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September Articles on the Development of the For-Profit MRI/CT Scan Clinics

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Private clinics are not the magic solution
September 22nd

No queue jumping at Ontario MRI clinics
September 20th

Private health clinics won't lead to queue jumping for the rich, Clement
September 20th

Cash payments to be limited at Ontario clinics
September 20th


The Ontario government insists people will not be able to jump hospital waiting lists at private, after-hours M-R-I
September 20th


HEALTH POLITICS
September 20th

Ontario won't allow 'queue jumping' at MRI clinics
September 20th

Queue-jumping won't be tolerated, Clement says; Better 'accessibility' aim
of private clinics, health minister insists
September 20th

Health-For-Profit-Update (newser)
September 20th

Ont.'s plan for for-profit MRI, CT clinics will increase health costs: report
September 19th

Provincial Plan to introduce private, for profit MRI/CT ; a lose-lose situation
September 19th

A report, obtained by the Toronto Star, says the Ontario government's plan to allow for-profit, private M-R-I and C-T
September 19th

Value of private clinics questioned; Coalition casts doubt on cost efficiency of for-profit scan centres
September 19th

Private MRI clinics boost costs, report says
September 19th

Ontario residents will not be allowed to walk into private, for-profit MRI clinics when they open in the next few months and simply put down cash for diagnostic tests
September 19th


 

Private clinics are not the magic solution
The Toronto Star
Sunday, September 22, 2002
News
A02
Michele Landsberg


PREMIER ERNIE EVES had better hope that Tinkerbell does sit on his bed
post - to borrow a phrase he used last week to mock environmentalists - if
he ever hops up on the bed of an MRI or CT scan machine in one of those
private clinics he's pushing.
Ernie is going to need a little fairy dust to protect him, because nobody
else will.
His health minister, Tony Clement, has called for 20 private, for-profit MRI
clinics and five CT clinics - for fast, fast, fast relief before the Romanow
commission on medicare can report later this fall and possibly prevent
further erosion of our public health care system. The intent of Tony
Clement's reckless rush to privatize seems to be to establish "facts on the
ground," as West Bank settlers used to say.
How safe are those clinics? How necessary are they? Will they reduce waiting
lists? Is there no other way to get the public diagnostic services we need
so desperately?
CT scans - magnificent diagnostic tools, when properly used - emit
radiation. Radiation is not harmless. In fact, the American College of
Radiology does not endorse whole-body scans for "the worried well." Even
more alarmingly, whole-body CT scans expose a patient to the equivalent of
400 to 500 chest x-rays, according to physicist Thomas Shope Jr. of the U.S.
Food and Drug Administration's office of science and technology, quoted last
year in The Washington Post.
A private owner of CT clinics, however, said the number was "absolute
nonsense."
Who do you believe, the physicist or the business owner? Even if it's only
twice or three times the amount of radiation, it seems scary to me to hawk
these services like used cars or package tours.
I'd like to think that someone a little more qualified than Tinkerbell is
supervising the whole procedure. What chilly comfort, then, to know that the
oversight for private diagnostic imaging clinics will fall to the College of
Physicians and Surgeons of Ontario.
You remember them. They're the ones who, The Star has revealed, did nothing
for 11 years after they were warned that Dr. Ronald Wilson and his
technologist were putting dirty EEG needles in patients' scalps at their
diagnostic clinic. Hundreds of patients were infected with potentially
deadly hepatitis B, while the college dozed. Even now that the horrifying
facts are known, and Wilson was found guilty of incompetence and is awaiting
his punishment, he and his employee are still running a sleep clinic.
I wonder if the current CT scenario will play out like the tainted blood
