New report: For-profit clinics expanded by Ford government charging patients thousands in unlawful fees
April 16 2024 - 11:11AM
Released today, a new report Illegal, Unlawful and Unethical: Case
Studies of Patients Charged for Medical Care in Ontario’s Private
Clinics, featured evidence from more than a hundred patients about
user fees being charged in Ontario’s private clinics. The Health
Coalition held press conferences to release the report with
patients who have been charged hundreds or even thousands of
dollars for access to care in for-profit clinics. Most of the
patients are seniors on fixed incomes who were charged up to $8,000
or more for eye surgeries and tests, reported the Health Coalition.
The fees impose significant financial strain, forcing one patient
to go back to work at the age of 71 to pay the bill, and others to
fall into debt, use up all their savings, borrow money or go
without other needs.
The Coalition noted that when Premier Doug Ford
announced his government’s plan to privatize surgeries and
diagnostics, he made a headline-grabbing promise that Ontarians
would never have to pay with their credit card, only their OHIP
card. His government also promised strong “guardrails” to protect
patients from extra-billing and user fees. Those promises are
belied by the reality of patient being charged user fees in private
clinics, said Coalition executive director Natalie Mehra, who noted
that not only were the guardrails performative, not real, the
government actually widened the door to the privatization of vital
health services with less checks and balances, and expanded user
fees.
In response to patient complaints, the Coalition
conducted a province-wide survey from February 5 to March 8. Of 231
patients surveyed, 120 patients were unlawfully charged by private
clinics. In addition to the surveys, the Coalition obtained
receipts and evidence to pull together eighteen more in-depth case
studies to illustrate what is happening to patients.
The most common fees were related to eye surgeries
in for-profit clinics. Patients reported that they were faced with
charges ranging from $50 - $8,000 when they went in for cataract
surgeries, as follows:
- Patients were told they had to pay for medically needed
surgeries that are, in fact, covered by OHIP.
- Patients were told that if they didn’t pay, they would face
extreme wait times (most often two years ranging up to five years).
In the report, the Coalition showed the actual wait times on the
public website for wait times in every public hospital in Ontario.
The highest priority patients are both seen by a specialist and
receive their surgery within an average of three months. Even the
lowest priority patients go from first referral to specialist to
completion of surgery within seven months.
- Patients were denied vital information about the effectiveness
of OHIP-covered eye surgery to compel the patients to pay. OHIP
provides for everything a patient actually needs related to all
medically necessary eye surgeries. No patient needs to pay in order
to get effective, quality care.
- For-profit clinics charged patients for extra eye measurements,
tests and special lenses, telling patients that these unnecessary
add-ons were necessary, safer or “better” than OHIP-covered
services for cataract surgery.
- Patients reported that the private clinics co-mingled
unnecessary services with necessary services in order to charge
fees. Those patients were charged for these unnecessary services
without discussion or were denied access to surgery if they did not
pay out-of-pocket for add-ons.
In addition to cataract surgeries, patients
reported being charged appointment, membership and administrative
fees for primary care, as well as user fees for diagnostics and
physician-ordered lab tests.
“The Ford government is expanding privatization in
the very for-profit clinics that are breaking our medicare
protection laws, charging patients outrageous prices and
manipulating them into paying for a burgeoning array of medically
unnecessary things,” warned Natalie Mehra, executive director of
the Ontario Health Coalition.
“The Health Coalition has monitored the situation
for decades. This widescale extra-billing and charging user fees to
patients never happened before the for-profit clinics began to take
over our public hospitals’ surgeries, and, in our experience, it
has never been worse than it is now,” she reported. “Ontarians need
to raise their voices in no uncertain terms and force the Ford
government to stop privatizing the ownership and control of our
public hospitals’ services.”
Patient quotes:
Kate Armstrong, a small business owner in Toronto,
was told by a surgeon in a private clinic that she would face an
impossibly long wait and that the public hospital could not provide
the “upgraded” lens, and thus was convinced to pay for extra tests
and eye surgery at a private clinic: “I feel that the close to
$8,000 I am out of pocket should’ve been covered by OHIP. At no
time ever was I told that any of this was covered under OHIP. This
was not a cosmetic procedure. This was a necessity. I could not
function without it.”
Shalom Schachter in Toronto reports his experience
at a for-profit clinic where he was recommended extra eye
measurement tests and lenses. He ultimately paid $350 for the use
of the diagnostic assessment machine, $190 for the lens for
one eye and $575 for the lens for the other eye: “I wanted to make
an informed decision so I asked for documentation from the clinic
supporting their claim that their private equipment would provide a
better outcome. I was promised the information would come later
that day by email. However, the only information forwarded was
the same schedule of extra fees that I was given in their office. I
wrote back asking for actual "scientific" explanations and received
a response that they were not going to respond substantively
to my inquiries and that if I was unsatisfied, I could find
another ophthalmologist.”
Maureen Monro in London reports that she was told
she would have to wait two years unless she paid thousands of
dollars for cataract surgery: “I was informed the cost to receive
the surgery would be almost $7,000. Being as I live alone, I did
not want to lose my quality of life. Therefore, I paid the $7,000.
Being a senior on a fixed income, I am still trying to catch up
with bills from this surgery.”
Mike Suta’s wife was charged $3,000 for cataract
surgery: “The optometrist told her there was a two-year wait to get
the surgery. However, he said that if she wanted to get done right
away it would cost $3,000. She did not want to have headaches for
the next two years, so she took her total life savings of $3,000
and said she was going to pay for it. When the optometrist called
back, the appointment was made with the same surgeon that did the
first operation in the hospital 4 years earlier and he now had a
for-profit eye surgery clinic. My wife got the surgery done at the
for-profit clinic and it cost $3,000 more than when it was done at
the hospital. We have one question: who is supposed to protect us
from such scams?”
For more information:
Ontario-wide - Natalie Mehra, executive director
(416) 230-6402, natalie@ontariohc.ca and Salah Shadir, operations
director (647) 648-5706, salah@ontariohc.ca;
Algoma – Al Dupuis, algomahc@gmail.com;
Brampton Caledon - Janine Herrmann-McLeod,
647-237-6276, info@BramptonCaledonHC.ca; Cornwall
- Louise Lanctot, louiselanctot18@gmail.com; Grey
Bruce - Brenda Scott, greybrucehc@gmail.com;
Halton - Trudi Ford, ohchalton@gmail.com;
Hamilton - Janina Lebon, janinalebon44@gmail.com;
Kingston - Joan Jardin,
kingstonhealthcoalition@gmail.com; London -
Peter Bergmanis, 519-860-4403, pbergmanis@rogers.com;
Niagara - Sue
Hotte, niagarahealthcoalition@yahoo.ca;
Oxford - Bryan J. Smith, bryasmit@oxford.net;
Port Dover - Ron
Keating, lorettaaron@aol.com; Thunder
Bay - Jules Tupker, jtupker@tbaytel.net; Waterloo
Region - Jim Stewart, 519-588-5841,
waterlooregionhealthcoalition@gmail.com