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RELEASE: Ford’s Cut to OHIP+: Clarifying What It Means for Patients, Businesses and Employees

Posted: July 4, 2018

July 4, 2018

Ford’s Cut to OHIP+: Clarifying What It Means for Patients, Businesses and Employees

Toronto –Assumptions being made regarding the Ford government’s cut to OHIP+ coverage should be carefully checked, said the Ontario Health Coalition, noting that the government’s press release expressly did not say that all extra costs for those cut off the public drug coverage plan would be covered. The government’s release states only that patients will have to seek reimbursement for drug costs from their private insurer first, then any “eligible” costs (eligible is not defined anywhere) could be billed to OHIP+.

Yesterday, the Health Coalition raised the concern that those people cut off of OHIP+ by Ford’s announcement will face deductibles and co-payments that can, for those with severely ill children, run to hundreds of dollars per month. This is a very real concern and so far the Ford government has not addressed it.

If some of these costs were to be covered — which the government has not committed to do — according to the government’s release, patients would have to try to seek payment from one insurance company first, then wait to get payment, then try to see what if any costs are eligible for coverage under OHIP+ and seek payment for those. In future budgets, the government could, as has happened with drug benefits for seniors, increase the co pays and user fees and decrease eligibility. This would be more difficult for a government to do with a clean and clear universal plan with full coverage. Since the new government issued the media release announcing the cut 24-hours after taking office and before there is even contact information publicly available for the new Ministers, the public will have to rely upon the media to ask the pertinent questions.

“As we noted yesterday, all the key details regarding this announcement are missing,” said Natalie Mehra, executive director. “If any user fees required by private drug plans are covered – and we must be clear that to date there has been no commitment from the Ford government to cover them – then people would face a double layer of bureaucracy to try to get these costs covered. Families with the sickest kids are hit the hardest. This is a real problem and the Ford government should be required to answer for it.”

The bureaucracy required by a system of this sort is significant and will eat into any “savings” that the cut to coverage would create. Furthermore, these are not true savings as the costs must be picked up by businesses and individuals paying for private drug plans.

“The reason that the universal public single-tier health care system is the most efficient, with the least administrative costs, is that it cuts out middle-men like private insurance companies and their profit taking. Also, the public system is run on a non-profit basis without all the bureaucracy – and costs — involved in marketing, determining eligibility, billing patients, collection of unpaid bills, etc.,” noted Ms. Mehra. “What the Ford government is planning is not only a cut and a move backwards from the progress our province just made towards a public drug plan for all, it also sounds like a bureaucratic nightmare for patients with sick children.”

The Coalition reiterated its call for the Ford government to rethink this policy and restore normal democratic public consultation processes for policy changes impacting the health of Ontarians.

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