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TORONTO — Ottawa and the provinces have abdicated their responsibility to ensure that health care remains universally accessible and publicly funded, allowing the country to slide into U.S.-style private health care, said a report released Monday by health-care lobby groups.
At least 130 for-profit surgical, CT and MRI, and “boutique” clinics are operating across the country, states the report, entitled “Eroding Public Medicare: Lessons and Consequences of For-Profit Health Care Across Canada.”
Researchers found almost 90 cases of suspected violations of the Canada Health Act, said author Natalie Mehra, director of the Ontario Health Coalition.
“The federal government has essentially abdicated its responsibility to enforce the Canada Health Act and protect patients against extra billing and two-tier health care,” said Ms. Mehra. “And no provincial government has set up adequate regulatory and enforcement regimes to fulfill their requirements to protect patients in their provinces.”
There were numerous instances of for-profit clinics billing not only patients but the government as well, and also “openly” selling medically necessary services to people who will pay to “jump the queue,” Ms. Mehra said.
The researchers say they found clinics that required patients to pay for treatments and consultations on top of what was publicly covered.
For-profit clinics also sap desperately needed staff from the public system, leading to longer wait times at public facilities but faster service for those who can pay, the report said.
But a “decline” into an American-style system isn't inevitable, the report states, citing examples where governments have clamped down on for-profit clinics.
Dr. Danielle Martin, chair of Canadian Doctors for Medicare, said doctors across the country are concerned that for-profit clinics can result in inappropriate care.
There are instances of “co-mingling” services, said Dr. Martin who cited a case where a patient who required a colonoscopy was referred by a hospital doctor to his private clinic.
The colonoscopy is covered under Ontario's health plan, but the patient found out after arriving at the clinic that she would also have to consult a dietician prior to the procedure.
The dietician was not covered and cost the woman $400.
“Along with physician colleagues across the country, I'm profoundly concerned with the emergence of these private, for-profit clinics across the country, in terms of their effect on patients and their effect on the public health-care system,” Dr. Martin said.
For-profit clinics also pose the risk of having investors or companies interfere in the practice — ordering unnecessary procedures, for example, she added.
“We hear stories about that kind of interference all the time from our colleagues in the United States,” Dr. Martin said.
“We want to know that qualified health-care providers in partnership with their patients are making decisions about what kind of care the person needs, not an investor or a shareholder whose primary concern is profit.”
