When things are going smoothly, you can count on privatized public services to be open, making a profit. But when trouble arises, reliability drops. And that leads to longer wait times and fewer services for all.
Sleep patients in southwest Ontario are learning this difficult lesson right now.
The publicly funded but privately owned and managed KCL Sleep Clinics closed abruptly earlier this month, leaving thousands of patients without care and unsure about how to obtain their health records or recent test results.
"We have written to the licensee seeking the status of any sleep study interpretations recently conducted, and have also requested that the licensee identify an individual with contact information for the ministry to obtain patient records if required," Ministry of Health and Long Term Care spokesperson David Jensen wrote in an email to CBC.
"The ministry is awaiting a response from the licensee."
An almost certain consequence of the shut-down will be increased wait-times for everybody with sleep problems in southwest Ontario.
"We've been very busy even before St. Thomas closed," Dr. Charles George of the LHSC clinic told CBC.
"I don't know how many patients that (London) clinic looked after. If they looked after as many as we did, that would become an issue."
Wait times are also one of the consequences of the sudden shut-down of a chronically unreliable long-term care facility north of North Bay.
Care at the Lady Isabelle Nursing Home in Trout Creek had become so bad that the provincial government was forced to revoke its licence in July.
Last year, a provincial inspector wrote that "there is a risk of harm to the health or well-being of residents of the home or persons who might be admitted as residents,” at Lady Isabelle.
With the licence revoked, the 66 residents are now in the process of finding new homes. But with a province-wide shortage of long-term care beds, MPP France Gélinas tells CBC that we'll all end up feeling the consequences.
"Our net of last resort, the net that catches us all when a part of our system fails is our hospital," Gélinas said.
"So those people will end up being and staying in our hospital causing all of the other problems that our hospitals are facing ... Overcrowding and the long delays and the canceled surgeries."