As health system crumbles, Ottawa working to ensure Canadians watch it crumble together
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The Trudeau government tightened the screws last week on Canadians’ ability to buy health-care services in the private sector. It appears they’re just getting warmed up.
The federal Liberals made good last week on their 2018 pledge to punish provinces that allow people to pay directly for diagnostic services, such as MRIs and CT scans. Federal Health Minister Jean-Yves Duclos announced Friday his government is clawing back $82 million in health-care funding from seven provinces, mostly for allowing private clinics to charge people for the scans — a cardinal sin under Canada’s government monopoly medicare system.
Manitoba was fined $353,827, although no details were released about what type of diagnostic services were sold privately, or who’s been providing them. When asked this week, the province refused to divulge any information, saying only that it plans to look into the matter.
It appears this is just the beginning of the Liberal government’s quest to prevent people from paying directly for “medically necessary” procedures, a loosely defined term that means different things in different provinces.
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Patients should not pay for virtual care: Duclos
Duclos said government plans to crack down on provinces that allow physicians to bill patients directly for online consultation services.
Virtual care grew during the COVID-19 pandemic. However, provincial governments are now loath to pay for the service. That has opened the door for some physicians to charge patients directly for it. Ottawa wants to end that, saying it creates inequities in society, since not everyone can afford to pay for online consultations.
“Universal, accessible and publicly funded health care is a point of pride for Canadians and protecting it is a priority for our government,” said Duclos. “Collectively we have made the choice to leave no one behind and deny no one necessary care, regardless of their ability to pay.”
To achieve that, no one should be allowed to pay out-of-pocket for any medically necessary service, said Duclos, even if that means languishing for months or years in pain and discomfort on a government wait list.
If Canadians have to suffer, they all have to suffer together — another point of national pride, evidently. There should be no safety valves for anyone outside the single-payer system.
JUSTIN TANG / CANADIAN PRESS FILES “Universal, accessible and publicly funded health care is a point of pride for Canadians and protecting it is a priority for our government,” said Health Minister Jean-Yves Duclos. 
That’s not just a Liberal government mantra, it’s the position of all major political parties in Canada. Even the freedom-fighting federal Conservatives and their leader Pierre Poilievre, who has vowed to get rid of all government “gatekeepers,” won’t challenge Canada’s holy grail single-payer system.
The next target for the federal Liberals: those who pay out-of-pocket for medical treatment by travelling to other provinces. It’s been going on for years, but Ottawa has largely ignored it — until now.
Under the Canada Health Act, doctors are prohibited from charging patients directly for “insured” services under provincial health-care plans. However, there’s nothing stopping physicians from billing patients who travel from other provinces to receive treatment, since those patients are not insured under that province’s health plan.
The Liberals want to end that, too.
“It is clearly seen and felt that there is such a loophole in the act which has been there for many, many years,” said Duclos. “So yes, we are mindful of that and we are going to work on that.”
How far the Liberals are willing to go in preventing Canadians from buying medical services from private providers is anyone’s guess.
How far the Liberals are willing to go in preventing Canadians from buying medical services from private providers is anyone’s guess. There is a small, but growing, group of physicians in Canada who have opted out of their provincial health-care plans and charge patients directly for their services (which is allowed under the Canada Health Act).
An orthopedic surgeon in Laval, Que., for example, opted out of the provincial plan and offers hip and knee surgery to patients willing to pay. For some, it’s worth the $20,000 or so (which won’t be reimbursed by government) to avoid the pain and agony of languishing for years on a wait list. Is that next on the government hit list?
If the goal is to ensure nobody in Canada pays directly for medically necessary services, that would be the next logical step.
But would Canadians stand for it, especially as wait times grow and provincial governments continue to mismanage their health-care systems?
That’s the showdown Canada is facing in the evolution of its troubled government monopoly health-care system.
tom.brodbeck@freepress.mb.ca
Tom Brodbeck
Columnist
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.
