Allowing international patients to pay for health care sets Ontario up for a challenge by Canadians who want to do the same, warns the head of the Registered Nurses Association.
Doris Grinspun, head of the Registered Nurses’ Association of Ontario, says the recent practice of some hospitals to accept foreign patients for profit may lead to demands by Canadians to be allowed to pay for prompter medical care.
If the province doesn’t order hospitals to stop practising medical tourism, it risks a court challenge over the right to pay out-of-pocket for health care, the head of the Registered Nurses’ Association of Ontario warns.
“If you seek out people from other countries to pay for health care here, you are inviting a lawsuit from someone in Canada who wants to pay,” Doris Grinspun suggested.
Among Ontario hospitals that treat patients from abroad are Sunnybrook Health Sciences Centre and the University Health Network.
Medical tourism is a threat to medicare because it creates a double standard that could see well-heeled Canadians demand to pay out-of-pocket to jump the queue and get quick treatment, Grinspun said.
Ontario could find itself in a similar position to that of British Columbia, which is headed to court this fall, she said. The western province is facing a legal challenge over patient access to private surgery centres.
Not only would Ontario be stuck with big legal bills if there is a court challenge here, but patients might end up with a weakened health system because resources were being drawn away to treat international patients, Grinspun said.
In a written statement, Health Minister Eric Hoskins said international patients can be treated in Ontario hospitals only if “zero public dollars” are used, domestic patients are not displaced, and any monies made are reinvested into improving care for Ontarians.
An ongoing ministry review is looking at ways to strengthen these rules, he said.
“There is no more ardent defender of our universal public health care system than our government, and Ontario patients should have full confidence that their hospitals have their care as their very top priority,” Hoskins said.
As part of a pilot program, Sunnybrook has so far this year treated three foreign patients for cancer, said hospital president Craig Duhamel. Two were from the Caribbean and one was from Europe.
The hospital has made about $100,000 so far, enough to cover the cost of the insurance for the international program, Duhamel said.
“At this point, we are breaking even, but if we treat others, we will be able to invest whatever revenue we generate, minus expenses, back into the provision of patient care for Ontarians,” he said.
Over at the University Health Network, 75 international patients have so far been treated this year. Of those, 31 have been from Libya and the rest from the Caribbean, Middle East and Africa.
These international patients have received orthopedic, cardiac and cancer care, and the University Health Network has taken in $4.5 million in revenue.
Dr. Nizar Mahomed, managing director of “UHN International,” said he does not consider what the University Health Network is doing to be medical tourism.
“This is about people who cannot get access to care” in their home countries,” he said. “I don’t think it has anything to do with two-tier (medicine).”
In an article that he co-authored in the online health policy magazineHealthyDebate.ca, Nizar explains that patients from Libya were wounded in that country’s civil war and that their care at UHN is paid for by the Libyan government.
Grinspun said it is disturbing that “medical tourism experiments” have been concocted out of the public eye and with no public debate. In an open letter to Premier Kathleen Wynn earlier this month, she urged the province to ban the practice.
Before becoming deputy health minister, Dr. Bob Bell was president of the University Health Network. In an interview last April, he made no apologies for the fact that the hospital was treating international patients and said plans were being made to do more of it.
But in an interview the following month, immediately before starting his new job as deputy minister, Bell was more cautious:
“I think it’s fair to say that the position I have at UHN and the position I have as the deputy, they would be different, obviously. I don’t like the term health-care tourism or medical tourism. I think it degrades the concept that we are trying to give good care. It has been something that has been one of the areas of strategic focus at UHN, but it is not something I will anticipate will be a focus at the ministry.”
source: http://www.thestar.com / The Star.com / Home> Life – Health & Wellness / by Theresa Boyle / Tuesday – August 05th, 2014
