Doctors oppose Saskatchewan's pay-per-use MRI proposal

“These systems always promise to provide faster health care service. But the reality is longer wait times for patients, more cost, and little or no benefit for most Canadians,” said Dr. Monika Dutt, Chair of Canadian Doctors for Medicare.

Ottawa (17 Oct. 2014)—Canadian Doctors for Medicare (CDM) is urging the Saskatchewan government not to introduce pay-per-use Magnetic resonance imaging (MRI) services. CDM is a national body supported by the National Union of Public and General Employees and is one of Canada's best advocates for high-quality, equitable, and sustainable health system built on the best available evidence.

The Premier of Saskatchewan, Brad Wall, is considering introducing a pay-per-use MRI service where patients can pay for priority treatment and move ahead of the queue. This service would signify step away from universal, publicly funded health care in Saskatchewan. The pay-per-use model could also mean longer waits for many, as this style of pay-for-care service has been shown time and again to increase wait times for the majority of patients.

Copying a tried-and-failed policy?

While Premier Wall is looking to Alberta as an example, the Government of Alberta has moved away from the policy at great cost. Alberta was forced to repay patients for medically necessary MRI scans that were found to be in contravention of the Canada Health Act, and moved virtually all MRI and CT services back into the public system. 

Alberta has since built public MRI capacity and cracked down on the practice of extra-billing. The government of Saskatchewan should look to other provinces and learn from their experience in exploring this decision.

“The evidence is quite clear, when parallel for-profit health services are introduced, the result is greater wait times and growing inequities within the public system. In these systems the patients in greatest need wait longer while those who can afford it pay to receive priority treatment,” said Dr. Ryan Meili, Executive Vice-Chair of Canadian Doctors for Medicare. “There are better solutions to wait times, and they involve strengthening Medicare, not undermining it.”

Costs would increase and harm public system

Wall claims pay-per-use MRIs would free up space in the queue, but evidence shows that parallel private health care systems fragment service, over-treat affluent patients, and drain public health resources, making care less efficient and increasing wait times across the board.

“Saskatchewan should look to Nova Scotia, which rejected a private imaging proposal in September,” said Dr. Monika Dutt, chair of CDM. Public scrutiny of the Nova Scotia plan showed that, under the private plan, costs for imaging would increase dramatically. “These systems always promise to provide faster health care service. But the reality is longer wait times for patients, more cost, and little or no benefit for most Canadians,” said Dr. Dutt.

Discriminates against rural communities

Nationwide research on private diagnostics in 2008 and 2014 showed that, without exception, private MRI and CT clinics are located only in the largest cities in each province. People in smaller communities, in rural areas and even in medium-sized towns never get access to the promised benefits of private care. These parallel systems drain staff and resources from public care, and drain the confidence of Canadians that health care will be there when they need it.

CDM thinks that Premier Wall should show leadership in improving access to, and appropriate use, of imaging within the public system, that’s the kind of innovation Canadians need and want.


The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 340,000 members. Our mission is to improve the lives of working families and to build a stronger Canada by ensuring our common wealth is used for the common good. NUPGE

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