According to an article in The Trillium (Queen’s Park Newspaper) today, “As millions of Ontarians struggle to find family doctors, private-pay clinics are having somewhat of a heyday.” We can no long labour under the illusion that we don’t have two-tier health care in this province.
“Executive Health” clinics charge patients for access to family doctors. Those who join these clinics are not left standing at the emergency room door waiting for primary care like so many of their fellow citizens. In a province where thousands of people cannot get a family doctor, some of our fellow Ontarians are paying for special attention. So how did we get here, you might ask? Many people wonder whatever happened to Medicare…and the Canada Health Act. That legislation, based on the principles of public administration, comprehensiveness, universality, portability, and accessibility should guarantee that everyone has a fair chance to access health care. All for one and one for all and nobody gets to jump the queue. But is that really the case?
This article asserts that not all executive clinics operate outside the Canada Health Act. An example given is the Executive Health Centre in Toronto which charges only for services not covered by OHIP such as diagnostics and nutrition advice. But then there are the others. It appears there is serious concern about unequal access to health care in executive clinics. Trillium staff members phoned clinics such as Medcan, MDDirect, Exec Health in Ottawa, and the Cleveland Clinic in Toronto. All clinics were accepting new patients. Wouldn’t residents in hard-hit rural Ontario love to hear that news! Accepting new patients, yes, but the trick is they will only accept patients with money…patients who can afford to pay several thousand dollars annually for deluxe health care. In a province crippled with inflationary prices for basics like food and housing, that leaves the working and middle classes standing at the door.
What do they get for their membership fee? Well, your list of entitlements might include appointments with a personal trainer, a physiotherapist, a chiropodist, a nutritionist, or a masseuse. But you also are guaranteed access to a family physician. MDDirect, for example, charges $5,000 for access to a personal family physician on a 24/7 basis. The payment of the fee is necessary in order to access the doctor’s services. In rural areas particularly hard hit by the privatization agenda of the government, ERs are often closed. Many operate on a permanent part time basis. Query why this is happening and you will be told it is the result of staffing shortages…they can’t get enough qualified staff to operate the facility safely. We used to have staff: where have they all gone? Many left because of unfair labour practices since declared unconstitutional by the courts. Other doctors, nurses and other health care professionals have been siphoned off from the public system into private clinics and services like Agency Nursing. So, a vicious cycle continues. People cannot get full time health care in the public system and if they also cannot pay exorbitant fees for boutique style medicine, they simply lose out.
The government allows this to happen. Committed to pretty well two tier everything, they simply allow what we used to call “American style medicine” to proliferate in this province. Remember the days when Canadians could say they were pleased that they didn’t have the USA’s medical system to deal with. We talked about people losing their homes due to crippling medical bills. Thank goodness we didn’t have that worry…well now we do. This week the Ontario Health Coalition is releasing a report about the activities of private health care clinics in this province. Well worth the read, the report is based on case studies and surveys completed by people who have been disadvantaged by practices such as upselling and overcharging for medically necessary procedures. Cataract surgeries are often the focus of this injustice but there are more examples coming forward about hip and knee replacements as well. Again, where is the government on this issue? Where is the protection people need?
The other three major political parties have all called for an end to this madness. When financial inequities determine the level and quality of the health care you receive, can we truly consider this a functioning democracy? Whatever happened to all for one and one for all?
Brenda Scott
Co-Chair Grey Bruce Health Coalition