SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
February 22, 2023 09:00AM
  • Feb/22/23 3:30:00 p.m.
  • Re: Bill 60 

We are open for business, all right. We are open for business so that we can make millions of dollars off of the backs of sick people.

I cannot stand for this, Speaker. I’m from the party of Tommy Douglas. I believe in care based on needs, not on ability to pay. I believe in medicare—but not this government. This government is putting this to the trash because there is money to be made off of the backs of sick people.

Of course, Paul is not the only one who came forward. Brenda Seaton said that her mother, who is 90 years old, needed cataract surgery. She went to the ophthalmologist and asked to have the cataract surgery done—she had had one done, but because the other was not done, it made her dizzy because she didn’t see well out of one eye and could see better out of the one that had had the surgery. The wait-list to have this done in a hospital where it would not cost anything was months long, but if she was willing to pay $1,000 for basic cataract surgery to be performed by Dr. Derek Lui of Woodstock, she could have it done right away. Since her mother was having a tough time at 90 years old—she didn’t want her mother to continue to be dizzy; the last thing you want is for her to fall and break a hip and ruin her health, ruin her ability to be independent—she came up with $1,000. She could not wait any longer. So they went to Woodstock. Ms. Seaton said that once they got to the private clinic in Woodstock, there were at least 10 people in the waiting room who she recognized from ophthalmologist Derek Lui’s practice, and all of those people had agreed to pay $1,000 so they would not have to wait months to get their cataract surgeries done in the hospital. Dr. Lui insists that that was not him charging $1,000; it was the clinic that kept those fees, that he received no financial benefit. He said, “I am just using their facilities. I am not an employee. I don’t have any shares in that clinic.... it makes no difference to me. I just bill OHIP.’” But it makes a difference to that family. Brenda did not have $1,000. It put her in financial distress to be able to gain access to the care she needed.

This is what medicare is all about—care based on your needs, not on your ability to pay.

I could go on and on with examples of other people who have had to pay to gain access to care, but I want to make sure that I save time to go through the whole bill.

The first thing that the government will have you believe, the first myth, is that if you have private clinics, they will alleviate wait times in the public system. There is a tremendous body of evidence that shows this is not true. This is a myth. The last jurisdiction to try this was Australia. In 1997, they brought in those private, for-profit corporations. What happened is, yes, the private corporations gave faster access to people who are able to pay for add-ons, but for the rest of the people in the system, the wait-lists got longer. We already have Australia that has this, and many other countries have what Ontario is about to do. And in all of those countries, the wait-lists for the publicly delivered services are longer, and in most of them the general wait-list is longer than in Ontario. So this is a myth. Bringing in for-profit delivery is not going to bring the wait-lists down in Ontario.

Myth number two is that private, for-profit ownership of health facilities leads to better health outcomes—“Let the private sector do things. They can do things better, faster, cheaper.” None of that is true, Speaker. Here again, you can look at the humongous body of evidence that exists. The truth is that the for-profit model does not incentivize high-quality care. In fact, for-profit delivery has been associated with increased mortality.

I would like to give a very sad example that happened right here in Ontario. You can look it up online. It’s the case of Levac v. James. Forever on end, pain clinics were only delivered in hospitals, where people would come and get injections to control their pain. Then, many pain clinics opened throughout—mainly, southern Ontario. As it is, independent health facilities have no oversight, no accountability. A physician opened up his pain clinic, saw thousands of people, billed OHIP for millions of dollars, but to try to cut costs, he did not follow best practices, infection prevention and control practices. Multiple people got infections. We’re talking about severe infections. When you get an infection in your spinal cord, it goes into meningitis, it goes into—some people got paralyzed from the waist down, from the injection site down, and a person died. All of this continued for two and a half years, because there is no oversight of independent health facilities in Ontario. If the same physician had done the same thing in a hospital—the first time somebody gets an infection, the hospital has mechanisms in place. It went on for two and a half years—same physician, same surgery. In a hospital, the first time somebody gets an infection, there is quality monitoring in place so they don’t get a second one—you change, you make sure that high quality is provided. With that private clinic, it went on for two and a half years, and it was only after three people got meningitis in the same week—meningitis is a reportable disease, so this disease had to be reported to Toronto Public Health. Toronto Public Health looked at three meningitis cases, started to do a bit of an investigation, realized that all three of them had dealt with Dr. James, and closed him down. Two and a half years—dozens of people with severe diseases, some of them incurable. They are paralyzed from the waist down for the rest of their lives, and a person is dead, because there is no oversight. This is happening right here, right now, in Ontario. To say that private clinics will have high-quality care—there is nothing in this bill to guarantee that.

Another myth is that private financing will make health care more efficient. This is also a myth. There is plenty of evidence that shows that health care is most efficient when it is delivered in the not-for-profit sector by a single payer, which we already have.

Myth number four: We can’t afford publicly funded health care. The truth is, we can’t afford privatized health care. Studies are there; I have dozens of them—it always costs more in the private, for-profit system because you have to make a profit. When it comes to private, for-profit, investor-owned corporations, the for-profit comes first. It will always be there before quality care, before safety, before anything else.

