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

Popular posts from this blog

Deficit? Public spending ain't the cause. Revenue, however...

With the election over, pressure to cut public programs has become quite intense. In almost all of the corporate owned media someone is barking on about it.

Another option -- increasing revenue from corporations and the wealthy is not mentioned.  However, data clearly indicates that Ontario does not have an overspending problem compared to the other provinces.

Instead, it indicates Ontario has very low revenue. 
Ontario has the lowest public spending of all the provinces on a per capita basis (see the chart from the 2014 Ontario Budget below).  So there is little reason to suspect that we have an over-spending problem.  If anything, this suggests we have an under-spending problem.

The Ontario government has also now reported in the 2014 Budget that Ontario has the lowest revenue per capita of any province.  This is particularly notable as other provinces are quite a bit poorer than Ontario and therefore have a much more limited ability to pay for public spending.  (Also notable in this…

Budget underwhelms on health care. Bait and Switch is such a nasty term

Last year the government promised a 4.64% health care funding increase in 2018/19. Then, earlier this month, they announced they would deficit spend to improve hospitals, mental health, home care, and child care.   Three of the four items cited by the government for improvement were part of health care. 

As it turned out the government did in fact promise in today's Budget to deficit spend $6.7 billion. (Due to a $1 billion fall in expected revenue, the extra spend amounts only to an extra $5.7 billion for 2018/19 programs – but that is still a significant chunk of new found cash for program spending.)  
If health care had gotten even a proportionate share of this new $5.7 billion in program spending, it would have added an additional $2.4 billion to health care  --  in other words about another 4% increase.  

But all health care got -- despite the government’s health care rhetoric -- was an extra $284 million. That may sound like a lot but with a total health care spend of $61 bill…

Ford government promise falls far short of solving hospital hallway medicine problem

Tens of thousands of new Long-Term Care (LTC) beds needed just to offset aging
The new Progressive Conservative government in Ontario has promised 30,000 new long-term care beds over the next ten years, often connecting this to their promise to end hospital hallway medicine.  But how does this promise stack up with growing demand for these facilities?
Most people 85 and older live in collective dwellings (LTC facilities, seniors residences, multiple level of care facilities).  The setting with the largest number of elders 85 and older is LTC facilities, with about 35% of the population 85 to 89  years old and almost 40% of the population 90 to 94 years. Older people are even more likely to be in a LTC facility.
The population 85 and older is the main driver of the need for long-term care beds.
An additional thirty thousand LTC beds by 2028 will only partially offset the rapid growth in the 85+ population.  The ministry of finance projects 42.5% growth in the most relevant population (85 a…