Ford government cuts medical funding for the uninsured, and a doctor finds it ‘shocking’

March 26, 2023 

The Ontario government is canceling a pandemic-era plan to pay for medical and hospital costs for the uninsured, a move some critics say will leave residents vulnerable without necessary medical care.

Doug Ford’s provincial government introduced the Hospital and Medical Services for the Uninsured program in March 2020. Under the plan, hospitals and doctors could bill the government for “medically necessary” treatment provided to patients without OHIP coverage.

The program was programmed for COVID, but was never specific to COVID; all medically necessary care was eligible for reimbursement.

Advocates dealing with the undocumented and homeless say it closed a crucial and long-standing gap in Ontario’s health coverage. Closing it now, they argue, is “devastatingly cruel.”

“We are now talking about a healthcare system in Ontario where homeless and recently arrived permanent residents, temporary workers and international students are at risk of paying significant medical bills and debt,” said Dr. Andrew Boozary, M.D. primary care and executive director of population. health and social medicine on the University of Toronto Health Network on Twitter. “The mirage of universality is over.”

Ontario hospitals were informed of the upcoming change, effective April 1, in a memo from the Ministry of Health. (The version sent to the Star is undated.) Many doctors only found out on Friday night when the Ontario Medical Association sent a note to its members.

“That was a shocking email Friday night,” Boozary said.

The ministry memo described the program as an effort “to help reduce the spread of COVID-19 by allowing uninsured people in Ontario, including those without Ontario Health Insurance Plan (OHIP) or other health insurance health, access medically necessary medical and hospital services. .”

But all that, says the government, is no longer necessary.

“Ontario continues to scale back COVID-19 response measures that are no longer appropriate or necessary,” the memo said. “As part of this, please note that the funding (of uninsured hospital and medical services) announced in … March 2020 will end on March 31, 2023.”

According to the OMA, the total cost of the program was about $15 million over three years. That dropped to about 400,000 individual patient services provided by 7,000 Ontario doctors as of March 2020.

Many of those caught by the program may actually have been OHIP-eligible, according to OMA president Dr. Rose Zacharias, but for whatever reason have never been able to enroll or keep their information up to date with the government.

“We know that a lot of people are going without coverage and don’t have easy access to coverage,” he said. “Anyone who has a language barrier or a mobility issue or is homeless, or even a migrant worker, these are people who have particular stressors and barriers that get in the way of getting their OHIP card.”

There are still programs available in Ontario to help those who are not covered by OHIP. But for Boozary, they are not complete enough.

“When you look at the elements here around health equity and health economics, this is scary on both fronts,” he said. “We knew about these health care gaps and who has had worse health outcomes for many decades before the pandemic… We have seen the most obvious lessons of the obstacles and barriers that exist for too many people. And now withdrawing the (program) and imposing the (barriers) again is a very cruel and reckless health policy.”

In a statement, the Ministry of Health said that “with lower rates of COVID-19 and the end of public health restrictions, the province is reducing its pandemic response measures to focus resources on service delivery. What Ontarians Need Most…

“As was the case before the pandemic, effective April 1, those who are not eligible for the Ontario Health Insurance Plan (OHIP) and do not have any other form of health insurance coverage are encouraged to speak with the treating hospital and/or physician to develop plans for future care.”

OMA’s note was sent out to its approximately 44,000 members just before 7pm on Friday night and quickly began to spread online. Maggie Keresteci, executive director of the Canadian Association for Health Services and Policy Research, call it “a horrible affront to the values ​​inherent in Canada’s universal healthcare system” on Twitter.

In the note, the OMA said it had asked the ministry to temporarily extend the program. The organization added that the WCO had not been meaningfully consulted about the change.

“This was definitely a band-aid during the pandemic, but there is no good reason not to continue. Works. It’s important,” said Marit Stiles, leader of the Ontario NDP. “It’s not a humane system if people who are sick don’t get the care they need.”

The New Democrats originally charged in a statement that eliminating the program would mean refugees from the Ukraine would no longer have access to health care in Ontario. Hannah Jensen, press secretary to Health Minister Sylvia Jones, insists that is not the case.

“Perhaps instead of making partisan attacks, (the) NDP should pay attention to the facts,” he said in an email. Last April, the government amended the Health Insurance Act to extend OHIP eligibility to people who have been granted emergency authorization to enter and remain in Canada for humanitarian reasons, he said. That should include Ukrainians fleeing the war, he said.

But Stiles said that doesn’t mean everyone who needs health care in Ontario will get it. “A lot of people fall through the cracks. They are not recognizing it,” he said.

“There are many, many people who end up in our communities who are undocumented… And we really can’t afford to make sure they don’t get the care they need when they need it.”