Behind the firmly closed doors of an Ontario cabinet meeting, there was probably a dialogue that went something like this:

“More people will die.”

“Okay. Nobody said things would be perfect.”

Things must have been tense as the cabinet grappled with whether to proceed with plans to privatize parts of Ontario’s health-care system despite striking evidence last year by medical researchers at McMaster University that for-profit health care results in substantially higher death rates.

Undeterred by the McMaster findings, the Ontario cabinet decided to push ahead with its privatization scheme, including “public-private partnerships” for hospitals, and private MRI and CAT-scan clinics.

Indeed, with an election expected soon, the government will herald the opening of eight such clinics as key to solving the province’s health-care crunch. Expect enthusiastic media reports featuring people thrilled at having a chance to jump to the front of a surgery lineup by getting a privately paid for MRI at the local mall.

Along these lines, the Globe and Mail recently ran a front-page teaser: “Can private clinics heal more for less?” You bet, according to columnist Margaret Wente. She derided federal health-care commissioner Roy Romanow for insisting medicare is a sacred trust, suggesting he may be “public enemy number one”

Wente and others would have us believe that the private sector is endowed with magical powers that allow it to do more for less.

Even in this post-Enron era, the myth of the superior efficiency of the private sector is still freely bandied about — although, as always, no evidence is provided to back up the claim. Romanow looked high and low for evidence of greater private-sector efficiency in health care, but found none. But then, what would we expect from public enemy number one?

Once we dispense with faith-based convictions about greater private-sector efficiency, we’re left with the real difference between private and public health care: The private model involves a company whose top priority is collecting a handsome profit for itself (presumably that’s the reason it’s in business). To come up with that extra money, it has to cut corners somewhere.

Cutting corners generally has consequences. In a dry-cleaning operation, it might mean more poorly pressed pants; in a fast-food outlet, it might mean soggier fries; in a hospital, it apparently means more dead bodies.

That’s what the McMaster researchers concluded. Examining all medical studies of the U.S. experience, the McMaster team found that profit-making hospitals tended to cut corners by hiring fewer highly skilled staff at lower pay. The result was higher death rates. If Canadian hospitals were profit-making, we could expect 2,200 extra deaths a year, they concluded.

But then, times are tight, right? We may have to lose a few people …

One braces for some sort of ghastly trade-off, something like: More people would die under private health care, but the Ontario treasury would save money (and therefore be able to deliver even bigger tax cuts). One can imagine the grisly calculations: For every extra death caused by private health care, some Bay St. financier would receive a $10,000 tax cut …

But wait. It turns out these nasty trade-offs don’t even apply; there is no trade-off. On the contrary, privatization is likely to cause more deaths AND cost more money. We’re not talking trade-off; we’re talking lose-lose.

Well, not everyone loses. Private companies — including many American ones — would finally gain a shot at our multi-billion dollar health-care pie.

Of course, there are limits. Canadians won’t tolerate what the companies really want — full-blown, U.S.-style private hospitals. But compromises that chip away at the edges of our medicare system, like private MRI clinics and “public-private partnerships” (P3s), are next best.

Under P3 deals — four are currently underway — a private corporation builds a hospital and leases it long-term to the government. When the lease is up, the corporation owns the hospital. It’s a partnership, you see. We pay; they profit.

I’m sure it’s not relevant but I’ll just mention in passing that the companies bidding on health-care contracts have made major donations to Conservative political campaigns.

To mention just a couple, Canadian Medical Laboratories, which recently won contracts for three MRI clinics, donated $10,000 to Premier Ernie Eves’ leadership campaign last year. KMH Cardiology, which will operate two clinics, gave $11,000 to Health Minister Tony Clement’s leadership bid.

Back to the cabinet meeting.

“Come on, guys, let’s not forget how good these companies have been to us …”

At this point, I guess we can assume the Premier interrupted and reminded those around the table that their duty is to protect the public.

Or something like that.

Linda McQuaig

Journalist and best-selling author Linda McQuaig has developed a reputation for challenging the establishment. As a reporter for The Globe and Mail, she won a National Newspaper Award in 1989...