by Written on behalf of Wise Health Law January 04, 2018 3 min read

Health Canada has flagged concerns with a Winnipeg clinic that is planning to offer elective echocardiograms (i.e. ECG’s/ heart ultrasounds) for $650. Manitoba’s health authorities had previously approved the plan.

The Services Offered

The clinic in question first opened over a year ago and began offering “executive health assessments” for $3,800. These assessments include a medical history, full physical, and lab tests and are intended to uncover risk factors and potential problems. In late December, the clinic announced that it would be offering ECG’s for a fee, “relieving pressure from our province’s strained healthcare system and providing Manitobans a local option to receive the care they need”.

The Clinic’s Position

The Winnipeg Regional Health Authority has said that there are over 4,000 individuals on the province’s waitlist for elective heart ultrasounds and that the average wait time for the procedure in Winnipeg is 39 weeks. One of the owners of the clinic, a physician, told CBC News that these long wait times have created an opportunity for the private sector to offer the service for any patients who are willing to pay, noting:
If people are willing to use their disposable income in order to have tests done, that have excessive waiting lists, then this is their choice to do.
He further argued that every test performed in the clinic opens up a space for a patient to receive the test in the public system:
Jumping the queue is not what we are doing here. It implies that someone steps in front of somebody else. This is not the case. Someone is stepping outside the line. You have people leaving the line, that means it gets shorter, so everyone benefits.

The Ministry of Health’s Position

A Ministry spokesperson told the CBC that the imaging tests offered by the clinic are specifically excluded from provincial coverage unless they are provided in a hospital, effectively opening the door for such tests to be offered in a private facility. The Ministry has previously noted its support for other paid services, calling them “inevitable” given the federal government’s plan to slow down health-care spending.

Health Canada’s Position

A Health Canada spokesperson has said that “health services should be based on medical need and not the ability and willingness to pay”. The spokesperson also noted that Health Canada does not have the jurisdiction to directly investigate the clinic’s practices, but that it intends to raise the issue with Manitoba’s Ministry of Health in the coming weeks. Health Canada disagrees with the Ministry of Health’s assessment, noting that MRI’s, echocardiograms, and ultrasounds are all a “medically necessary diagnostic service” and should, therefore, be covered by provincial or territorial health plans, regardless of whether they are offered in hospitals or in private clinics. Health Canada did note that it had not received any formal complaints about private payments for otherwise insured services in Manitoba but noted that it had also flagged a separate clinic that was planning to offer paid MRI’s in partnership with the town in which it was located.

The Supreme Court of Canada

In a 2005 majority decision, the Supreme Court of Canada found that the Quebec government could not prevent individuals from paying for private insurance for health-care procedures otherwise covered by provincial insurance. The clinic’s owner pointed to this previous decision in support of his position that the clinic ought to be able to provide paid elective ECG’s.

Health Care Advocates

The Canadian Health Coalition, a lobby group pushing for the preservation of Canada’s public health care system, noted that extra elective tests often end up burdening the system because the test results end up being analyzed by publicly funded doctors. The group notes that it has heard from Canadians nation-wide who are concerned about the privatization of health care and a resultant lack of access to care. At Wise Health Law, we provide exceptional guidance on health law matters to Regulated health professionals, health care clinics (including family health teams), regulatory bodies, and national and provincial health professional associations across the province. We regularly monitor trends and developments in health here in Ontario and across Canada so that we can provide forward-thinking legal and risk management advice to all our clients. Contact us online, or at 416-915-4234 for a consultation.

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