MASSIVE PRICE TO PAY

Closing OHIP loophole responsible thing to do

Should Ontario be paying for the health services of anyone who shows up in this province from tourists to people in the country illegally? That’s the view of some doctors and activists and they’ve started to get media coverage that makes it sound like this is the way it should be.

A main premise of our single payer health system in Canada is that we pay for our health services through our taxes. Part of the health pact between the government and citizens is that we pay our taxes, we are part of the system and they provide the services.

During the COVID-19 pandemic, the Doug Ford government dropped several requirements that had been in place for decades including residency requirements, for access to the OHIP system. They did this in the early days of the pandemic to ensure everyone who was infected would seek and get care rather than spread a deadly virus.

On April 1^st, with the worst of the pandemic behind us, Ontario reverted to the old ways. You need to be resident, a citizen or permanent resident, and you need to live in Ontario for 183 days per year to maintain your coverage. These are similar requirements to what is in place in Quebec, British Columbia, Alberta and Manitoba – in fact every province has eligibility requirements.

Two weeks ago, activists protested at the offices of the Ministry of Health with the irresponsible message of “health care for all” and “access for all.” It might sound good, it might sound compassionate, but it’s an unsustainable idea for a system that is already stretched.

As part of their coverage on the protests, a TV station in Toronto ran the story of a pregnant woman who was told she would have to pay $6000 in advance of her C-section because she didn’t have health insurance. The reason she didn’t have coverage according to the report, was that the woman from Central America was “undocumented” or put another way, in the country illegally.

Our medical system, regardless of province, covers immigrants who come to Canada legally. For anyone claiming refugee status, the federal government covers the costs through a program of its own.

The only reasons this woman would not be covered is that she overstayed a visa, her refugee application was rejected and she was ordered out of the country by the federal government or had entered and stayed in Canada in some other way that was a violation of the law. Not only is she in the country illegally, she isn’t paying taxes that pay for the health system.

Should our health system cover people in the country illegally when we have trouble providing timely care to those paying for it?

Some would argue we should, that this woman is in a precarious position and we should provide care for all.

Let me explain why opening our system – like these activists are calling for – is a bad idea by using a slightly different scenario.

Let’s say that instead of Central America, a pregnant woman from New York simply wanted a cheaper birth. According to the New York State Health Department, the median cost of a vaginal birth at Claxton- Hepburn Medical Center, just south of Ottawa but over the border in the state of New York, was more than $7,500 US in 2017, while at Mercy Hospital of Buffalo, New York, the cost was $6,700 US in 2017.

A C-section is much more expensive. A more recent review put the average cost of delivering a baby in New York at more than $15,000 US.