Ontario could see federal health-care funding deducted if patients are charged for care

The federal government is warning provinces that it will deduct funding from its health transfers if patients are charged for medically necessary services.

In a letter sent to the Ontario government, Health Minister Jean-Yves Duclos said he was “very concerned with the recent increase in reports of patient charges.”

He noted that virtual care, telemedicine, and the expansion of health workers’ scope of practice have the potential to help provinces meet health-care needs. However, he said in this has also resulted in some patients facing charges to access medically necessary care that would have otherwise been covered.

“Canadians pay for their health-care services through their tax dollars, and should not be asked to pay again by way of patient charges when they need to access those services,” the letter, which was also sent to all provinces in Canada, read.

“As our health-care system evolves, it must do so while respecting the Canada Health Act, in order to protect and preserve public coverage for all medically necessary health services.”

The minister said his office has seen evidence of residents paying out of pocket for access to diagnostic services such as MRI and CT scans.

“This is not acceptable and will not be tolerated,” he said in a statement released Friday.

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Duclos said the government intends to reduce the amount of federal health transfers to provinces if patients are charged for these services. The first deductions for patient charges levied during the 2020-2021 year will be applied over the next couple of weeks.

Ontario is one of three provinces that are not seeing a deduction under this policy. Officials said that Health Canada found no evidence of patient charges during this time period for medically necessary services.

The province will, however, see about $32,800 removed from health transfers for “other deductions.” A spokesperson said this would be for overhead charges for abortion services.

In total the federal government is deducting about $82 million from its Canada Health Transfer deductions to provinces.

“We will work with provinces and territories to eliminate future patient charges and the circumstances that led to them,” Duclos said.

“In doing so, provinces and territories may be eligible for reimbursement of their deductions under the Canada Health Act Reimbursement Policy.”

The policy comes as MPPs debate Bill 60—also known as the Your Health Act—which allows licenced independent health facilities to conduct surgeries covered under the Ontario Health Insurance Plan (OHIP).

Health-care advocates have expressed concern about a lack of oversight, particularly around upselling and overhead costs that may trickle down to the patient.1.6307804

• MORE: Advocates warn of 'manupulative upselling' at private clinics

The province, for its part, has insisted there will be oversight and that patients will not be charged for OHIP-covered services.

It also comes as virtual care becomes more prevalent under a straining health system. Some companies have resorted to charging patients a subscription fee for access to doctors.

A new fee structure for doctors providing virtual-only services could also be contributing to further fees, as companies try to make up the difference.

If a patient hasn’t seen a doctor in person, the doctor can only charge $20 per video visit and $15 for a telephone visit.

The health transfers are part of a $196 billion deal the federal government made with provinces for funding over the next 10 years.

The deal with Ontario includes $8.4 million in new money plus a $776 million one-time top up to address urgent needs such as emergency room wait times and surgery backlogs.