scandal. Will thousands of sick people be suing the Ontario government 20
years from now for wilful negligence?
It's not as though we're taking risks in order to save public dollars.
According to the Ontario Health Coalition's recent report, the private
clinics in Alberta cost 21 to 25 per cent more than the public facilities,
and did not shorten waiting lists.
Most people in favour of the clinics imagine that, in a crisis, they'd love
to be able to fork over $800 and get a very quick diagnosis. But under the
rules of medicare, you can pay privately for these scans only if they're not
medically required. In an urgent medical crisis, you'd go to the head of the
public waiting list and would not pay anything.
In the U.S., private companies haul their CT machines around the country,
setting up shop in church parking lots (they pay the pastor with two free CT
scan coupons) and touting themselves as the Wal-Mart of medical care. One
physician who succumbed to the lure of a quickie scan had his sad tale
retold in The New York Times last spring. The scan revealed suspicious
masses and nodules; more and higher-risk scans were done, and then more
tests. The doctor finally insisted on painful, invasive surgery, with a
two-month recovery time, only to learn that the so-called masses were
innocuous scars from childhood illness. Whole-body CT scans, the doctor
concluded, were "prescriptions for panic."
But, you may argue, the public system is bankrupt and can't buy the
desperately needed machines.
Wrong. The federal government gave the provinces $1 billion over the last
two years specifically to buy diagnostic machinery. Ontario, alone of all
the provinces, stole a huge whack of that money, $60 million, and gave it to
private, for-profit companies. That money could have bought more than enough
machinery for all the hospitals with waiting lists. Instead, private owners
like Extendicare, Leisureworld, DiagnostiCare and Central Park Lodge "lucked
out," in the words of one of their staff.
But wait, there's more. At least two towns, Kenora and Oakville, have raised
the money, through public campaigns, to buy MRI or CT scan machines for
their local hospitals. Their offers are languishing unanswered on Tony
Clement's desk.
The private sector knows no bounds in its hunger for public money.
DiagnostiCare, an Alberta-based company which says it owns 120 private
clinics in Ontario, last year demanded from three small towns in eastern
Ontario that they provide public subsidies to increase the clinics' profit
margin to 23 per cent, or the clinics would have to close. They got $12
million from Tony Clement - and closed the clinics anyway, according to the
Canadian Association of Radiologists.
There's an agenda here that has nothing to do with public health, waiting
lists or strengthening medicare. The agenda is to privatize now, and fast,
and without scruples. It's the government's very own going-out-of-business
sale.
Neither the Canadian Association of Radiologists nor their Ontario
counterparts have been consulted about this massive shift of care into the
private sector. Both have publicly and strenuously objected to Tony Clement.
He has not bothered to reply to them.
On the other hand, the Tories are thick as thieves (it's just a metaphor)
with private sector lobbyists - at least three of whom have left the
corporate medical world to join the government staff.
There's another threat the continent-wide shortage of radiologists. Private
clinics poach their radiologists from public hospitals, luring them with
rich "signing bonuses." In cities like Calgary, Vancouver or Halifax, the
impact of this raiding has been to impair or actually kill some public
hospitals' capacity to offer diagnostic imaging. This is privatization by
stealth.
"It's a speeding train with no conductor," said Normand Laberge of the
Canadian Association of Radiologists. "The only thing that can happen is a
derailment."
Tony Clement, on the other hand, blandly assures us, without offering a
shred of evidence, that the private clinics will end waiting lists and offer
universal access.
Clap if you believe in fairies.
Michele Landsberg's column usually appears in The Star Saturday and Sunday.
Her e-mail address is mlandsb@thestar.ca



