Is Private Healthcare coming to Ontario?

[mimico_polak]

While I admit that REDDIT is NOT the most reliable of sources, and is definitely an echo chamber at times...there seems to be more chatter around Doug's slow moves towards normalizing private health care in Ontario.

Doug Ford’s government is quietly privatizing health care

On the cusp of an election, Ford may play down plans for privatizing hospitals. But it is his record, not his words, that is important.

www.thestar.com

https://twitter.com/x/status/1503076211660054534

‘We are seeing the creation of a two-tier system of health care in Ontario’

WATERLOO REGION — A provincewide call to action on the alleged privatization of health care will see a series of emergency summits held across Ontario over the next month.

www.therecord.com

Anyone have some input on this? Is there anything to it?

In theory we currently have a 'private' healthcare system, as private clinics are doing the bulk of the work and then OHIP pays. Would this be different? Or would it be a 'cash for service' thing where the public doctors/nurses/practitioners would be moving over to the private network?

Thoughts?

 

[油井緋色]

Anyone have some input on this? Is there anything to it?

In theory we currently have a 'private' healthcare system, as private clinics are doing the bulk of the work and then OHIP pays. Would this be different? Or would it be a 'cash for service' thing where the public doctors/nurses/practitioners would be moving over to the private network?

Thoughts?

We're already semi private and I'm not surprised we're moving this direction.

As I've mentioned before, I work in the field and have close friends who are doctors. They've mentioned something about how "the government offsets costs to pharmacies" and something involving kickbacks since it's illegal for pharmacies to bribe doctors.

Now, I've always thought our system was great....except there's a whole subsection of drugs that cost $1000+ per dose. If you need these, and you don't have insurance, free health care might as well not exist (it's not fun going to the doctor knowing they can't do anything and the drug that helps is out of reach.)

Now, with regards to opticians and dentists: these impact quality of life as much as regular health care. While glasses are affordable for many, dentist bills utterly insane because the dentists target insurance payout maximums and not what the average can afford.

Audiologists (hearing) is another that isn't covered. I'm certain I'm missing a dozen or more medical related things that should be covered.

------------
As for my personal thoughts....I'll have coverage. I personally don't care lol

As for everyone who doesn't....¯\_(ツ)_/¯, wealth gap is just getting worse at this rate.

 

[woot]

We're already semi private and I'm not surprised we're moving this direction.

As I've mentioned before, I work in the field and have close friends who are doctors. They've mentioned something about how "the government offsets costs to pharmacies" and something involving kickbacks since it's illegal for pharmacies to bribe doctors.

Now, I've always thought our system was great....except there's a whole subsection of drugs that cost $1000+ per dose. If you need these, and you don't have insurance, free health care might as well not exist (it's not fun going to the doctor knowing they can't do anything and the drug that helps is out of reach.)

Now, with regards to opticians and dentists: these impact quality of life as much as regular health care. While glasses are affordable for many, dentist bills utterly insane because the dentists target insurance payout maximums and not what the average can afford.

Audiologists (hearing) is another that isn't covered. I'm certain I'm missing a dozen or more medical related things that should be covered.

------------
As for my personal thoughts....I'll have coverage. I personally don't care lol

As for everyone who doesn't....¯\_(ツ)_/¯, wealth gap is just getting worse at this rate.

Private doesn't even have to mean out of pocket. Orang is a private company that you do not pay out of pocket. All of the labs (Dynacare, etc.) are private companies. My wife used to work for an infusion clinic that was private (Private pays better fyi). No one there were paying for their medical treatment. Obviously there is a lot that can be said about private putting profits first and governments wasting money but I think that this "Conservatives want to be American" is just fear mongering. Big business doesn't want us paying out of pockets. They want the government to take that money and pay the private companies on our behalf.

 

[Ash]

Parts of the health system are already two-tier. When I broke my shoulder the surgery was free, but when it came time for physio the guy at the hospital asked what sort of health insurance I had. I happen to have great health insurance through work, so I could go to any physio clinic that I wanted.

The list of OHIP-approved physio clinics was much smaller. So if you happen to be stuck with just OHIP coverage your choices will be a lot more limited. And if you're stuck using public transit those OHIP clinics would have been incredibly inconvenient to get to. That's bad enough when you're talking about physio, but applying the same model to hospitals seems like a bad idea.

 

[TwistedKestrel]

I thought that Star article had a remarkable amount of links in it. When I got to the last paragraph then that made sense.

This seems depressing to me, a boiling the frog situation that is almost inevitably going to come to pass, and people will act surprised in five years or so when consequences start becoming apparent.

 

[油井緋色]

Parts of the health system are already two-tier. When I broke my shoulder the surgery was free, but when it came time for physio the guy at the hospital asked what sort of health insurance I had. I happen to have great health insurance through work, so I could go to any physio clinic that I wanted.

