Private medical clinics are offering COVID-19 tests to Canadians willing to pay a fee to circumvent lengthy lineups at government sites and long waits for results from laboratories.
The for-profit clinics serve individual patients as well as companies that require employees to test negative for the coronavirus before returning to work. Individuals pay anywhere from $50 to $250 for a test.
Critics say the clinics open the door to two-tier health care that prioritizes treatment based on a person’s ability to pay over need, upending the very foundation of Canada’s publicly funded system.
Canadians' basic health needs are covered by their provinces under the country’s single-payer system. But private clinics allow people to pay their way to the front of the line, said Danyaal Raza, a family doctor at St. Michael’s Hospital in Toronto and chair of Canadian Doctors for Medicare, which advocates for universal, publicly funded health care.
“This is absolutely jumping the queue in a time of crisis,” Dr. Raza said in an interview. “It’s unconscionable.”
The coronavirus has hit low-income and racialized people the hardest in Ontario, Dr. Raza added. “The cruel, cruel irony of those tests is that those are the people who will not be tested by these services.”
The private clinics are expanding across Canada as coronavirus ramps back up in the country’s two largest provinces and demand for testing outstrips the capacity of laboratories.
Ontario’s lab network, where all test samples from the province’s 153 COVID-19 assessment centres are sent, had just less than 79,000 samples in the queue waiting to be tested on Saturday, more than it is capable of processing in a day.
Executives of the private clinics say they are not draining resources from the public health care system, noting they use commercial labs to process their tests.
Dilian Stoyanov, chief executive officer of Switch Health Holdings Inc., said he is taking some of the burden off the public system by making the test available to individuals and employers. Switch employs more than 100 medical staff, including registered nurses. It operates four clinics in the Greater Toronto Area and this week plans to add locations in Halifax, Montreal, Ottawa, Calgary and Vancouver.
“We cannot hire fast enough,” Mr. Stoyanov said. “There is a lot of demand.”
Switch charges individuals $160 for a COVID-19 test. Most people can get a same-day appointment and their results in 24 to 48 hours. Mr. Stoyanov said his goal is to get the price below $100.
“We are trying to work as hard as we can with our supply chain partners to make these as affordable as possible,” he said. “It keeps me up at night.”
At Care and Family Health in Toronto, patients can get a COVID-19 screen by paying $50 for a single visit to the clinic or $200 for an annual health package.
The clinic was doing about 50 tests a day until 10 days ago, when it ran out of swabs, CEO Alon Birshtein said.
“The volume of COVID testing has grown over the past couple of months, especially as the lineups and wait times grew at public testing centres,” he said in an interview.
Mr. Birshtein said he is waiting for a new shipment of swabs from Ontario Health, the agency that oversees the delivery of health care.
According to an e-mail response to The Globe and Mail on Sunday evening, the provincial government has told Ontario Health not to provide swabs to clinics that charge patients for the test and is looking at further action to ensure the practice is discontinued.
“It has been brought to our attention that some providers are asking patients to pay in order to receive a COVID-19 test,” Alexandra Hilkene, a spokeswoman for Health Minister Christine Elliott, said in the e-mail. “This is not permitted.”
In Alberta, Ichor Blood Services, a private mobile lab company, is doing both serology testing, which uses blood samples to detect virus antibodies, as well as COVID-19 tests. The company does about 500 tests a week in Calgary and Edmonton and plans to expand to other cities in the province. It uses a private lab in Alberta to process the tests.
Ichor charges individuals $120 for COVID-19 tests in Alberta, company president Mike Kuzmickas said. He also offers the COVID-19 test in Ontario, but the price is $250 because the swabs are shipped to a lab in the United States for processing.
“People will say we are pandemic profiteering,” Mr. Kuzmickas said in an interview. “The reality is we are making a small margin to provide the service.”
The private sector has a role to play, he said, because the public system should not bear the cost of testing every person. For example, he said, his company recently tested a teenager who was sidelined from playing hockey because of a runny nose.
“Do you want that spot in line [at a government site] to go to someone who needs a waiver to get back on the ice?” he asked.
Alberta Health Services is not responsible for testing “completed outside of the publicly funded health system,” spokesman James Wood said in an e-mail response to The Globe. The government does not provide swabs to private clinics that charge for testing.
The Ontario government has announced a series of changes to testing rules as it tries to clear the backlog of tests. Beginning this week, the province’s assessment centres will switch to an appointment only model, and no longer accept walk-ins as of Sunday. Children with symptoms do not need to get tested to return to schools and daycare centres.
Caroline McIsaac, a Toronto mother of four-year-old twins who waited in line four hours last weekend for one of her children to get tested, said fee-based testing is not the answer to the backlog.
“This is a public-health emergency and all people should have equal access to testing,” she said in an interview.
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