(April 7, 2016 ) \u00a0Author: \u00a0 0 Comments, \u00a0Orangevill Citizen<\/b><\/p>\n
AMONG THE MANY CHALLENGES faced by the new federal government, few will be as tough as those involved in protecting and improving our health-care system in the face of an aging population and a weak economy.<\/p>\n
From time to time we hear horror stories about the Ontario Health Insurance Plan\u2019s refusal to cover some costly, life-preserving medications or complex surgeries performed in the United States.<\/p>\n
But this week we received a thoughtful opinion piece from a Saskatchewan doctor about the need for the Trudeau Liberals to do something about provincial governments that he says have been violating the Canada Health Act, the legislation that requires the provinces to provide universal access to health care in return for annual grants from the federal government.<\/p>\n
Ryan Meili, vice-chair of Canadian Doctors for Medicare, cites extra-billing in Ontario, private MRIs in Saskatchewan and user fees in Quebec as among violations of the Canada Health Act that are on the rise across the country.<\/p>\n
Under the Act, provinces not in compliance with its terms are supposed to have their federal grants reduced, but Health Canada\u2019s latest annual report on compliance showed that in 2014-15 the only penalized province was British Columbia, and its grant was cut only $241,637, \u201cabout half the amount in extra billing a 2012 audit found was committed just by Dr. Brian Day\u2019s Cambie Surgery Centre in Vancouver in just one month.\u201d<\/p>\n
Dr. Meili says physicians and clinics \u201chave quietly been charging extra fees for health services for many years, yet calls for the federal government to enforce the act have been ignored. Coming down hard on extra-billing may not sound as exciting as announcing new funding for specialized medical services, but it is the job of provincial and federal health ministers to protect the Canada Health Act and guarantee equitable access to health care.\u201d<\/p>\n
He says that in Ontario, the frequency of such charges has grown at an alarming rate, yet it seems to have escaped the notice of provincial and federal auditors and health ministers. \u201cThe Ontario Health Coalition (OHC) published a report in 2014 listing dozens of instances where independent health facilities (e.g. eye surgery, colonoscopy, diagnostic and executive health clinics) charged extra fees for medical consultations, examinations, diagnostic testing and other \u2018upgraded services.\u2019 These fees are for services covered by the health system. This is otherwise known as extra-billing, which is against federal and provincial law.<\/p>\n
\u201cBut despite these contraventions, Canada Health Act reports show that Ontario has never been penalized.\u201d<\/p>\n
Dr. Meili says the OHC report \u201ccan be the springboard for federal Health Minister Jane Philpott to assert her government\u2019s commitment to defending medicare, Canada\u2019s most treasured social program.\u201d<\/p>\n
Saying the investigation should include actions or non-actions by the Saskatchewan and Quebec governments, he singled out Saskatchewan\u2019s introduction in November of \u201cpay-per-use MRI services, allowing those who can pay to jump the queue and receive priority treatment,\u201d and Quebec\u2019s allowing doctors to charge extra fees for some services already insured under public medicare.<\/p>\n
He says the Quebec government included provisions for extra billing in response to pressure from the Quebec College of Physicians.<\/p>\n
\u201cBreaches of the act have never been addressed in Quebec,\u201d he said, adding: \u201cUser fees, access charges and extra billing all come down to one thing \u2013 inequitable access to Canadian health care.<\/p>\n
\u201cCharging patients at the point of care for medically necessary services strikes at the heart of the principle that access to health care should be based on need rather than ability to pay. It undermines equity, increases system costs and reduces commitment to universal coverage.\u201d<\/p>\n
Noting Prime Minster Justin Trudeau\u2019s promise of \u201creal change,\u201d he said Dr. Philpott, \u201can acclaimed physician, should take a new approach to defending health care by sending a strong statement that the provinces must adhere to the Act.\u201d<\/p>\n
We most certainly agree.<\/p>\n