Skip to main content

Physiotherapy: One more privatization scandal?



Lurking only slightly below the surface in the recent fight over changes to funding for physiotherapy is yet another problem with health care privatization.

The government is stopping the ability of 94 physiotherapy clinics to directly bill OHIP. Ontario Health Minister Deb Matthews says that, over the years, licences to provide these services have been bought up by large corporations. Currently, two-thirds of the billing goes to four companies that are, she says, "behind the protests" against her reforms.

Moreover, she charges that the "existing 94 clinics have had an unlimited ability to bill the government and have become very creative in they way they bill."

By reforming how the money is distributed, the government claimed they will provide physiotherapy, exercising and fall-prevention classes to 218,000 more people, mostly seniors.  


And they are going to do this while providing less money for physiotherapy than they otherwise would: $16,000,000 less according to the Toronto Star.

To boot, in late July, the government went after the private clinics for money it claims they wrongly billed OHIP.  

Reportedly, a 2011 audit looked at 15,000 records and found that 58% of them failed to support OHIP billings.  Five-minute exercise classes were sometimes billed as physiotherapy,  care plans did not measure up, record keeping was incomplete, and  physician referrals were sometimes lacking.

“There is extraordinary growth in expenditures and the audit was one of those factors that just demonstrated to me that there were companies who were just taking advantage of the way the program was set out and taking advantage of their unlimited ability to bill OHIP,” Health Minister Deb Matthews told the Star.

The Perils of Privatization
It almost sounds like the government thinks these private corporations have been milking the system.  


And that is a widespread problem with privatization:  In the US, the centre of private health care, corporations are regularly accused of gaming the system and over-billing.  Sometimes taking the public for billions of dollars.  

We have had quite a run of health care privatization scandals in Ontario: e.g. e-Health, Ornge, chemotherapy mixtures, the Brampton P3 hospital. 


 But the Ontario government just keeps trying to privatize, despite the results.

Keeping on the same privatization track
Indeed, right in the midst of its fight with the physiotherapy clinics, the government is also moving to turn surgeries done in public hospitals over to private clinics (see OCHU's comments on the private surgical clinics here).  

Maybe if they just keep on trying the same thing they will get a different result...

Photo: Amir Kukovic

Comments

Post a Comment

Popular posts from this blog

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2. 

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medavie Blue Cross with 1,900 employees.  It now a