Ontario passes health reform, expands publicly-funded-private-delivery of medical treatment

The move is part of the government's plan to decrease wait times and reduce a massive backlog of surgeries, more than 200,000 procedures.

Ontario passes health reform, expands publicly-funded-private-delivery of medical treatment
The Canadian Press / Adrian Wyld
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To the chagrin of opposition parties, experts and medical professionals, Ontario has passed meaningful reform to permit publicly funded surgeries and procedures in private clinics.

On Monday, Premier Doug Ford passed Bill 60, the Your Health Act, which permits for-profit and not-for-profit clinics to conduct several surgeries, scans and other procedures under the Ontario Health Insurance Plan (OHIP). It articulates that a private clinic cannot prevent patients from paying with their OHIP card.

The move is part of the government's plan to decrease wait times and reduce a massive backlog of surgeries, more than 200,000 procedures.

"Today is a sad day, a day that will go down in the history of our province as the day that the Ford government delivered a fatal blow to working treasured Medicare," NDP health critic France Gélinas told reporters Monday.

Gélinas said the Tories did not accept one of the 74 amendments presented by the Official Opposition. "Today, this Conservative government will say goodbye to care based on needs and come on to investors who want to make money off the backs of sick people."

The Ontario Tories will work to expand these publicly-funded services in private clinics to include hip and knee replacement surgeries. The province already allows cataract surgeries and diagnostic imaging and testing in private clinics.

According to SecondStreet.org, Ontario Health data revealed a 24% increase in surgical waiting list deaths over the past four years. Information obtained from them also shows an increase of over 400% in waiting list deaths for CT and MRI scans since 2015/16.

"People should not have to wait for months for a diagnosis, and if necessary, surgeries," Health Minister Sylvia Jones told reporters on February 21.

SecondStreet.org submitted a freedom of information access request revealing Ontario Health cancelled 1,417 procedures in 2021/22 due to patient death. Of those who died, 42% waited for cataract surgery, while 12% waited for hip and knee replacement surgeries.

Approximately 900 private clinics operate across the province, though most only perform diagnostic imaging and testing. 

"Mortality is impacted by many complex and interrelated clinical, socioeconomic, and cultural factors," wrote Ontario Health. "The surgical statistics do not indicate the procedures were intended to be life-saving, nor that patients passed away due to an extended waitlist for a surgical procedure."

"Except for the province of Nova Scotia, provincial governments and their respective health bodies do not break down the number of patient deaths potentially linked to the state taking too long to provide needed services," said SecondStreet.org president Colin Craig.

"Oddly, governments across Canada routinely require businesses to detail even the most minor workplace injuries, such as accidents where employees are bruised as a result," he added. "If businesses must track this, why can't the government tell us how many patients are dying due to long waiting lists?"

Regardless, the NDP repeatedly claimed Bill 60 promotes a two-tiered system that allows patients to "jump to the front of the line." The Ontario Health Coalition added the bill fails to counter "manipulative upselling" at private clinics.

"Before they brought in the legislation, Doug Ford said that they had guardrails, and they will be protecting against all sorts of things," said Natalie Mehra, executive director of the Ontario Health Coalition.

The coalition said patients have had to pay out of pocket for procedures they said should be covered entirely through their OHIP. They noted some incurred the costs of eye measurements and invoiced for contrast dye needed for imaging.

Mehra warned of possible legal action against the province over Bill 60, as they intend to file a formal complaint over the legislation. "If you think you're going to set up shop here and charge OHIP and patients on top, you have another thing coming," she said.

The Ontario Nurses' Association urged the province to invest in hospitals. In contrast, the Ontario Medical Association proposed offloading the surgical backlog to private clinics acting like non-profits.

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