Don’t get me wrong; I have nothing against community-based care. Some hospitals in Ontario already do this. They have opened up surgical suites where all they do is day surgery. Across the street, this way—go to Women’s College Hospital. They don’t have beds. All they do is day surgery. But they do this within the confines of a hospital, with all of the oversight and accountability to make sure that they provide quality care. We have many other great examples right here in our province, in order to do that—but that’s not what this government has chosen to do.

This government has chosen to open the door to private, for-profit, investor-owned corporations, which we already know will put profit ahead of care.

In the bill, there is very little about oversight, except to let us know that there will be some oversight; it’s yet to be determined as to what that will be. This is not how you build a strong and robust health care system—you put those oversights in place before anything else.

We have 10 independent health facilities right now that provide surgery. We have over 800 independent health facilities; 98% of them are for-profit. There are a few—Kensington Eye Institute is a not-for-profit. But that’s not the intention of this government. The intention of this government is to bring the for-profit system in.

The bill talks a bit about what will happen if people have complaints. Apparently, they will be able—I need a drink. Sorry about that, Speaker. It’s all my husband’s fault, I want you to know. He plays hockey. One guy gets a cold in the change room, then he gets a cold and brings it home. I blame hockey. But that’s an aside.

Complaints: In the bill, they talk about how people will be able to make complaints to the ombudsman. This already happens. With the independent health facilities, people can put a complaint to the Patient Ombudsman. The Patient Ombudsman reports on those complaints. I had the stats in front of me, but I have a bit of a mess, so I will go by memory: Of over 332 complaints, over 228 of them were found to be valid complaints. The Patient Ombudsman has no authority to carry out any changes. “Yes, your complaint is valid; yes, you were charged for an upsell; yes, you were told something that wasn’t true; you did not need to buy the different lens; you could have had the OHIP-covered lens”—and this is where it ends.

There’s also a line where you can call the ministry and complain about those overpayments. Same thing—you look at the number of complaints that have been received, and two thirds of them were found to be valid. Where people had been charged for something that was covered by OHIP and they should not have been charged, the physician or the clinic was made to pay back that one person who had complained, and they could continue to charge $1,000 an eye to the other 500 patients who came in—because unless they complain, nothing happens. And even for the physicians who were found guilty, there were no consequences, except for giving back the money that they should have never taken before. What kind of oversight is this, when you know the power imbalance, when you know that the physicians have all the power and the patients have none? They have been found guilty of charging for something they shouldn’t have, and all you ask of them is to give the money back; you don’t even look at the other 500 people who have been charged the same thing.

Make no mistake, most people don’t want to complain against their physician. Most people say, “The physician was a very nice guy. He did the surgery, and I see very well now. I don’t even need my glasses. I was able to keep my driver’s licence. Could you help me, because I don’t have the $2,000 to pay him. Do you figure there’s a government program that could help me pay the 2,000 bucks? But no, no, no, I won’t make a complaint against the physician”—because they have all the power, and you have none.

I went to a seniors fair organized by the YMCA and a seniors group in Sudbury. They had given me an opportunity to talk, and I talked about the different programs that were there to help seniors stay home safe. When I ended my talk, I said, “I’m curious to see: Have any of you ever been charged when you went and saw a physician?” I had 142 people in line to come and tell me their stories. About two hours into this, I realized that Dr. S charges about $500 an eye; the other one charges about $1,000 an eye. If you don’t pay, then you’re put on the hospital wait-list and you lose your driver’s licence. If you agree to pay, you get to keep your driver’s licence because you will be seen within a short period of time. If you don’t pay, you’re put on the long wait-list in the hospital and you lose your driver’s licence. The stories were all the same. After a while—I still listened to them all. Out of 140 people, I asked, “Can I bring your story forward? Would you be willing to make a complaint?” Zero. Not one of them felt that they wanted to put in a complaint. Many of them wanted me to help them find a way to get funding for this, but none of them were willing to put in a complaint.

If this happens in Nickel Belt, I am absolutely positive that it happens in every part of the province—but although the Auditor General’s report told them about this, Canadian Doctors for Medicare told them, the Ontario Health Coalition told them and Health Quality Ontario told them, the government didn’t think it was important enough to put it in the bill. How could you not think it was important enough to put it in the bill? But they did not.

Apparently, we will get some oversight at some point in the future in some kind of regulations; we don’t know when, we don’t know what it will look like. But I’m worried because we already know that this is happening, and once you open the door to the private, for-profit, investor-owned corporations, it will just increase exponentially.

Another concern that I have: We’ve talked about the complaint mechanism to the ombudsman. First of all, the Patient Ombudsman has less power than the ombudsman, and second, he has no way of implementing changes. We’ve talked about the complaint lines that happen at the Ministry of Health. By the way, we are all pretty good with computers in our jobs—try to find that complaint line. Use the last 20 minutes of my speech to try to find it by yourself; let me know if you do. I know the number by heart, but for you to find it by yourself and connect with it—good luck with that. That system fails more people than it helps, and even when you do get your money back, no consequences come of it.

Then it’s the poaching of staff—you are about to open up a brand new, private, for-profit, investor-owned corporation—

2505 words
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