Jagmeet Singh says the Canada Health Act can be used to challenge private health care. Can it? News Jani

Jagmeet Singh says Canada’s Health Care Act can be used to challenge private health care. It can?

National leader of the NDP, Jagmeet Singh, sounds the alarm about the privatization of the public health system.

Recently, Ontario Premier Doug Ford announced that he would like to take on a larger role in privately run for-profit clinics. These facilities are privately owned clinics that receive public funding from the Ontario Health Insurance Plan (OHIP) to perform medically necessary procedures.

But Singh says he fears the trend towards using public money to fund procedures at private clinics will drain resources from the public system.

He said the federal government must use the Canada Health Act (CHA), which he says has significant powers to challenge privatized care for profit.

“And it should be used more regularly and aggressively to protect public health services,” Singh told reporters on Parliament Hill on Monday.

But what exactly does CHA do, how is it used, and is it a tool that opponents of healthcare privatization can count on to stop this trend? CBC News explains:

What is the Canadian Healthcare Act?

The Canada Health Act, enacted in 1984 after being passed unanimously by the House of Commons, set standards to ensure “reasonable access to health services without financial or other barriers”.

This meant Canadians could access medically necessary services without being billed directly for those services. According to the law, all such services are covered by the provincial or territorial health insurance plan.

Look, Singh accuses Trudeau of being flipped in healthcare:

Singh accuses Trudeau of “flipping” on Ontario’s healthcare privatization

During the first Question Time of the year, NDP Chair Jagmeet Singh called Ontario’s recent health initiatives under Prime Minister Justin Trudeau “innovation”.

It also established a set of health care access conditions that provinces and territories must meet to receive transfer payments from the federal government, known as the Canada Health Transfer (CHT). One of those conditions was that patients were not allowed to be charged additional fees for medically necessary services, also known as “excess billing.”

What restrictions apply to private healthcare?

Singh said he wants the government to use the CHA to challenge for-profit care. But there are no restrictions on private care within the public health system, said Colleen Flood, director of the Center for Health Law, Policy and Ethics and graduate research chair at the University of Ottawa.

“So what Ford has proposed with private, for-profit clinics is perfectly fine under Canadian health care law.”

According to the federal government’s website, the CHA does not prohibit the provision of healthcare services by private companies as long as residents are not billed for the insured services.

“In fact, many aspects of healthcare in Canada are privately provided. GPs often serve as private contractors for provincial or territorial health care plans. household and clothing. ) will be conducted privately,” the website says.

“Finally, in many provinces and territories, private institutions are contracted to provide services under public health insurance.”

Flood said it is the finance side of the CHA that puts restrictions on what patients can pay out of pocket for medically necessary hospital and doctor services.

look The Ford government unveiled plans to reduce surgical waiting lists:

Increasing the number of surgeries available at Ontario for-profit clinics

Ontario is significantly expanding the number and range of medical procedures performed in privately owned clinics. Premier Doug Ford says the move is necessary to improve wait times for surgeries.

“What is medically necessary and how those laws are determined is determined by the province.”

He said no province or territory would stop the two-tier system entirely – they would just try to make it less demanding on doctors.

“Almost all provinces have this rule that says, ‘Look, if you want to account for the public system, you just need to account for the public system. If you want to opt out, log out.’.”

Bacchus Barwa, director of health policy studies at the Fraser Institute, said one problem with the CHA is that the conditions it imposes are “remarkably vague,” which poses health policy risks. Create an environment that avoids.

“Because of this risk aversion, many provinces are actually going beyond what is specifically required by the CHA to avoid being inadvertently biased by federal government interpretation,” he said.

“We don’t see any experience with policies that have been proven elsewhere, mainly in other global health systems.”

What happens if a province or territory breaks the law?

As the CHA notes, when hospitals and physicians charge for medically necessary services, the federal government must account for so-called additional billings for every dollar from the provincial or territory annual grant or CHT.

Does the federal government stand behind the federal states in the event of a violation?

Prime Minister Justin Trudeau responded to Singh’s concerns about the implementation of the CHA, saying Monday his government will continue to defend the Canada Health Act and can recover money from provinces that violate it. Is.

“In the past, this government has drained funds from provinces that they have not respected. We will continue to do so.”

Federal NDP leader Jagmeet Singh says he fears more provinces will start using public money to fund procedures in private clinics and take resources out of the public system. He urges the federal government to use the Canada Health Act to curb the trend. (Adrian Wild/The Canadian Press)

According to the Canada Health Act Annual Report 2020-2021, provincial and territorial health insurance plans largely meet the requirements of the Canada Health Act. But there were also cases where the federal government said it had to withhold funds.

$4,521 was deducted from CHT payments in March 2021 to Newfoundland and Labrador for fees at a private eye clinic. Private abortion clinics in New Brunswick and Ontario were fined $65,000 and nearly $14,000, respectively, for the charges.

According to the report, British Columbia was the top violator, producing fiscal 2018-2019 financial statements with approximately $14 million in additional billing and user fees. The same amount was deducted from British Columbia’s CHT payments in March 2021. (The federal government reimbursed the province in recognition of its reimbursement action plan).

This was at the center of a lawsuit brought by private health advocate Dr. Brian Day, owner of Cambie Surgery Center in Vancouver, who argues that patients should have the right to pay for services when there is a long wait in public. Should. The system is very long.

But dr Michael Rachels, a public health physician and associate professor at the University of Toronto’s Delaware School of Public Health, says the federal government has largely imposed restrictions on provinces to violate the overbilling ban. Or is not behind areas. Medically Necessary Services.

“The way the law is enforced — it’s not like there are federal inspectors,” he said. “Provinces are asked to conduct their own investigations. There is no real enforcement mechanism.”

Rachlis also believes there are many private clinics across Canada that charge for Medicare-covered services or upsell services, citing a 2017 study by the Globe and Mail and work by the Ontario Health Coalition.

“And the federal authorities are doing nothing.”