Cutting out-of-country OHIP coverage is wrong and pointless

Posted on April 25, 2019 in Health Policy Context

Source: — Authors: – Opinion
April 25, 2019.   By

Wrong in principle and pointless in practice. That’s the gist of the Ford government’s out-of-the-blue proposal to end out-of-country OHIP emergency medical coverage.

It’s wrong in principle because, on the face of it, it violates the portability principle of the Canada Health Act.

That’s the straightforward proposition that Canadians are covered by their provincial health plan wherever they go —to another province or indeed another country.

They might not be reimbursed the full cost of the service (indeed, if they fall into the clutches of a U.S. hospital, for example, they almost certainly won’t be). But medicare will reimburse at least some of the bill, usually equivalent to what it would pay at home.

All provincial plans do this. Ontario would be the first to break with this long-standing pattern.

The proposal is also pretty much pointless because of the tiny amount of money involved.

According to Ontario’s auditor general, the government paid out just $9 million last year for emergency coverage. It also spent $2.8 million to administer the program (an issue in itself) for a grand total of $11.8 million.

That’s a miniscule percentage, a tiny fraction of one percentage point, of overall Ontario medical spending of $63.5 billion (with a b).

There’s a good reason why you haven’t been reading about the issue of out-of-control spending for out-of-country medical services. That’s because it simply isn’t happening.

The Ford government’s proposal is, in essence, a solution in search of a problem.

The government’s argument is that the existing program covers only a fraction of medical costs abroad. On that it’s correct; hospitalization coverage, for example, is a maximum of just $400 a day. A prudent traveller should take out private insurance just in case she falls ill or has an accident.

But eliminating all coverage entirely takes away the little the province already covers. It will hit hardest at casual cross-border shoppers who will now have to weigh the cost of private insurance whenever they pop over to a Buffalo mall.

And it’s a gift to private insurers who no doubt will see a spike in business if all out-of-country coverage is yanked away.

In fact, the Canadian Snowbird Association estimates travellers will end up spending an additional $17 million on private travel insurance. “Taxpayers” will supposedly save $11.8 million, but Ontario travellers (i.e. taxpayers) will hand over quite a bit more than that to the insurance companies.

What a deal.

The government is also misrepresenting how this proposal came about.

It says it’s acting on recommendations from, among others, the provincial auditor general. But in her report last year, AG Bonnie Lysyk did not suggest ending out-of-country OHIP coverage.

She put a dollar figure on how much the government pays out to travellers and she suggested the government “better educate” the public on the fact that OHIP doesn’t cover much and the wisdom of purchasing additional private insurance.

Importantly, she also called attention to the disproportionate cost of administering the program — about a quarter of the total cost. She urged the government to “revisit opportunities to reduce administrative costs.”

That’s an excellent idea, one that should be right up Ford’s alley. The government should seize on it and get those administrative costs under control.

At no point, though, did Lysyk propose ending out-of-country coverage. The government came up with that all on its own.

It’s hard to imagine how this proposal could be worse, but the government has managed that trick as well.

It posted the idea on its website on Wednesday, and has given the public until Tuesday to respond with comments. Five whole working days.

If the government was truly confident in this proposal, it would not shrink from a full debate. The fact that it’s trying to sneak it past Ontarians suggests the opposite: that it knows it’s a lousy idea but simply figures it can get away with it.

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