(Ottawa) Ottawa wants wealthier patients to stop having better access to the health care system by paying for online medical consultations or virtual care and is threatening recalcitrant provinces to cut the amounts paid to them.
“In cases where patients are charged for these services, I will be obliged, in accordance with the Act, to reduce federal health transfers by an equivalent amount”, writes the Minister of Health, Jean-Yves Duclos, to his provincial and territorial counterparts in letters he sent to them on Thursday.
In his letters, the minister says he is “concerned” about a recent spike in reported cases and says improvements in the way health care is delivered should not be used as a “pretext” to authorize charges “that would otherwise have been covered if they had been provided in person by a doctor”.
“Whether provided in person or virtually, it is essential that access to medically necessary services remains free and continues to be based on medical need,” he insists.
PHOTO PATRICK DOYLE, REUTERS ARCHIVES
Jean-Yves Duclos
Mr. Duclos believes that the situation must be “examined and resolved” and that he intends to “clarify this point” in a letter interpreting the Canada Health Act to ensure that the evolution of the system is true to its spirit and intent.
The Canadian health care system is based on “common principles” — notably its public and universal nature — to which the federal government is “firmly committed” and “the respect of which […] has always been linked to federal payments under the Canada Health Transfer,” added the Minister.
The popular Maple platform offers, for example, virtual consultations with a general practitioner licensed to practice in Canada for $69 or up to 30 times a year with a plan billed at $30 monthly.
Benefit plans also offer private telemedicine services. In some cases, patients pay the costs directly and then are reimbursed by their group insurance.
When he arrived at Cabinet on Thursday, Mr. Duclos explained that the provision of care has always been partly private and will remain so, but that in terms of payment “it is absolutely out of the question” that Canadians have to take out “their credit card”.
From words to deeds
The last letter of interpretation dates back to 2018. It related to diagnostic services, such as ultrasounds, magnetic resonance imaging (MRIs) and CT scans, for which patients had to pay money.
This situation is “unacceptable and […] will not be tolerated,” said Minister Duclos in a written statement released Friday.
As a result, he reveals that Ottawa will deduct what it estimates Canadians have paid out of pocket “to access insured health services that should be free” from health transfers for 2020-21, the first year the policy is in effect.
In total, Ottawa intends to cut 76 million from the sums paid to the provinces and territories in the coming weeks, the minister’s office told The Canadian Press. Quebec will suffer the greatest impact with a $41 million reduction.
By way of comparison, Ottawa pays the provinces and territories for the year in question $41.9 billion under the Canada health transfer. This is therefore a reduction of 0.2%.
For the past few years, Ottawa has been refunding deductions to provinces and territories that correct course and stop violating the Canada Health Act.
NDP support
A federal source denied that Friday’s outing to the provinces is meant to send a message to the NDP to help convince them that the Liberals are good partners just weeks before the federal budget is tabled.
In recent months, the use of the private sector in health care, particularly in Ontario, has made the New Democrats cringe a lot with whom the Liberals, who lead a minority government, have an agreement “of support and confidence in order to stay in power.
The leader of the New Democratic Party (NDP), Jagmeet Singh, has also said that he sees that Prime Minister Justin Trudeau visibly considers the private sector as an “innovative solution” to solve the problems and accused him of doing an “about-face”. from its past positions.
Ontario Premier Doug Ford’s Progressive Conservative government announced in January the transfer of some procedures to publicly funded private facilities in a bid to reduce a growing wait list for surgeries, which worsened during the COVID-19 pandemic.
Provinces such as Quebec, Alberta and Saskatchewan have already adopted similar measures to reduce their waiting lists and unclog hospital operating rooms, particularly for cataract, hip and knee surgeries.