I suppose it depends on your priorities but public healthcare isn't necessarily best served by "improved efficiency" as much as by the delivery of quality health care. If improved efficiency doesn't result in the latter - or indeed compromised delivery of the latter - then it's foolishness personified.
If the goal is the provision of quality health care, perhaps less "introducing fear" and more listening to doctors and nurses and other health care providers is a better path? At this point in time, 650,000 Albertans don't even have a GP - the earliest and most efficient point in delivering quality health care. That's only going to get worse as Alberta experiences national and internation migration numbers at the fastest rate the province has ever had and none of them bring their own doctors or nursed or emergency rooms or hospitals with them...
You aren't wrong about quality being important, I have no argument against that. But quality can be efficient too. Getting the diagnosis right the first time saves time for medical staff and patients/users alike.
Freeing the system of people/users that didn't need to be there in the first place helps medical staff provide better quality treatment to those that really need it.
And you're very spot on about the impact of Canada's record immigration and TFWs on these services too, the medical system is getting crushed along with much of Canada's other services and infrastructure.
Competitive hospital operators isn't the only solution to that of course, I think there needs to be increased focus on encouraging healthier lifestyle among people, so they don't need as much medical attention.
I'm also of the belief that Canada's "free" healthcare has given some people the impression that it can and should be used for anything, no matter how minor.
I've been fortunate enough to not have to deal with hospitals on a regular basis, and haven't since well before COVID, but there's no need for people with medicenter-tier issues to be clogging up an ER waiting room.
What's the solution there? Maybe it's token user fees to access hospitals directly. I'm also hopeful that the AI era may be helpful in helping take some initial diagnosis load off of more senior medical personnel too.
One thing is certain though, Canada's record population growth has meant there's really no time to mess around with finding solutions!