No queue jumping at Ontario MRI clinics
The Standard (St. Catharines)
Friday, September 20, 2002
News
B7


SARNIA - Patients will not be able to jump hospital waiting lists at
private, after-hours MRI clinics proposed by the Ontario government, Health
Minister Tony Clement said Thursday.
"If there is evidence of queue jumping we will come down hard," warned
Clement, who threatened to revoke the licence of any hospital or any private
clinic caught allowing it.
Clement said he will rely on Ontario doctors to ensure no one skips ahead of
those on public waiting lists for diagnostic services just because they have
written a cheque.
Physicians, he said, are the "gatekeepers" in the government's plan.
In June, Clement announced Ontario would allow the creation of 20 privately
run MRI clinics and five more to provide CAT scans in an effort to reduce
waiting lists.
"Citizens are concerned about wait times, and they should be," Clement said
at a Conservative caucus retreat in this southwestern Ontario city.
He said patients would only be able to pay for a non-medically necessary MRI
or CAT scan if a doctor agrees and provides a note to the after-hours
clinic.
Medically necessary scans would always be covered by the Ontario Health
Insurance Plan, but individuals will be able to buy an MRI scan for between
$700 and $1,200.

 

SARNIA
The Canadian Press


Private health clinics won't lead to queue jumping for the rich, Clement
Friday, September 20, 2002
BY KEITH LESLIE


SARNIA, Ont. (CP) _ Patients will not be able to jump hospital waiting lists
at private, after-hours MRI clinics proposed by the Ontario government,
Health Minister Tony Clement said Thursday.
``If there is evidence of queue jumping we will come down hard,'' warned
Clement, who threatened to revoke the licence of any hospital or any private
clinic caught allowing it.
Clement said he will rely on Ontario doctors to ensure no one skips ahead of
those on public waiting lists for diagnostic services just because they have
written a cheque.
Physicians, he said, are the ``gatekeepers'' in the government's plan.
In June, Clement announced Ontario would allow the creation of 20 privately
run MRI clinics and five more to provide CAT scans in an effort to reduce
waiting lists.
``Citizens are concerned about wait times, and they should be,'' Clement
said at a Conservative caucus retreat in this southwestern Ontario city.
He said patients would only be able to pay for a non-medically necessary MRI
or CAT scan if a doctor agrees and provides a note to the after-hours
clinic.
Medically necessary scans would always be covered by the Ontario Health
Insurance Plan, but individuals will be able to buy an MRI scan for between
$700 and $1,200.
Clement said he never meant to leave the impression the government would
allow people to walk up and pay for a scan without a doctor's note approving
the procedure.
Premier Ernie Eves told reporters his government's policy on the proposed
private clinics is still developing ``as we speak,'' but insisted he wants
to abide by the Canada Health Act, which outlaws payment for medically
necessary services.
Patients in Nova Scotia and Quebec can pay directly at a private clinic for
an MRI scan without a doctor's note, but Clement says those provinces have a
different interpretation of the Canada Health Act.''
The Ontario Health Coalition released a report Thursday questioning the
social and economic benefits of for-profit health care clinics.
The medicare lobby group says the private clinics will do little to reduce
long waiting lists, but Clement insisted the intention is to increase
accessibility for everyone.
The first step towards the private health clinics in Ontario will be a
request for proposals from companies interested in the contracts, but
Clement said that process has not started yet.
The Ontario Association of Radiologists has also come out against the idea
of private clinics, saying it won't solve the waiting list problem.
Canadian Press Newswire
Quebec-Ontario Regional General News
HEALTH POLITICS



Cash payments to be limited at Ontario clinics
Port Hope Evening Guide
Friday, September 20, 2002
National News
14


TORONTO (SN) - Ontario residents will not be allowed to walk into private,
for-profit MRI clinics when they open in the next few months and simply put
down cash for diagnostic tests, Health Minister Tony Clement said Thursday.
Clement acknowledged that MRI services can be directly purchased from
private MRI operators in Quebec and Nova Scotia but argued that governments
in those provinces "have a different interpretation of the Canada Health Act
than Ontario does.
"Ontario feels that the Canada Health Act is quite clear - that diagnostic
services, MRI services, CT services, X-rays are medically necessary
services" which must be paid for by the provincial health insurance program.
Patients requiring the diagnostic tests will have to present their health
cards at the clinics so procedures will be covered by the Ontario Health
Insurance Plan.
The Ontario government in its June budget announced it will allow 20
privately owned and operated MRI clinics and five CT clinics to open in the
province beginning as early as this fall.
Clement said the new clinics will be able to accept private cash payments
but that will only happen after hours and in situations where the tests
aren't medically necessary, such as when people need full MRI scans for
insurance purposes. Those same rules currently apply to existing MRIs in
hospitals, which also do after-hours insurance work to earn extra cash, he
said.
"Right now under the current rules, (people can) go to the doctor, say 'I
need a body scan for the insurance for the company I work for' ", the
minister said. "The doctor would sign a form saying it is not medically
necessary (and) that individual would then go to a hospital MRI in off
hours, have the scan done and pay for it."
The same rules will apply to the new clinics, reiterated Clement, who warned
that "if there's evidence of queue jumping they (the clinics) lose their
licence."
Clement, who said the government's request for proposals for the new clinics
has yet to be issued, said the whole point of the new clinics will be to
improve access to diagnostic services.

