More than 55, 000 Ontarians have voted to support public health care and stop private clinics. The poll, released Monday, April 7, was conducted over two and a half weeks by the Ontario Health Coalition (OHC) and comes on the heels of a press conference where researchers, including U of T students, identified what they think are critical issues with private health clinics in the province.
In a report to the provincial government, the OHC claimed that many private clinics were billing extra user fees to patients for procedures not medically necessary and thus not covered by OHIP. These findings come in light of the Ontario government’s August 2013 decision to cut certain clinical services from public hospitals and contract them to private clinics. These services include MRIs and CT scans, cataract surgery, as well as endoscopy and colonoscopy surgeries.
The press conference, held on Monday, March 27, featured three of the six student researchers who conducted the study, along with the OHC’s executive director, Natalie Mehra. Ryerson University nursing student Michelle O’Shaughnessy joined University of Toronto global health policy students Ruhi Kiflen and Chelsea Konya at the press conference. In the course of the study student researchers called the 133 private clinics that provide the specific services the government will be shifting over to the private sector. By speaking to these clinics directly about pricing, they found that the vast majority of them used mark-ups, unnecessary add-ons and illegitimate administrative costs that should already be covered by OHIP. Mehra noted that touting “medically unnecessary” treatments as superior was commonplace amongst staff and physicians at these clinics.
Speaking at the conference, Mehra said, “the charging of extra fees is a real danger to single tier medicare in Canada.” She claimed that many of these practices were an explicit violation of the Canada Health Act. She questioned the decision of the government to outsource key medical services. “I don’t understand why you would transfer away from public facilities, which have a whole regime of quality care regulation, to the private realm which has long been suspect for providing sub-standard levels of healthcare” Mehra said.
The report argued that the most egregious violators of health policy were boutique physician clinics, which Mehra described as clinics advertising fast access to 24-hour physicians, extra tests, as well as some medically necessary treatments. Examples included charging a host of $2,595 a year for ‘membership’ to the clinic, in addition to a marked up colonoscopy price of $745.
Kiflen was shocked with how easy it was to come by such information, despite its legal consequences. “Most clinics are willing to speak to people openly about these practices on the phone.” She cites the example of one eye-clinic where staff charged a referral fee that would ensure a patient faster access to cataract surgery.
When asked why a patient consulting private physicians was a problem, Mehra responded that there was an incentive in private facilities to upsell because it is more lucrative. “If a physician tells you an extra test will be more accurate, despite its medical efficacy being unproven, that’s a violation of medical ethics,” she said. The OHC hopes to work closely with the provincial government, and the minister of health in particular to address their concerns with private health clinics.