of its staff decide to leave - and will have no control over who gets poached by a private operator.

As a result, the resources used by a private firm to operate a scanner will all too likely be cannibalized from RQHR, resulting in little actual increase in capacity. And the private firm will have no incentive whatsoever to avoid damaging RQHR's ability to deliver services; in fact, its long-term interests will be best served by forcing the region to rely on it more and more.

In contrast, another scanner operated by RQHR in a new location would allow for the region to determine where its staff are best used, moving over only those health care professionals needed to get a new scanner up and running - with the end result that the capacity from the new machine would actually be added to the region's existing capacity. But in the Sask Party's haste to sell off everything it can, it apparently isn't even looking at that option.

In sum, the Sask Party's excuse about wanting to build capacity only highlights the futility of privatization as a strategy to deal with the areas of Saskatchewan's health care system that can stand to be improved. And if the Wall government is indeed in a rush to privatize as much as it can over the next year and a half, that should make for all the more reason to ensure it isn't in a position to keep up the damage at the end of 2011.

(Edit: fixed wording.)

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