TORONTO
Southam News
SARNIA, Ontario -- The Ontario government insists people will not be able to
jump hospital waiting lists at private, after-hours M-R-I

Friday, September 20, 2002


SARNIA, Ontario -- The Ontario government insists people will not be able to
jump hospital waiting lists at private, after-hours M-R-I clinics.
Ontario Health Minister Tony Clement says it'll be up to doctors to keep
people from paying for high-tech diagnostic services ahead of those on
public waiting lists.
The province wants to open 20 privately-run M-R-I clinics and another five
to provide C-T scans.
Clement says patients will only be able to pay for a non-medically necessary
M-R-I or C-T scan for insurance or other purposes if a doctor agrees.
He says the doctors are needed as gatekeepers to make sure people don't jump
public lineups.
Clement warns the province will revoke the licence of any hospital or clinic
that allows people to jump lines by paying for diagnostic services.
Premier Ernie Eves says the government's policy on the proposed private
clinics is still evolving, but insists he wants to abide by the Canada
Health Act.
The Ontario Health Coalition says it doubts private clinics will reduce long
waiting lists, but Clement insists the idea is to increase access for
everyone.
(BN)
kjl

 


Broadcast News
General And National News
HEALTH POLITICS
Ontario Audio at 2:25 p.m. 19-09-02
Friday, September 20, 2002


R14 - (Ontario-MRI-Clinics)
SARNIA, Ontario (Keith Leslie BN) 33s. The Ontario government insists people
will not be able to jump hospital waiting lists at private, after-hours
M-R-I clinics. (SOURCE:BN-WA) (225p)
R15 - (Ontario-MRI-Clinics)
SARNIA. X--14s. Health Minister Tony Clement says it'll be up to Ontario
doctors to keep people from paying for high tech diagnostic services ahead
of those on public waiting lists. And Clement warns hospitals could lose
their licence if anyone is caught paying to jump public queues.
(''...their licence.'') (SOURCE:BN-A) (225p)
TAG: Clement says the province wants to open 20 private M-R-I clinics and
another five to provide C-T scans to reduce waiting lists.
R16 - (Ontario-MRI-Clinics)
SARNIA. X--13s. The Ontario government insists its plan to open 25 private
clinics for high-tech diagnostic services won't lead to queue jumping.
Health Minister Tony Clement says the whole idea is to reduce public waiting
times for M-R-I and C-T scans.
(''...they should be.'') (SOURCE:BN-A) (225p)
TAG: Critics claim private, after-hours clinics failed to reduce waiting
lists when tried in other jurisdictions.
R17 - (Ontario-MRI-Clinics)
SARNIA. X--15s. Premier Ernie Eves says his government wants to open private
clinics to offer high-tech diagnostic services to cut waiting lists. Eves
admits the policy on the idea of private health services still evolving.
(''...Health Act.'') (SOURCE:BN-A) (225p)
TAG: Health Minister Tony Clement says Ontario doctors will act as
gatekeepers to make sure no uses their wallet to jump ahead of public
waiting lists.
Broadcast News
Audio Schedules


Ontario won't allow 'queue jumping' at MRI clinics
The Ottawa Citizen
Friday, September 20, 2002
News
A5
April Lindgren


TORONTO -- Ontario residents will not be allowed to walk into private,
for-profit MRI clinics when they open in the next few months and simply put
down cash to queue jump the system for diagnostic tests, Health Minister
Tony Clement said yesterday.
Mr. Clement acknowledged MRI services can be directly purchased from private
MRI operators in Quebec and Nova Scotia but argued governments in those
provinces "have a different interpretation of the Canada Health Act than
Ontario does.
"Ontario feels that the Canada Health Act is quite clear -- that diagnostic
services, MRI services, CT services, X-rays are medically necessary
services" which must be paid for by the provincial health program.
The Ontario government in its June budget announced it will allow 20
privately owned and operated MRI clinics and five CT clinics to open in the
province beginning as early as this fall.
Mr. Clement said the new clinics will be able to accept private cash
payments, but that will only happen after hours and in situations where the
tests aren't medically necessary, such as when people need full MRI scans
for insurance purposes. Those same rules now apply to existing MRIs in
hospitals, which also do after-hours insurance work to earn extra cash, he
said.
Mr. Clement warned that "if there's evidence of queue jumping they (the
clinics) lose their licence."
Mr. Clement, who said the government's request for proposals for the new
clinics has yet to be issued, said the whole point of the new clinics will
be to improve access to diagnostic services.
But the Ontario Health Coalition released a report yesterday saying evidence
indicates that opening for-profit clinics would, at best, have minimal
impact on waiting times.
In Alberta, British Columbia, Quebec and Nova Scotia, for-profit clinics
allow people to queue jump without respect to medical need, the report also
said.

