Ontario doctors are not paid when they treat patients without patients. Here’s how to change how
Several times a week, a person facing homeless and mental health issues falls in the busy emergency department in Toronto city, where Dr. Bernard Ho works, and does not treat doctors despite not paying to do so.
This is because the man does not have a valid health card – and he is not the only one.
Ho said that many doctors are forced to bear the cost of taking care of the needy people who cannot prove that they have health insurance.
“We see them all the time. And unfortunately, we don’t pay for them,” Ho told CBC Toronto.
Currently, most doctors across the province cannot challan Ontario Health Insurance Plan (OHIP) for patients that cannot prove that they have coverage.
The Ontario Medical Association is hoping to change it and is working with the provincial government to finalize a new compensation deal, including it that it is called a “good-confident” payment policy, which was previously scraped in 1998.
What is a ‘good-fath’ payment policy?
During the Covid-19 epidemic, Ontario revived a version of the 20th-century “good-confidence” payment policy, making a stream of funding to ensure that doctors are still paid whenever they treat someone, even when the patient was not insured. The policy was Scrap again in 2023.
The Health Ministry told CBC Toronto in a statement that it is unable to comment on specific proposals in active bargaining with OMA.
If the proposal is approved, according to the OMA, the “Good-Fath” payment system will kick in three scenarios:
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Newborn patients experience glitter or delay, while they wait for a permanent health card.
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Those who are OHIP-3gible, but do not have legitimate documentation or valid coverage are a category that may include people who experience homeless, mental health issues or other obstacles for documentation.
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In important conditions, unlicensed patients who are unable to provide documents or are not available with anyone. This category may include unspecified residents, temporary residents, temporary inhabitants, temporary inhabitants, unaffected passengers facing medical emergencies and persons facing complications or emergency conditions after alternative health or birth tourism.
‘Oma -free for all’, not Oma, says the president
This is the third scenario, in which the doctor will pay a bill to take care of the unlicensed patients, which can withstand pushbacks, OMA noted in the 2024 report.
The report said, “The ministry may indicate that it is not their problem to manage … some members of the public may feel like this.”
Under the proposed policy, hospitals will need to make appropriate efforts to verify someone’s coverage, OMA Chairman Dr. Zainab Abdurhman said.
But if this is not possible, she believes that doctors should still pay to take care of them.
“Our real focus is really OHIP-Aligible. Can someone (unqualified) slip there? There is always a possibility,” said Abdurrahman.
“We are getting very special and very deliberate … to help overcome the apprehensions that it is just going for a free-all, coming for all, coming for all and getting Ontario Taxpayer-Bharatiya health care,” he said. “This is not our goal.”
When the policy was implemented during the epidemic, the OMA found that 7,000 Ontario physicians provided 400,000 examples to patients without insurance.
Similar programs are present in Canada: OMA
It is unclear whether more medical tourism can be encouraged by bringing back the policy, Dalla Lana said at the School of Public Health, Assistant Professor of Health Economics Boriana Milucheva.
“The option (bill) already exists to receive and not pay medical services,” he said. “This is a good-confidence program, but should be reviewed about who is really a billing and they are really billing,” he said.
Other provinces, such as BC, Alberta, Suskechewan and Quebec, according to OMA, provide equal payment options for emergency. Some of them allow retroactive billing or accept mailing addresses from homeless shelters, which are as evidence of residence without health cards.
There was a similar policy Recently implemented in Manitoba.
Ontario is expecting a new deal with the province of Medical Association that will change the way they compensation to family physicians. What is included in the proposed deal in CBC’s Dale ManucDoc is more on.
Finally, Dr. Ho says, it is more than getting compensation for the work. He says that this is a health equity issue for the weakest population of the province, which can delay care or close prescriptions that they cannot pay because they cannot prove that they are eligible for OHIP.
Ho says that the policy may end in saving the province’s money, as people who postpone care can face more serious health issues that need later treatment.
“We need to reduce these obstacles to take care and … make fair procedures for these patients because they disagree with it,” he said.
Abdurrahman said that she is expecting an update on the proposed policy of this decline.