The list of OHIP-approved physio clinics was much smaller. So if you happen to be stuck with just OHIP coverage your choices will be a lot more limited. And if you're stuck using public transit those OHIP clinics would have been incredibly inconvenient to get to. That's bad enough when you're talking about physio, but applying the same model to hospitals seems like a bad idea.

I forgot about physio and chiro. I guestimate I've spent at least $5,000 over 7 years on both; don't know because insurance.

Private doesn't even have to mean out of pocket. Orang is a private company that you do not pay out of pocket. All of the labs (Dynacare, etc.) are private companies. My wife used to work for an infusion clinic that was private (Private pays better fyi). No one there were paying for their medical treatment. Obviously there is a lot that can be said about private putting profits first and governments wasting money but I think that this "Conservatives want to be American" is just fear mongering. Big business doesn't want us paying out of pockets. They want the government to take that money and pay the private companies on our behalf.

Thanks for posting that for everyone. I went private for that reason lol

I am almost certain the scenarios you are referring to are covered by insurance or government. Part of my job is automation of searching for stuff that can pay in these scenarios. Won't say more than that because I have no clue what I'd be violating, but...yeah if there's no coverage, the average person is ******.

Hell, I'd be ******. How many $10k bills a month can an individual take?

 

[Mad Mike]

While I admit that REDDIT is NOT the most reliable of sources, and is definitely an echo chamber at times...there seems to be more chatter around Doug's slow moves towards normalizing private health care in Ontario.

Doug Ford’s government is quietly privatizing health care

On the cusp of an election, Ford may play down plans for privatizing hospitals. But it is his record, not his words, that is important.

www.thestar.com

https://twitter.com/x/status/1503076211660054534

‘We are seeing the creation of a two-tier system of health care in Ontario’

WATERLOO REGION — A provincewide call to action on the alleged privatization of health care will see a series of emergency summits held across Ontario over the next month.

www.therecord.com

Anyone have some input on this? Is there anything to it?

In theory we currently have a 'private' healthcare system, as private clinics are doing the bulk of the work and then OHIP pays. Would this be different? Or would it be a 'cash for service' thing where the public doctors/nurses/practitioners would be moving over to the private network?

Thoughts?

I think the definition of OHIP is a publicly funded Health Insurance system delivered by a mix of private and public service providers.

Delivery is a mix of private and public providers, always has been. Public health, hospitals, and municipal long-term care are publicly run/delivered, everything else (doctors, clinics, rehab centers, labs, pharmacy, diagnostic imaging, ophthalmology, dental etc) are private.

I think there are 2 groups that get vocal when there is a change in the wind.

1) Socialists - the fear and war cry against a belief that private operators lead us to a '2-tier' system where the bourgeois get quicker access because they can pay. A common argument might be that a rich person could pay $1500 for an MRI right now, whereas a poor person might wait 6 months for an MRI delivered at a hospital.

2) Unions - that's mostly the good fight to retain and grow membership for their business.

 

[GreyGhost]

If implemented properly, I am all for it. Lots of benefits for all with few downsides. I like the Oz approach. To maintain your medical license you have to work something like 20 or 30 hours a week in the public system. If you want to work more hours and make more money, you are welcome to work in the private system as much as you want as long as you do your public hours.

Obviously people that can pay (or have insurance) have better access to the private system and shorter lines but that pulls those people out of the queue for the public system so the lines are shorter for the people that can't pay as well. There is also a decent chance that a patient of the public system gets the same rockstar doctor that people pay a lot of access in the private system.

EDIT:
My dad had a stent placed for an AAA months ago. Doc called him this week and said she is giving up on scheduling a CAT scan to check placement as he will never get a spot. They will try an ultrasound and hope they can see enough. Public only where the system is so broken that it is not possible to obtain care obviously needs a rethink.

 

[油井緋色]

If implemented properly, I am all for it. Lots of benefits for all with few downsides. I like the Oz approach. To maintain your medical license you have to work something like 20 or 30 hours a week in the public system. If you want to work more hours and make more money, you are welcome to work in the private system as much as you want as long as you do your public hours. Obviously people that can pay (or have insurance) have better access to the private system and shorter lines but that pulls those people out of the queue for the public system so the lines are shorter for the people that can't pay as well. There is also a decent chance that a patient of the public system gets the same rockstar doctor that people pay a lot of access in the private system.

I'd like for them to redo the entire doctor billing system tbh.

Among my doc buddies, there are two distant personalities: pure altruistic (chances are, less years worked), and pure pragmatism (more likely with years 5+ in field, and with an amount of jadedness.) What I've learned from the ones who went pragmatic is that the system heavily favors compliant patients with procedures/tests that can be done efficiently. So what do pragmatic doctors do? Fire as many ****** patients that they can, and eventually specialize in procedure/tests that make the most $/h.

