Report reveals Ontario for-profit clinics charging patients thousands in unlawful fees

Posted: April 17, 2024

(April 16, 2024) By: Ainsley Smith & Caryn Lieberman, Global News

More than 100 patients have come forward to voice their concerns over being charged for care in private clinics in a newly-released report by the Ontario Health Coalition (OHC). A majority of these patients are seniors living on fixed incomes, with the fees imposing significant financial burdens on them.

The OHC, which advocates for publicly-funded health care, held press conferences across the province on Tuesday to release the report, titled Illegal, Unlawful and Unethical: Case Studies of Patients Charged for Medical Care in Ontario’s Private Clinics, which stated that for-profit clinics expanded by the Ford government have been charging patients thousands in unlawful fees.

The report featured case studies on more than 100 patients, who said they’ve either been charged extra fees, been denied treatment, been told if they didn’t pay, they would face “extreme” wait times, or even been tricked into add-on fees.

The report said some patients faced bills upwards of $8,000 for eye surgeries and tests, resulting in considerable financial strain. According to OHC, one patient had to go back to work at the age of 71 to cover their bill, while others resorted to accumulating debt, depleting their savings, borrowing money or sacrificing other necessities.

One patient, Shalom Schachter from Toronto, told Global News he was sold a story about needing extra eye testing and lenses by an ophthalmologist surgeon and ended up paying close to $1,200 at a for-profit clinic.

“I could use the OHIP paid-for equipment, but that wasn’t going to be the best for me. He had diagnostic equipment that was going to identify my condition in a more accurate way,” said Schachter.

Maureen Monro of London reported that she was told she would have to wait two years unless she paid thousands of dollars for cataract surgery.

“I was informed the cost to receive the surgery would be almost $7,000. Being as I live alone, I did not want to lose my quality of life. Therefore, I paid the $7,000. Being a senior on a fixed income, I am still trying to catch up with bills from this surgery.”

In the report, the OHC highlighted discrepancies in Premier Doug Ford’s assurances regarding the privatization of surgeries and diagnostics. Despite his “headline-grabbing” pledge that Ontarians would only need to use their OHIP cards, not their credit cards, for medical payments, and the promise of robust safeguards against extra billing and user fees, the reality of patients being charged user fees at private clinics contradicts these commitments.

“It is unlawful to charge a patient for any OHIP-covered service or any part of an OHIP-covered service. In fact, it’s illegal,” said Natalie Mehra, executive director of OHC.

The report also revealed the predominant fees patients faced were associated with eye surgeries at for-profit clinics, particularly for cataract procedures. Many patients said they were not informed the service was OHIP-covered, while a third of patients said they were charged between $500 and $5,000 per eye for the surgery.

Kate Armstrong, a small business owner in Toronto, was one of these people.

Armstrong was informed by a surgeon at a private clinic that the wait time at a public hospital would be “impossibly long” and that the hospital could not offer the desired “upgraded” lens. Consequently, she opted to undergo additional tests and eye surgery at a private clinic.

“$8,000 later, I don’t believe it was an accident that they swiped my Visa card instead of my OHIP card. It was never actually discussed on any level that OHIP covered any of it,” she said to Global News.

In the report, the OHC said the most common violations of public medicare laws in private clinics included telling patients they had to pay for medically-needed surgeries, requiring patients to pay for add-ons not needed or covered by OHIP and charging for preferential access to care for those who paid out of pocket.

“They’re seniors… They’d have to go back to work at 70 and 80 years old to cover these costs. It’s disgusting. It violates every moral that we have,” said Mehra.

In response, a spokesperson for the Minister of Health told Global News that over the last year they’ve added tens of thousands of OHIP-covered cataract surgeries and achieved some of the shortest wait times of any province in the country.

“Through Bill 60, our government has further strengthened the oversight of community surgical and diagnostic centres, by bringing these centres under the oversight of a patient ombudsman, ensuring access to services cannot be conditional on their choice to pay or not pay on additional, uninsured service and putting into law that Ontarians will always access insured services at community surgical and diagnostic centres with their OHIP card and never their credit card,” the spokesperson said.

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