One payoff has yet to come, though. Motivated by an injection of competition, doctors have found ways to perform certain surgeries far more quickly and cheaply than before. But provincial health bureaucracies have been slow to make similar adjustments to the fees they pay for those procedures.
On a recent Wednesday afternoon, Jane Swarney is relaxing in the recovery room at the Kensington Eye Institute, feeling relieved that the operation to remove a cataract from her right eye went so smoothly.
The retired nurse has worked in hospitals in Toronto, New York and Honolulu. She says her experience at Kensington was "first class," from the staff who patiently told her what to expect to the wood-panelled reception area that looks like a hotel lobby and her comfortable reclining chair that folds back to become an operating room table.
"It was just a non event," she says. "I would gladly come and have this done all over again."
Ms. Swarney was one of 27 patients that Wednesday, a slow day for one of the country's busiest cataract clinics. It has single-handedly made a huge dent in the waiting list for cataract surgery in the Toronto area, where the wait is now 127 days for the surgery, down 60 per cent from 2005.
Kensington is a leader in adapting manufacturing practices to medical care. From its unassuming perch on the sixth floor of a medical building in downtown Toronto's eclectic Kensington Market neighbourhood, the private, not-for-profit clinic is quietly bucking the trend of health-care costs that seem to go nowhere but up.
When Kensington opened its doors in January, 2006, it received $5-million in funding to perform 6,700 cataract surgeries a year. Two years later, the clinic had increased its caseload to 7,200 patients a year with the same budget.
"We did that through operating efficiencies," says Brian McFarlane, chief executive officer of the clinic.
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