For-profit health-care: Fears of upsell pressure as private clinics take on surgeries

As the Ford government allows thousands of backlogged surgeries to take place at private clinics, there are concerns patients could be paying for more than they need.

“As soon as the for-profit delivery happens, there are barriers to access,” says Nickel Belt MPP and NDP health critic France Gélinas.

Gélinas says, at private clinics, patients will feel pressured to spend money on options not covered by OHIP, and that will begin when cataract surgeries start taking place in for-profit clinics.

“[The doctor] prefers to use that lens,” says Gélinas, “and you know, that guy is about to put a laser to my eye. If he prefers to use that lens, so do I. But it costs $400.”

Moving cataract surgeries into private clinics is the province’s first step in clearing a surgical backlog, and represents roughly 25 per cent of surgeries waiting to take place at Ontario hospitals.

“I think there always has to be some safeguards in place, and I think public awareness is number one,” says Morgan Welburn, an optometrist at the Renfrew Eye Clinic.

“I can see where you would be totally overwhelmed, there’s just so many options,” she says about cataract surgery, for which her clinic refers one to two people a day.

“And how are you to know what’s the proper option for you?”

While the standard cataract surgery is covered by OHIP, the Eye Physicians and Surgeons of Ontario list diagnostic eye measurements, special feature lens implants, and certain surgical procedures, diagnostics, and lasers as additional expenses patients could choose to pay for out-of-pocket.

A graphic showing uninsured cataract surgery options, including diagnostic eye measurements, special feature lens implants, and certain surgical procedures, diagnostics, and lasers. (CTV News Ottawa)

“Every and all medically necessary procedures and surgeries would be OHIP covered,” Dr. Rose Zacharias, president of the Ontario Medical Association (OMA) told CTV News.

The OMA is in favour of moving such non-invasive surgeries to private clinics, but says doctors should not be in a position of sales.

“If there are patients being denied services because they’re not paying, there are regulatory ways to deal with those scenarios,” says Zacharias.

The province also intends for procedures such as diagnostic imaging, colonoscopies, endoscopies, and knee and hip replacements to take place at for-profit clinics in the future.

“Keep it in the not for profit,” says Gélinas, “keep it attached to our hospital systems.”

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