Queue-Jumping Foes Fear Launch of MRI Clinics
By Richard Mackie
Globe and Mail
July 9, 2002
Ontario Health Minister Tony Clement acknowledged yesterday the government will have to closely police new diagnostic clinics to ensure that they are not offering wealthy people a better standard of health care than that provided to the rest of the province's residents.
His comments reopened the political debate in the province over whether the Conservatives are covertly introducing two-tier health care, where those with money can pay for better treatment.
The government plans to allow private operators to establish clinics in the province to operate as many as 20 new MRIs and five new CT scanners, Mr. Clement said. The clinics are supposed to reduce waiting times and would keep promises made in the May 9 Throne Speech and June 17 budget.
The new clinics will provide diagnostic services paid for by the Ontario Health Insurance Plan. They also will be allowed to provide supplementary services paid for by the patients themselves or by their insurance coverage.
Preventing people from paying for the supplementary services to jump the queues for medically necessary tests will be a challenge for the government, Mr. Clement said.
"We will have an oversight system to make sure that people aren't jumping the queue by characterizing something as a non-medically necessary service when, in fact, it is a medically necessary service," he said.
Under the Canada Health Act, medically necessary services must be paid for by government health plans. Individuals are allowed to pay only for non-medically necessary services. The system is designed to ensure equal access to basic health services.
Mr. Clement said the government will have to find a way to allow doctors to use the results of non-OHIP tests when they point to a medical problem without encouraging individuals to pay for their own tests to avoid long waits.
"If the intention is to use the service to avoid the medically necessary line, then of course we have a problem with that," he said. "But there's lots of times where people, through other means, find out that they have a condition, and we're not disallowing that."
At present, most magnetic resonance imaging machines and computed tomography scanners used in health care are operated by publicly funded institutions, mainly hospitals. They can be used for private purposes when not being operated to provide OHIP-funded-diagnostic services.
Mr. Clement said he hopes to have some of the new clinics in operation by the end of the year.
The lengthy wait for tests at the existing 43 MRIs in Ontario, which can be as long as a year, has been one of the chief complaints about the province's health-care system, according to a survey of 400,000 people conducted by the Health Ministry last year.
The announcement of the clinics was condemned by the opposition Liberal and New Democratic parties as a step toward establishing two-tier health care.
"It is absolutely wrong to allow wealthy people to buy themselves to the front of the line," said Sandra Pupatello, Liberal deputy leader and health critic.
She said that establishing 25 new MRI and CT scan clinics will increase the shortage of people qualified to operate the systems.
The president of the Ontario Association of Radiologists, Giuseppe Tarulli, also criticized the announcement, because it does not deal with "the acute shortage of radiologists and technologists." There are only 150 radiologists who are able to use the test to diagnose illnesses.