Powerful lobby group seizes on change in cancer drug approval system to push for introduction of potentially broad system of user fees
Toronto (7 August 2006) - Several powerful medical groups are pushing for a change in OHIP (the Ontario Hospital Insurance Plan) that could lead to significant user fees being introduced to provincial hospitals, says the Ontario Public Service Employees Union (OPSEU/NUPGE).
"When you go to the hospital for medical treatment, you may be asked for your OHIP card, but never your VISA or MasterCard," OPSEU president Leah Casselman says in an open letter to the editor. "Even drugs administered in the hospital have been covered under the Medicare system – up until now."
However, this may change if a working group of three powerful organizations get their way. The members include the Ontario Hospital Association, the Cancer Care Ontario and the Council of Academic Teaching Hospitals of Ontario.
These organizations are recommending that Ontario hospitals be permitted to administer non-funded intravenous cancer drugs and that the patient be charged for both the cost of the drugs and the visit.
"They have even suggested ballpark fees such as $250 per visit for basic infusions, a flat annual fee of $2,500 for more complex cases. Those fees don’t include the cost of the drugs, which could be an additional $20,000," Casselman warns.
'Wedge to introduce other user fees'
She says door to this initiative by the working group was opened by "an unheralded change to the way cancer drugs are approved for public coverage."
"Last year the Liberals quietly changed the criteria from one of determining whether or not a drug had any medical benefit, to one of whether the benefit outweighed the cost. To that end, they placed an economist and a medical ethicist on the panel to help make these decisions," she notes.
"Now that cost has crept into the decision-making process, this could be the wedge to introduce other user-fees in the hospitals, especially when these proposed fees extend to associated health services."
Casselman says the lobby organizations hafve a legal opinion suggesting that the changes would not violate existing law. They also claim there is "an exodus of patients" to a private Toronto clinic and to U.S. hospitals, "but provide no statistics to back this up," she adds.
"The Canada Health Act is quite clear in its definition of insured hospital services, including 'drugs, biologicals and related preparations when administered in the hospital'," Casselman says.
"While the working group may seem to think there is wiggle room on whether or not these treatments fit the definition of 'medically necessary' under the Act, they may find themselves at odds with many of Ontario’s oncologists over the issue," she argues.
"Released on a Friday in July, no doubt the working committee is hoping this will be quietly adopted. Given its implications, Ontarians should take note and urge the Health Minister to leave this report on the shelf. If these treatments are medically necessary, cancer patients should expect the province to pay these bills and uphold the provisions of the Canada Health Act." NUPGE
Lobby pushing for VISA and MasterCard in Ontario hospitals - pdf