Ending medical coverage for uninsured patients will harm vulnerable people, says Ontario Medical Association head

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The Ontario Medical Association will continue to press the provincial government to reinstate a program that extended health coverage to people without insurance, its president Dr. Rose Zacharias has said.

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The program began three years ago as a temporary COVID-19 measure. It directed hospitals to provide medically necessary care to uninsured patients and reimbursed them for the expense. That program, like many COVID-19-related programs, ended on March 31, despite a campaign urging the government not to stop it.

The Ontario Medical Association (OMA) asked for an extension, which wasn’t granted. Zacharias said Friday the organization is in talks with the government about the issue.

The OMA is committed to working with the province to find a solution, she said, but “we don’t see a clear plan from the government to cover these services for the uninsured.”

She said data from the past three years has shown how crucial the program is to the thousands of people without OHIP coverage. Often, they are the most vulnerable in society — people with mental health challenges, migrant workers, those who are marginalized, or who have difficulty getting to a Service Ontario office to fill out a form for coverage, she said.

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Since the program was introduced, 7,000 physicians have billed OHIP for a total of 400,000 services. The program cost the province $15 million over three years.

Zacharias said the program has helped underscore how big the need is for health services among people who are uninsured.

“This is a need that has now been newly understood that needs to be seriously addressed. Every medically necessary service needs to be covered in Ontario for anyone who needs it.”

Zacharias was in Ottawa Friday as part of a provincial tour when she learned the province had discontinued the program as of March 31, despite pleas from the OMA and numerous health organizations and individuals to continue it. That day, hundreds of people blocked traffic around the ministry of health in Toronto protesting the decision to end the program.

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The Canadian Association of Emergency Physicians has also added its voice to those raising alarm about the ending of the program, saying it will put more pressure on emergency departments and hospitals, which will end up absorbing the costs, and will put vulnerable people at risk. Prior to the program, an estimated half of a million Ontario adults and children were living without health coverage.

“If this coverage ends, people’s health will suffer, with potentially fatal consequences. This has a disproportionate impact on the most marginalized, including temporary foreign workers, humanitarian claimants, non-status migrants and those experiencing poverty or homelessness,” the group said in a statement signed by its president Dr. Michael Howlett, and board members.

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Pediatricians and others were also speaking up.

“Without public health insurance, we know that children and their families are less likely to seek or receive necessary health care,” wrote the heads of provincial and national pediatric health organizations in a letter to Health Minister Sylvia Jones and Premier Doug Ford.

Meanwhile, Zacharias, an Orillia emergency physician who is nearing the end of her one-year term as president of the OMA, said she has also been hearing from physicians who are dealing with burnout, in part related to the heavy administrative burden doctors now face. On average, she said, doctors spend an entire day a week filling out forms. She said she spoke with a surgeon who decided to take early retirement largely because of burnout related to being buried in paperwork.

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“We have seen early retirements, we are seeing a reluctance to go into family medicine. The number one reason doctors are burned out is the documentation burden. It impacts their ability to see patients and their desire.”

That burnout is a crucial problem at a time when more than one million Ontario residents don’t have family doctors, she said.

As an emergency physician, Zacharias said she has been shocked to see rural emergency departments closing.

“Never did I think we would see the day when we would be closing emergency room doors, yet over the last year that is what has happened many times.”

Included in its plan for better health care in Ontario, the OMA wants to see investments in home care, community care and palliative care to help get people out of hospitals who should be elsewhere. The Ontario government has announced some steps in that direction, including a commitment to invest $1 billion in home and community care.


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