No judgment with any of the above; I just think the system dumb and promotes the above.

 

[Mad Mike]

...

Now, with regards to opticians and dentists: these impact quality of life as much as regular health care. While glasses are affordable for many, dentist bills utterly insane because the dentists target insurance payout maximums and not what the average can afford.

Audiologists (hearing) is another that isn't covered. I'm certain I'm missing a dozen or more medical related things that should be covered.

...

These businesses have really changed in the last decade. Most are running sophisticated health management systems that include CRM, Booking/scheduling, and sophisticated tools that help them maximize revenues. It's amazing that my son (with no dental issues or insurance) gets billed about $500/year for checkups and cleaning. His sister (full benefit plan) gets billed 25% more for the same procedures AND gets scheduled for 4 cleanings a year. When I go in, the sales lady has all the services the insurer will allow (panoramic Xrays, gum measurements, etc) on a worksheet for the hygenist and dentist.

 

[GreyGhost]

We're already semi private and I'm not surprised we're moving this direction.

As I've mentioned before, I work in the field and have close friends who are doctors. They've mentioned something about how "the government offsets costs to pharmacies" and something involving kickbacks since it's illegal for pharmacies to bribe doctors.

Now, I've always thought our system was great....except there's a whole subsection of drugs that cost $1000+ per dose. If you need these, and you don't have insurance, free health care might as well not exist (it's not fun going to the doctor knowing they can't do anything and the drug that helps is out of reach.)

Now, with regards to opticians and dentists: these impact quality of life as much as regular health care. While glasses are affordable for many, dentist bills utterly insane because the dentists target insurance payout maximums and not what the average can afford.

Audiologists (hearing) is another that isn't covered. I'm certain I'm missing a dozen or more medical related things that should be covered.

------------
As for my personal thoughts....I'll have coverage. I personally don't care lol

As for everyone who doesn't....¯\_(ツ)_/¯, wealth gap is just getting worse at this rate.

My dentist takes 10% off the bill if you don't have insurance. That's appreciated but still expensive. Nothing compared to the bill for a vet to work on a dogs teeth though.

 

[Wingboy]

My observation.
In and out of hospitals for my wife over the last 5 yrs. Hamilton, Cambridge, Kitchener 1, Kitchener 2. All were not pleasant. Understaffed and overworked.
Now she is Waterloo Hospice and it's like a 5 star hotel. Very peculiar.

 

[Mad Mike]

Parts of the health system are already two-tier. When I broke my shoulder the surgery was free, but when it came time for physio the guy at the hospital asked what sort of health insurance I had. I happen to have great health insurance through work, so I could go to any physio clinic that I wanted.

The list of OHIP-approved physio clinics was much smaller. So if you happen to be stuck with just OHIP coverage your choices will be a lot more limited. And if you're stuck using public transit those OHIP clinics would have been incredibly inconvenient to get to. That's bad enough when you're talking about physio, but applying the same model to hospitals seems like a bad idea.

I think good, accessible health care is the mandate. I'm not sure that means delivery needs to be as convenient as finding a coffee shop.

Years ago my kid broke his shoulder in a hockey accident, we had a similar discussion. The surgeon put it to me like this: The physio program offered by the hospital's fracture clinic will get him on the ice in 4-6 months. If you use a sports injury clinic for rehab, you might shorten that to 6 weeks.

Both options deliver the same final result, the paid option is just quicker. Some will have a problem with that, arguing nobody should be able to heal faster because they have money.

 

[油井緋色]

These businesses have really changed in the last decade. Most are running sophisticated health management systems that include CRM, Booking/scheduling, and sophisticated tools that help them maximize revenues. It's amazing that my son (with no dental issues or insurance) gets billed about $500/year for checkups and cleaning. His sister (full benefit plan) gets billed 25% more for the same procedures AND gets scheduled for 4 cleanings a year. When I go in, the sales lady has all the services the insurer will allow (panoramic Xrays, gum measurements, etc) on a worksheet for the hygenist and dentist.

Yeah...it's the same in the drug world. There are even algorithms for "compassionate scenarios" (aka. free) but it's not actually free most of the time (patient doesn't pay, money comes from something else.)

My dentist takes 10% off the bill if you don't have insurance. That's appreciated but still expensive. Nothing compared to the bill for a vet to work on a dogs teeth though.

When I was a student, with student coverage, the dentists waived anything not covered. I never expected this and went in with cash ready...but yeah, some are very nice.