TORONTO
The Ottawa Citizen



Queue-jumping won't be tolerated, Clement says; Better 'accessibility' aim
of private clinics, health minister insists

The Toronto Star
Friday, September 20, 2002
News
A06
Richard Brennan


Richard Brennan
Ontario Health Minister Tony Clement denies plans to allow privately run
diagnostic clinics will lead to queue-jumping.
"If there is any evidence of queue-jumping we will come down hard ... they
will lose their licence," Clement said yesterday at the end of a two-day
government caucus retreat in this border city.
The Ontario Health Coalition, a group of health-care activists, released a
report Wednesday questioning the social or economic benefit of opening
for-profit clinics, saying they "will likely detract from the public system,
escalate costs and increase risks
patients."
Clement has insisted the new private clinics, which could be run by foreign
firms, would not create queue-jumping or two-tier medicine. He said these
clinics will only be approved if they can prove that their service will
improve accessibility.
"This is all about accessibility for our patients, reducing the wait times.
We reserve the right through the request-for-proposal process ... to assess
whether it approves accessibility," he said.
Premier Ernie Eves said he is looking forward to seeing what the upcoming
Roy Romanow report on the future of health care in Canada has to say on
for-profit clinics.
"The government's policy is developing as we speak and that should be the
case. It will be interesting what Mr. Romanow recommends when he comes
forward in November," Eves said yesterday.
When Clement announced the government's plans for privately run, publicly
paid-for MRI (magnetic resonance image) and CT (computed tomography) clinics
in July, he said people would be able to pay out of their pockets for
diagnostic services. That caused howls of protest from critics saying it
would lead to queue-jumping.
Soon afterward, Clement wrote a letter to doctor representatives, assuring
them the government remains fully committed to the principles of the Canada
Health Act.
"Let me be clear, patients will not be permitted to purchase faster access
to these important medical services," he wrote. "As is currently the case,
medically necessary insured scans will continue to be fully funded under
OHIP."
MRI machines are used in the diagnosis of cancer and other conditions, while
CT scanners are used to diagnose cancer, strokes and certain diseases.
However, what remains unclear is what position the government will take when
it comes to MRI or CT scans that are not considered medically necessary. In
other provinces, private-pay clinics do allow patients to buy speedy access
to scans. It is uncertain whether the Ontario government will allow these
private-pay scans.
Clement said yesterday any private clinic or hospital that allows a person
to pay directly for an MRI without a doctor's request would be shut down.
"The rules and regulations governing that are already found in our Canada
Health Act," he said, adding that a person requiring a scan for insurance
purposes, for example, who has a doctor's note, will still be able to pay
directly for the service.
Clement added that "most services that the MRIs are used for are medically
necessary services to diagnose some form of affliction or illness. That
would never be for pay. That is contrary to the Canada Health Act."
With files from Vanessa Lu

CLEMENT
SARNIA
Toronto Star

Health-For-Profit-Update (newser)
Friday, September 20, 2002


TORONTO -- A health-care lobby group says the province's plan to set up
private M-R-I and CAT scan clinics will do little to reduce long waiting
lists.
And the Ontario Health Coalition questions whether it will reduce health
costs.
The coalition made the conclusion in a report released in Toronto today.
Report author Ross Sutherland claims waiting lines in Calgary didn't drop in
1999 despite having three private clinics in the city.
He says the waits were reduced only after the government decided to give
those clinics public money.
But he says it cost taxpayers more than it would have if public services
were expanded.
Health Minister Tony Clement announced in June that the government will set
up 20 M-R-I and five CAT scan clinics.
Clement has denied the clinics will create two-tier health care, but
Sutherland says it would allow people to jump the queues.
(BN)
SAF
Broadcast News
Ontario-Quebec Regional News
HEALTH POLITICS

