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Ottawa is not enforcing the Canada Health Act, report says

Ontario Health Coalition says public health care being undermined by private for-profit clinics

Ottawa (7 Oct. 2008) - The federal government has failed to enforce Canada Health Act requirements for equal access to hospital care by turning a blind eye over the past five years to the activities of private for-profit medical clinics, says the Ontario Health Coalition (OHC).

In a report released Monday, the group says it investigated 130 for-profit surgical, MRI/CT and "boutique" clinics that sell access to doctors and health professionals across Canada for thousands of dollars per patient per year.

It found evidence to suspect that 89 clinics in five provinces may have violated requirements by openly selling medically necessary services and double-billing both patients and governments for services. The list included 41 operations in Quebec, 29 in B.C., 11 in Ontario, seven in Alberta and one in Nova Scotia.

"For-profit clinics are also taking specialists, health professionals and operating room nurses out of local public hospitals to serve less urgent patients, often for extra fees," says Natalie Mehra, director of the Ontario Health Coalition.

"Despite claims about reducing wait times, we found direct evidence that poaching staff out of local hospitals by for-profit clinics worsened shortages in local hospitals, forcing the hospitals to reduce MRI hours."

Make it an election issue

Mehra said the private clinics are eroding fairness and equality in a public health system designed to provide access to hospital and physician services based on need, not wealth.

"A significant proportion of for-profit surgical and diagnostic clinics are billing provincial health plans and also charging extra fees to patients to maximize their revenues and profits,” she said.

“The charges are unaffordable for all but the wealthiest Canadians. Clinics told us they charge $13,000 - $20,000 or more for knee surgery, $1,200 - $2,000 or more for cataract surgery, and hundreds to thousands of dollars for MRIs.”

The report found that for-profit clinics overwhelmingly locate in large urban centres where there are more wealthy people to buy health procedures, raising concerns about worsening access in rural areas.

Abdicating responsibility

“This report should serve as a wake up call and a call to action. The federal government has all but abdicated its responsibility to uphold the fairness and equality of our public health system,” Mehra concluded.

“It is required, by law, to ensure that patients are not exploited by extra-billing or two-tier health care. In turn, our provincial governments have failed to set up adequate regulatory and enforcement regimes to protect patients. The evidence is clear that the for-profit health care industry is undermining equal and fair access to health care for all Canadians by taking resources out of the public health system, by selling two-tier access and by levying extra charges on patients," she said.

"We should use the next two weeks leading into the federal election (Oct. 14) in particular, to ensure that each of the federal party leaders promise to take concrete action to halt two-tier health care and improve access for all Canadians, not just the wealthy. We should require our provincial governments to improve access in our local public hospitals and clinics, and to ensure improved access to care is equitable and based on medical need, not high income as is evidenced in the for-profit clinics.”

Health Coalitions

The report was authored by Natalie Mehra of the Ontario Health Coalition. It was supported by the Canadian Health Coalition (CHC) and a number of provincial health coalitions. The National Union of Public and General Employees (NUPGE) is a member of the CHC and a supporter of the OHC. NUPGE

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