Health Minister Philpott promises action against double-billing doctors

Practitioners cite lack of public healthcare resources as a contributing factor

Health Minister Philpott promises action against double-billing doctors
Responding to revelations of illegal extra billing by doctors through private clinics, Federal Health Minister Jane Philpott has said she is “determined to find ways to make it very clear that we expect the law to be upheld.”

Patients lacking access to care, ranging from basic medical appointments to surgery, are increasingly paying out of pocket at private clinics where doctors are charging for services while billing the public system, according to an investigation by the Globe and Mail.

Without mentioning specific measures, Philpott promised more federal pressure on provinces, to look harder at doctor and clinic billings, especially in BC where the double-dipping is most rampant. That could be problematic as Ottawa relies on the provinces to accurately report evidence of misconduct — which provinces have a vested interest in downplaying, since they can get fined for such violations.

The Globe and Mail report also cited data from the Ontario Health Coalition, which found 71 mostly doctor-owned diagnostic and surgical clinics across Canada selling patients quicker access to treatments that should be covered under provincial health insurance.

BC Health Minister Terry Lake has said the province is vigorously trying to enforce the Canada Health Act through audits. However, their efforts to crack down on private clinics have been met with lawsuits by the offenders.

According to doctors, rationing of public healthcare resources contributes to the problem. A survey done by the Royal College of Physicians and Surgeons, a national doctors’ group, found 16% of respondents unable to secure employment nationwide. The top reason: “more physicians competing for fewer resources.”

The Doctors of BC, an organization representing BC physicians, told the Globe that “surgeons are required to share the ORs … [and] there aren’t enough ORs.” As a result of these and other rationing measures, doctors say patients are forced to pay for timely treatment at private clinics.

Tellingly, BC health authorities have also been hiring private clinics on contract to treat patients who need minor surgeries. Fraser Health, Northern Health, and Vancouver Health have confirmed that they have outsourced part of their patient load. Out of 61,417 surgeries done in BC’s private clinics last year, a little more than half were publicly funded.

The Globe investigation found that patients paying out-of-pocket for surgery are charged significantly more than health authorities for the same services; in effect, patients who are billed extra end up subsidizing patients covered by public healthcare. Doctors are therefore asking the government to either legalize private billing or provide adequate funding for stand-alone clinics to meet patient demand.

However, Dr. Philpott has rejected the doctors’ arguments, citing evidence that some treatments and tests being performed on patients are actually unnecessary.

“We can root out over-testing and over-treatment and, through innovation, make the system much more effective in managing wait times,” she told the news outlet.

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