Ont.'s plan for for-profit MRI, CT clinics will increase health costs:
report

Thursday, September 19, 2002


TORONTO (CP) _ The Ontario government's plan to allow for-profit, private
MRI and CT clinics will increase health-care costs and do little to reduce
long waiting lists, warns a new report by medicare defenders obtained by the
Toronto Star.
``It is questionable what social or economic benefits can be derived from
opening for-profit health-care clinics that will likely detract from the
public system, have little public accountability, escalate costs and
increase risks to patients,'' reads the Ontario Health Coalition report, due
to be released Thursday.
Health Minister Tony Clement announced in June that his government will
allow the creation of 20 magnetic resonance imaging and five computed
tomography clinics, some of which could be up and running by later this
year.
Clement has insisted the new private clinics, which could be run by foreign
firms, will not create queue-jumping or two-tier medicine. The Ontario
Health Insurance Plan will cover medically necessary scans, but individuals
will be able to walk in to buy scans, at a cost of $700 to $1,200 for MRIs
and $650 for CT scans.
Both machines provide internal body images that aid in disease and trauma
detection.
Although the official process of requesting proposals from companies
interested in the contracts hasn't begun yet, Clement spokesman Mike Heenan
said it should start soon.
The report, written by Ross Sutherland, an emergency-room nurse in Kingston,
Ont., finds that use of private clinics surges only if the public health
plan covers the costs.
(Toronto Star)
Canadian Press Newswire
Quebec-Ontario Regional General News
HEALTH POLITICS


Provincial Plan to introduce private, for profit MRI/CT ; a lose-lose
situation

Thursday, September 19, 2002


QUEBEC, Sept. 19 /CNW/ - Radiology services should be provided by
radiologists, not nameless faceless corporations without regard for patient
care, said the Ontario Association of Radiologists (OAR) in reaction to a
damning report released by the Ontario Health Coalition today.
"Certainly we agree that statements by this government about large
corporations or for-profit entrepreneurs being able to provide cheaper and
better health care, especially MRI and CT services, are outrageous," said
Dr. Giuseppe Tarulli, President. "However, what we need to focus on are our
patients. When was the last time you went to a businessman for a diagnosis
of a life threatening disease? As physicians our patients depend on us to
provide high quality health care always keeping in mind that their diagnosis
and treatment is our number one priority."
Tarulli made his comments at the Canadian Association of Radiologists annual
meeting in Sainte-Anne de Beaupre today as he spoke out against the Ontario
government's plan to move to a private, for profit system.
"Healthy patients not healthy profits are our priority and the government
needs to step up to the plate to protect Ontarians from these entrepreneurs
with little or no interest in health care, and certainly no regard for high
quality patient care."
Tarulli said the Ontario announcement to expand MRI and CT services by
allowing large corporations and entrepreneurs without any medical training
to apply to operate the sophisticated diagnostic equipment is concerning. He
added that the Ontario government announcement was made in the absence
meaningful consultations the public, the health care community and
radiologists, who are the experts and front-line providers of radiology
services.
"Why would anyone support the Americanization of our universal system and
emulate a health care model that provides the least amount of health care
and is the most expensive system in the world?" said Dr. Tarulli. "Health
care should be provided by health care professionals. CEOs, accountants and
investors don't diagnose or treat disease, doctors do."
The Ontario Association of Radiologists is a non-profit organization
representing 700 radiology physicians who provide medical imaging services
in both hospitals and community-based clinics across the province.
   -0-                           09/19/2002


Canada News-wire
12:36 (Eastern Time)
General News
ENGLISH; E
Health Care/Hospitals; Quebec
Ontario Association of Radiologists
QUEBEC
/For further information: contact: Susan deRyk, Director of
Communications, Tel: (905) 337-2680 or (416) 706-8532 (cell)/


TORONTO -- A report, obtained by the Toronto Star, says the Ontario
government's plan to allow for-profit, private M-R-I and C-T
Thursday, September 19, 2002


TORONTO -- A report, obtained by the Toronto Star, says the Ontario
government's plan to allow for-profit, private M-R-I and C-T clinics will
increase health-care costs.
The study by the Ontario Health Coalition also suggests the changes will do
little to reduce long waiting lists.
It's set to be released today.
Health Minister Tony Clement announced in June that the province will allow
the creation of 20 magnetic resonance imaging and five computed tomography
clinics.
He's insisted the new private clinics won't create queue-jumping or two-tier
medicine.
The official process of requesting proposals from companies interested in
the contracts hasn't begun yet.
The report also says use of private clinics surges only if the public health
plan covers the costs.
(Toronto Star)
KRM
 

Broadcast News
Ontario-Quebec Regional News
HEALTH POLITICS
Value of private clinics questioned; Coalition casts doubt on cost
efficiency of for-profit scan centres

