Private For-Profit Health Clinics Eroding Public Health Care, 89 Suspected Violations of the Canada Health Act in 5 Provinces: New Report

    OTTAWA, Oct. 6 /CNW Telbec/ - In cities across Canada, Health Coalitions
released a groundbreaking new report investigating 130 for-profit surgical,
MRI/CT and "boutique" physician clinics across Canada. Researchers found
evidence to suspect 89 possible violations in 5 provinces of the Canada Health
Act's requirement for equal access to hospital and physician care and
prohibition on extra-billing patients. The report reveals a new phenomenon of
a for-profit health industry that has emerged significantly over the last five
years, and the first forays of U.S. private health companies into Canada.
    Report author, Natalie Mehra, Director of the Ontario Health Coalition
revealed the report's key findings and called upon the federal government to
live up to its responsibility to protect Canadians from extra-billing and
two-tier health care:
    "We found evidence that for-profit clinics are eroding the fairness and
equality of Canada's health system that is supposed to provide access to
necessary hospital and physician services based on need, not wealth. A
significant proportion of for-profit surgical and diagnostic clinics are
billing provincial health plans and also charging extra fees to patients to
maximize their revenues and profits," she explained. "The charges are
unaffordable for all but the wealthiest Canadians. Clinics told us they charge
$13,000 - $20,000 or more for knee surgery, $1,200 - $2,000 or more for
cataract surgery, and hundreds to thousands of dollars for MRIs."
    "For-profit clinics are also taking specialists, health professionals and
operating room nurses out of local public hospitals to serve less urgent
patients, often for extra fees. Despite claims about reducing wait times, we
found direct evidence that poaching staff out of local hospitals by for-profit
clinics worsened shortages in local hospitals forcing the hospitals to reduce
MRI hours. We found evidence of staff poaching out of local hospitals by
for-profit clinics in Nova Scotia, Quebec, British Columbia, Ontario and
    "Ironically, while some provinces are considering introducing for-profit
clinics for the first time, we found that three provinces - Alberta, Ontario
and Manitoba, under governments of varying political stripes -- all have
rolled back their experiments with for-profit MRI/CT clinics or surgical
clinics, opting instead to build capacity in the public non-profit health
system where access is improved on an equitable basis. In Ontario and
Manitoba, the for-profit cancer and cataract surgery clinics revealed direct
evidence of higher costs per treatment than non-profit clinics. This should
serve as a warning to provinces like Quebec, New Brunswick, Nova Scotia,
Saskatchewan and British Columbia where more for-profit privatization of
health care is being considered."
    "We found that the for-profit clinics overwhelmingly locate in large
urban centres where there are more wealthy people to buy their health care
procedures, raising concerns about worsening access in rural areas," she
added. "Particularly regarding the physician clinics that charge thousands of
dollars per patient per year, there should be grave concern that their low
caseloads and their high costs impair access to care for the majority of
people. In cities like Montreal where Statistics Canada reports patients have
the worst shortage of family doctors in the country there is a high incidence
- perhaps the highest concentration in the country - of "boutique" physician
clinics selling executive health care for hundreds or thousands of dollars per
year per patient. Yet the vast majority of people could not afford these
services. This low volume high cost approach of "boutique" physician clinics
is simply not sustainable and threatens health care access for many more
people if it is allowed to spread."
    "This report should serve as a wake up call and a call to action. The
federal government has all but abdicated its responsibility to uphold the
fairness and equality of our public health system," she concluded. "It is
required, by law, to ensure that patients are not exploited by extra-billing
or two-tier health care. In turn, our provincial governments have failed to
set up adequate regulatory and enforcement regimes to protect patients. The
evidence is clear that the for-profit health care industry is undermining
equal and fair access to health care for all Canadians by taking resources out
of the public health system, by selling two-tier access and by levying extra
charges on patients. We should use the next two weeks leading into the federal
election in particular, to ensure that each of the federal party leaders
promise to take concrete action to halt two-tier health care and improve
access for all Canadians, not just the wealthy. We should require our
provincial governments to improve access in our local public hospitals and
clinics, and to ensure improved access to care is equitable and based on
medical need, not high income as is evidenced in the for-profit clinics."

    The full report in English and a French summary are available at or

    The Ontario Health Coalition is the province's largest public interest
group on health care, comprised of 400 member organizations including doctors,
nurses, health care agencies, seniors' organizations, unions, ethnic and
cultural organizations, more than 70 local health coalitions and thousands of
individual members. The coalition's mandate is to protect a universal public
health care system under the principles of the Canada Health Act, to
contribute to public debate about public policy regarding health care and to
protect the public interest.

For further information:

For further information: Natalie Mehra, Ontario Health Coalition, (416)
441-2502, cell (416) 230-6402; Mike McBane, Canadian Health Coaltion, (613)

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Ontario Health Coalition

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