The Bell Media cuts are mirrored in healthcare

Both Prime Minister Trudeau and BC Premier David Eby have been highly critical of the recent decision from Bell Media (BCE) to cut 4,800 jobs and shut down numerous local media outlets. Over the past 10 years, the federal government has allowed BCE to acquire numerous local news and radio stations. Federal Heritage Minister Pascale St-Onge had this to say on the cuts:

"… when acquisitions were allowed for those big companies… it came with the promise that they would deliver on news content. And today, they are backing [away] from that promise."

BCE is claiming that when those outlets were acquired, the market was different and the government has been “too slow to react to the changing media landscape” and is “taking too long to provide relief for media companies.”

It’s apparent that BCE has made some regrettable business decisions over the past decade and wants the fed to provide ‘relief’, which clearly sounds like yet another corporate bailout.

Over the past decade, something similar has been unfolding in healthcare, specifically in the medical records software market. In this case, Telus has bought up about half of the medical records market (via 14 acquisitions), and is systematically shutting down each company by migrating customers onto a single platform. And very much like with BCE, the federal government is passively allowing this.

To be clear, I don’t agree that BCE is evil or a ‘corporate vampire.’ Large corporations are filled with honest, hard-working Canadians. But the sole purpose of a publicly-traded company is to generate wealth for its shareholders. We therefore cannot ask corporations to be both profitable and to ‘do the right thing’, because to them the ‘right thing’ will always be to act in the interest of shareholders. It is the responsibility of the federal government to alter corporate incentives through legislation to make sure corporate behaviour aligns more closely with the public interest than it would in a laissez-faire, deregulated market.

The situation with BCE is eerily reminiscent of Conrad Black acquiring newspaper outlets in the ‘90s. Buy up market share, shut down the less profitable businesses, and leave customers with fewer choices. This isn’t always a bad thing. However, when large corporations start using this playbook on entities viewed as public assets, such as news outlets or healthcare organizations, it’s a problem.

I find it quite performative for local and federal governments to allow market consolidation to occur, and then turn around and try to shame corporations when they behave exactly how they were designed and encouraged to. Corporations will always present their takeover decisions in a way which makes it easy for government officials to approve of acquisitions. The truth is that they are very seldom acting in the best interests of the Canadian public over and above their own sets of priorities.

By the time Canadian physicians begin raising alarm bells because they have no choices left for business-critical EMR software and are potentially locked in to paying exorbitant software fees, it will be too late to act or do anything about it, much as we see this week with Bell Media. Our government must be proactive here.

Most Canadian physicians can clearly see what’s happening in the electronic medical records (EMR) market; the similarities with Bell Media’s recent decision shouldn’t be ignored. As with with Bell Media, EMR vendors are shutting down small companies and leaving physicians with fewer choices.

It’s already too late to prevent consolidation in the EMR market. However, the federal government still has time to prevent a bad outcome. They must create a non-profit organization and fund a technology initiative to allow physicians to easily move their data onto any platform. This will allow smaller, innovative EMR companies to grow and prevent 2 or 3 organizations from achieving total market dominance. The question is, will our government act now to protect our healthcare system, or will tomorrow’s government simply give EMR companies a finger wag and a “shame-on-you” once changing course is no longer possible?


This piece is a follow-up to an earlier opinion piece that first appeared on Canada Healthwatch on Feb 1, 2024.