Ending medical coverage for the uninsured harms vulnerable people: OMA

Ending medical coverage for the uninsured harms vulnerable people: OMA

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The Ontario Medical Association will continue to press the provincial government to reinstate a program that extends 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 OMA asked for an extension, which wasn’t granted. Zacharias said Friday the organization was 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 had shown how crucial the program was 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 those who have difficulty getting to Service Ontario offices to fill out forms 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 costs the province $15 million over three years.

Zacharias said the program had helped underscore how big the need was for health services among uninsured people.

“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 on Friday as part of a tour when she learned the province had discontinued the program 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 to protest the decision to end the program.

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The Canadian Association of Emergency Physicians has 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-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,” the heads of provincial and national pediatric health organizations wrote in a letter to Health Minister Sylvia Jones and Premier Doug Ford.

Zacharias, an Orillia emergency physician who is nearing the end of her one-year term as OMA president, said she had also been hearing from physicians dealing with burnout, in part related to the heavy administrative burden doctors are now facing. 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 desires.”

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 he had 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 several steps in that direction, including a commitment to invest $1 billion in home and community care.

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