...also, I brush my dog's teeth for that reason lol

My observation.
In and out of hospitals for my wife over the last 5 yrs. Hamilton, Cambridge, Kitchener 1, Kitchener 2. All were not pleasant. Understaffed and overworked.
Now she is Waterloo Hospice and it's like a 5 star hotel. Very peculiar.

Sunnybrook and St Michaels are top tier but both are downtown.

I don't know if you'd want to be in Sunnybrook though.....neurosurgery is not something I want again lol. St Michaels is the hospital every health care friend I have tells me to go to if I can physically get there myself.

I've been to Bowmanville....waited nearly 6 hours for an xray. Stouffville was also horrible: waited 3 hours to be told everything is okay, only to find out I got hospital grade STDs growing on a surgical wound (not where you guys are thinking lol) from a doctor in Taiwan a month later lol

 

[Mad Mike]

If implemented properly, I am all for it. Lots of benefits for all with few downsides. I like the Oz approach. To maintain your medical license you have to work something like 20 or 30 hours a week in the public system. If you want to work more hours and make more money, you are welcome to work in the private system as much as you want as long as you do your public hours.

Obviously people that can pay (or have insurance) have better access to the private system and shorter lines but that pulls those people out of the queue for the public system so the lines are shorter for the people that can't pay as well. There is also a decent chance that a patient of the public system gets the same rockstar doctor that people pay a lot of access in the private system.

EDIT:
My dad had a stent placed for an AAA months ago. Doc called him this week and said she is giving up on scheduling a CAT scan to check placement as he will never get a spot. They will try an ultrasound and hope they can see enough. Public only where the system is so broken that it is not possible to obtain care obviously needs a rethink.

This perplexes me - I can understand an MRI, but I've never heard of CT scans being an issue.

Last year I got tangled in a pool tarp and took a tumble down a stone staircase. After stitching me up they did a CT scan on the spot, then another a week later when the stitches were removed.

 

[GreyGhost]

This perplexes me - I can understand an MRI, but I've never heard of CT scans being an issue.

Last year I got tangled in a pool tarp and took a tumble down a stone staircase. After stitching me up they did a CT scan on the spot, then another a week later when the stitches were removed.

Dunno. Southern ontario but not GTA may affect availability? Doctor may have ****** off scanning department? When your doctor gives up, there isn't a lot you can do as a patient to move things along.

 

[mimico_polak]

My dentist takes 10% off the bill if you don't have insurance. That's appreciated but still expensive. Nothing compared to the bill for a vet to work on a dogs teeth though.

I know a LOT of dentists that cover the 20% if your plan only covers 80%.

Cleaning with insurance: $250
Cleaning w/o insurance: $50-100

It's ridiculous. I had one dentist tell me that I owe them for the last 20%...

- why?
- because your plan covers only 80%
- ya, but your cost to the uninsured is less than 50% of your insured bill
- oh....
- yes, lots of friends come here and they're contractors w/o benefits. We all talk
- Ok. Don't worry about the 20%

One dentist found out I was quitting my job and would lose benefits for 3-6 months, and somehow magically she found 6 cavities. The week before that my teeth were in perfect health...shocking.

 

[mimico_polak]

This perplexes me - I can understand an MRI, but I've never heard of CT scans being an issue.

Last year I got tangled in a pool tarp and took a tumble down a stone staircase. After stitching me up they did a CT scan on the spot, then another a week later when the stitches were removed.

When I went into the hospital a few weeks ago I had to wait 2.5 days for an MRI just so they can slot me in. Ultrasound was within 24h or so, but also wait list for cancellation / spot.

Doctors told me 'You can leave, but the MRI could take you months to get a spot...and surgery even longer. You decide.'

 

[油井緋色]

I know a LOT of dentists that cover the 20% if your plan only covers 80%.

Cleaning with insurance: $250
Cleaning w/o insurance: $50-100

It's ridiculous. I had one dentist tell me that I owe them for the last 20%...

- why?
- because your plan covers only 80%
- ya, but your cost to the uninsured is less than 50% of your insured bill
- oh....
- yes, lots of friends come here and they're contractors w/o benefits. We all talk
- Ok. Don't worry about the 20%

One dentist found out I was quitting my job and would lose benefits for 3-6 months, and somehow magically she found 6 cavities. The week before that my teeth were in perfect health...shocking.

I've fired my dentist for this before.

Tbh I don't care if they want to maximize me to make profit. I start caring when their actions waste my time however, which is that exact "6 cavities" scenario....damn ********.

 

[GreyGhost]

I've fired my dentist for this before.

Tbh I don't care if they want to maximize me to make profit. I start caring when their actions waste my time however, which is that exact "6 cavities" scenario....damn ********.

If they are going to do unnecessary work, at least learn from the physio crooks and kick back some money to the person that is supposedly injured.