‘This is not acceptable’: Federal government fires off warning to provinces over private health-care creep

The federal government is notifying the provinces and territories that Ottawa is keeping a close eye on the growing creep of for-profit health care in this country.

Health Minister Jean-Yves Duclos sent warnings to provinces Thursday, alerting them to potential clawbacks in federal health transfer payments should patients keep paying out of pocket for medically necessary care.

“I am very concerned with the recent increase in reports of patient charges for medically necessary services,” Duclos wrote in letters sent to provincial and territorial health ministers.

“It is critical that access to medically necessary services, whether provided in-person or virtually, remains based on medical need and free of charge.”

The warning comes at a time when private companies, including those that offer virtual care, are increasingly filling gaps in a strained health-care system struggling to recover from the years-long pandemic.

Among the federal government’s main concerns is virtual health-care companies charging patients to see a physician or nurse practitioner, according to a senior government official who spoke to the Star.

“We believe this is going against the Canada Health Act,” the official said, adding that the federal government is not against virtual care. “We believe that patients should not have to pay money out of their pocket for that.”

In a statement released Friday morning, Duclos also pointed to evidence of patients paying for medically necessary care, including diagnostic imaging, saying such services “should be accessible at no cost.”

“This is not acceptable and will not be tolerated,” Duclos said.

In a February interview with the Star, Duclos hinted he would be tackling breaches of the Canada Health Act following the completion of the federal health transfer deals.

He told the Star’s Althia Raj that situations involving Canadians paying for virtual health-care services and people travelling to other provinces and paying for faster access to medically necessary surgeries were “loopholes” and of “great concern.”

Duclos also said that health professionals charging for medically necessary services through expanded scopes of practice was another example of how for-profit care is creeping into the public system.

“Now, that’s not all right, this is something which we are very mindful of and will be acting on in the near future,” Duclos said at the time.

In letters to provincial health ministers, Duclos acknowledged the benefits to improvements in health care, including virtual care, telemedicine and health professionals drawing on expanded scopes of practice. But he added that these advances have also “resulted in the emergence of new patient charges to access medically necessary care that would otherwise be covered if provided in-person by a physician.”

Duclos noted that he plans to clarify new terms for virtual health services in a separate Canada Health Act interpretation letter. He said this will take place in collaboration with provincial and territorial health ministers.

He said that as the health-care system “continues to evolve” governments must ensure “it remains true to the spirit and intent of the Canada Health Act.”

“No matter where in the country Canadians live or how they receive medically necessary care, they must be able to access these services without having to pay out of pocket,” Duclos said.

Megan Ogilvie is a Toronto-based health reporter for the Star. Follow her on Twitter: @megan_ogilvie or reach her via email: [email protected]


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