Federal NDP leader Jagmeet Singh has warned that privatization is creeping into the public health system.
recently, Ontario Premier Doug Ford He announced that he wanted to give privately owned for-profit clinics a bigger role. These facilities are private sector operated clinics that receive public funding from the Ontario Health Insurance Program (OHIP) and provide medically necessary procedures.
But Singh said he fears the trend of using public funds to fund surgeries in private clinics will take resources away from the public system.
He said the federal government should take advantage of the Canadian Health Act (CHA). It has important powers to challenge commercial privatized care, he said.
“And it should be used more regularly and more aggressively to protect public health,” Singh told reporters at the Capitol on Monday.
But what exactly does CHA do, how will it be used, and is it a credible tool for those opposed to healthcare privatization to stop the trend? increase.
What is the Canadian Health Act?
After being unanimously passed by the House of Representatives, the Health Canada Act of 1984 established standards to ensure “reasonable access to health care services without financial or other barriers.”
This meant that Canadians could access medically necessary services without being charged directly. According to the law, all such services are covered by state or territory health insurance plans.
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It also established a number of medical access-related conditions that provinces and territories must meet in order to receive transfer payments from the federal government, known as Canada’s Health Insurance Plan (CHT). One of these conditions stipulated that patients could not be charged additional fees for medically necessary services, also known as “additional charges.”
What are the restrictions on private medicine?
Mr Singh said he hopes the government will use CHA to challenge commercial care. But Colleen Flood, director of the Center for Health Law, Policy and Ethics at the University of Ottawa and chair of the university’s research committee, said there are no restrictions on private deliveries within the public health system.
“Therefore, Ford’s proposed private, for-profit clinic is perfectly fine under the Canadian Health Act,” she said.
According to the federal government website, the CHA does not prohibit private companies from providing medical services unless residents are billed for insurance services.
“In fact, many aspects of Canadian health care are provided privately. Family doctors almost always bill provincial or territory health care plans as private contractors. Often incorporated into private foundations, many aspects of hospital care (laboratory services, housekeeping and linens) are private,” the website says.
“Finally, many states and territories have private facilities contracted to provide services under public health insurance plans.”
According to Flood, it is the CHA’s finances that are subject to restrictions that prevent patients from charging out-of-pocket for medically necessary hospital and doctor services.
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“What is medically required and how those rules are fixed is determined state by state.”
No state or territory completely prevents a two-tier system. She’s just trying to whet the doctor’s appetite, she says.
“Almost every state has a rule that says, ‘Look, if you want to charge the public system, you should only charge the public system. If you want to opt out, opt out.’.'”
Backus Barua, director of health policy research at the Fraser Institute, said one of the problems with CHA is that the terms it imposes are “very vague,” creating a risk-averse environment for health policy. said that.
“Because of that risk aversion, many states have actually exceeded what the CHA expressly requires and cannot be erroneously influenced by federal interpretation,” he said. .
“We have not seen the kind of policy experimentation that has been proven elsewhere to work in most other universal health care systems.”
What if a state or territory breaks the law?
As CHA Statewhen a hospital or doctor charges for medically necessary services, the federal government will deduct $1 from the state or territory annual subsidy or CHT for each $1 of the assessed value of the so-called additional charge. It is
Has the federal government ever pursued state violations?
Prime Minister Justin Trudeau responded to Singh’s concerns about CHA enforcement on Monday, saying his government will continue to defend the Canadian Health Act and will be able to get money back from provinces that violate it.
“In the past, this government has collected funds from states that have not respected it. We will continue to do so.”
According to the Health Canada Act Annual Report 2020-2021, provincial and territory health insurance plans, in most cases, meet Health Canada requirements. However, there have been some instances where the federal government has said it had to withhold funds.
$4,521 was deducted from March 2021 CHT payments to Newfoundland and Labrador for claims at private eye clinics. Both New Brunswick and Ontario were charged about $65,000 and $14,000, respectively, in fees at private abortion clinics.
According to the report, the largest offender was British Columbia, which filed financial statements for additional charges and user fees for the 2018-2019 fiscal year, amounting to approximately $14 million. A similar deduction was made from her March 2021 CHT payment in British Columbia. (The federal government has granted refunds to states in recognition of its refund action plan).
The state has become the center of Court battle waged by private health care advocate Dr. Brian DayThe owner of Vancouver’s Cambie Surgical Center, he argues that patients should be entitled to pay for services when waiting times in the public system are too long.
But Dr. Michael Lacriss, a public health physician and adjunct professor at the University of Toronto’s Dalarna School of Public Health, said in most cases the federal government violated the ban on additional charges against states and territories. He said he was not investigating. Medically Necessary Services.
“The way the law is enforced is not like there are federal inspectors,” he said. “States have been asked to investigate themselves. There is no real coercion mechanism. “
Rachlis also said he believes Canada has many private clinics that charge for Medicare-covered and upselling services. Globe and Mail 2017 survey Work done by the Ontario Health Coalition.
‘The federal government is doing nothing’