Science

For-profit clinics double-billing: report

The federal government has failed to enforce the Canada Health Act's requirements for equal access to hospital care, instead allowing more for-profit medical clinics over the last five years, the Ontario Health Coalition said in a report released Monday.

The federal government has failed to enforce the Canada Health Act's requirements for equal access to hospital care, instead allowing more for-profit medical clinics over the last five years, the Canadian Health Coalition said in a report released Monday.

The health lobby group said it investigated 130 for-profit surgical, MRI/CT and "boutique" clinics across Canada that sell access to doctors and health professionals for thousands of dollars per patient per year. 

Eroding Public Medicare report, Canadian Health Coalition (in .pdf format)

 

The report's authors said they found evidence to suspect 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 suspected violations were in:

  • Nova Scotia - 1
  • Alberta - 7
  • B.C.  - 29
  • Ontario - 11
  • Quebec - 41

"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," said report author 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."

At a news conference in St. John's on Monday, Kathleen Connors, national chair of the Canadian Health Coalition, called the research groundbreaking. The coalition held similar events across the country to highlight dozens of clinics it said are undercutting medicare, and to urge parties to make health care a priority in the federal election campaign. 

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"The report is the first of its kind, and has taken some 13 months to compile," said Connors, a retired nurse and former New Democratic Party candidate.

"Researchers set out to find all the for-profit diagnostic, surgical and boutique-type physician clinics across the country, to see how they work and how they're affecting the cost and access to public health care in this country," she said.

"We've heard increasing reports of companies selling the ability to jump the queue, to move patients up in accessing services without penalty … and, in fact, the report validates what we're hearing out there."

In Ontario and Manitoba, for-profit cancer and cataract surgery clinics gave evidence of higher costs per treatment than non-profit clinics, the report said, noting Quebec, New Brunswick, Nova Scotia, Saskatchewan and British Columbia are considering more for-profit privatization.

But governments of varying political stripes in Alberta, Ontario and Manitoba have rolled back for-profit MRI/CT clinics or surgical clinics and have instead boosted capacity in the public, non-profit health system, the report said.

The for-profit clinics told the group that they charge $13,000 to $20,000 or more for knee surgery and $1,200 to $2,000 for cataract surgery.

Dr. Robert Ouellet, president of the Canadian Medical Association, has said he doesn't see privatization as a step backward.

"I'm a doctor for medicare," Oullet said. "We're in favour of a universal system, but if the private sector could help, that's fine."