medicare in Canada

Medical care in Canada is widely praised, and is indeed excellent, especially compared to the costly medical care system of its southern neighbour. Slowly and illegally, though, in some provinces the system is becoming less universal. If this trend continues, access to basic health care in Canada will depend more and more on price (ability to pay) rather than need.

Dr Ryan Meili, a Saskatchewan physician, appeals for the federal government to restore the universality of medicare by enforcing existing legislation (the Canada Health Act).

Extra-billing in Ontario, private MRIs in Saskatchewan and user fees in Quebec: violations of the Canada Health Act are on the rise across the country. Canadian doctors are concerned about the impact of this trend not only on their patients, but on our public health care system as well.

…. Provinces that are not in compliance [with the conditions for payment under the Canada Health Act] are to be penalized with a reduced Canada Health Transfer (CHT) payment.

This year’s report showed that in 2014-15, the only province that received such a penalty was British Columbia. Their CHT payment was docked $241,637 ….

In Ontario alone, the frequency of such charges has grown at an alarming rate …. [I]ndependent health facilities (e.g. eye surgery, colonoscopy, diagnostic and executive health clinics) charged extra fees for medical consultations, examinations, diagnostic testing and other manners of “upgraded services.” These fees are for services that are covered by the health system. This is otherwise known as extra-billing, a practice that is against federal and provincial law.

Despite these contraventions, … Ontario has never been penalized. ….

User fees, access charges, extra billing all come down to the same thing — inequitable access to Canadian health care.

Charging patients at the point of care for medically necessary services strikes at the heart of the principle that access to health care should be based on need rather than ability to pay. It undermines equity, increases system costs and reduces public commitment to universal coverage. ….

It is time … to ensure medicare will be there for all Canadians in their time of need.

Ryan Meili, “It’s Time For The Federal Government To Enforce The Canada Health Act“, The Blog, Huffington Post, 4 April 2016.

Dr Meili (born 1975) is a family physician. He teaches at the University of Saskatchewan’s College of Medicine, where he heads its Division of Social Accountability.

HT Chris Willmore.


One Response to “medicare in Canada”

  1. Christopher Maule says:

    I think if you ask patients you will discover that level of service is a prime promoter of the private part of the Canadian healthcare system. Patients are willing to pay for timely service by not having to wait for too long a time. For this reason I had a hernia operation in NY state a few years ago six months before I would have had it in Ottawa. Jeffrey Simpson writes that there are unused operating theatres in Ontario with surgeons ready to operate but a nurse or bed shortage prevents their use.

    All healthcare systems are a combination of public and private, the U.K. being one example. In Ontario, dental and some drugs are not covered by the government scheme. I think if you query patients and not certain doctors you will get a more complete analysis of what the issues are. Unfortunately excellent is not a term I would use to describe the Canadian health care system.