The Toronto Star
Thursday, September 19, 2002
News
A27
Vanessa Lu


Vanessa Lu
The Ontario government's plan to allow for-profit, private MRI and CT
clinics will increase health care costs and do little to reduce long waiting
lists, warns a new report by medicare defenders.
"It is questionable what social or economic benefits can be derived from
opening for-profit health care clinics that will likely detract from the
public system, have little public accountability, escalate costs and
increase risks to patients," says the Ontario Health Coalition report, due
to be released today at a news conference at Queen's Park.
Health Minister Tony Clement announced in June that his government will
allow the creation of 20 MRI and five CT clinics, some of which could be up
and running by later this year.
Clement has insisted the new private clinics, which could be run by foreign
firms, will not create queue-jumping or two-tier medicine. The Ontario
Health Insurance Plan will cover medically necessary scans, but individuals
will be able to walk in to buy scans, at a cost of $700 to $1,200 for MRIs
and $650 for CT scans.
Although the official process of requesting proposals from companies
interested in the contracts hasn't begun yet, Clement spokesperson Mike
Heenan said it should start soon.
The coalition's report, written by Ross Sutherland, an emergency room nurse
in Kingston, argues that the cost effectiveness of private clinics is
questionable. It points to Calgary, which at one time contracted out work to
the private sector to cope with excessive waiting times. Since last year,
when three new MRI machines were installed in hospitals, it has ended the
practice.
The report finds that use of private clinics surges only if the public
health plan covers the costs.
"But the real question is whether that is the best use of dollars. Is it the
cheapest way? Is it the most efficient way?" Sutherland said. "We would now
be paying somebody to make a profit."
The Ontario Association of Radiologists has spoken out against the Clement
plan.
"This is not going to solve the waiting list problem. In fact, you may be
cannibalizing it," said spokesperson Ray Foley, who warns staff could be
lured to the for-profit sector. There is already a serious shortage of
radiologists and technologists.
"Ontario needs 40 more MRI machines and 25 CT scanners to deal with the
waiting list," he said.
Foley says that in some areas of Ontario patients can wait more than a year
for a non-urgent MRI and up to 30 weeks for a CT scan.

Toronto Star


Private MRI clinics boost costs, report says
The Hamilton Spectator
Thursday, September 19, 2002
Canada & World
B03
Vanessa Lu


A report by medicare defenders warns that the Ontario government's plan to
allow for-profit private MRI and CT clinics will increase health care costs
and do little to reduce long waits.
"It is questionable what social or economic benefits can be derived from
opening for-profit health care clinics that will likely detract from the
public system, have little public accountability, escalate costs and
increase risks to patients," says the Ontario Health Coalition report, due
to be released today at a news conference at Queen's Park.
Health Minister Tony Clement announced in June that his government will
allow the creation of 20 MRI and five CT clinics, some of which could be up
and running by later this year.
Clement has insisted the new private clinics, which could be run by
foreign-owned firms, will not create queue-jumping or two-tier medicine. The
Ontario Health Insurance Plan will cover medically necessary scans, but
individuals will be able to walk in to purchase scans -- with costs ranging
from $700 to $1,200 for MRIs and $650 for CT scans.
Although the process of requesting proposals from companies interested in
the contracts hasn't begun, Clement spokesperson Mike Heenan said
information should be going out soon.
The coalition's report, written by Ross Sutherland, an emergency room nurse
in Kingston, argues that the cost-effectiveness of private clinics is
questionable. It points to Calgary, which at one time contracted out work to
the private sector to cope with excessive waiting times. Since last year,
when three new MRI machines were installed in hospitals, it has ended the
practice.
The report finds that use in private clinics surges only if the public
health plan covers the costs.
"But the real question is whether that is the best use of dollars,"
Sutherland said. "Is it the cheapest way? Is it the most efficient way? We
would now be paying somebody to make a profit."
The Ontario Association of Radiologists has spoken out against the Clement
plan.
"This is not going to solve the waiting list problem," said spokesperson Ray
Foley. "In fact, you may be cannibalizing it."
Foley said staff could be lured to the for-profit sector. There is already a
serious shortage of radiologists and technologists in the province.
"Ontario needs 40 more MRI machines and 25 CT scanners to deal with the
waiting list."
Waiting times vary across the province, but Foley says that in some areas
patients can wait more than a year for a nonurgent MRI and 30 weeks for a CT
scan.

Torstar News Service



Thursday, September 19, 2002
April Lindgren


TORONTO - Ontario residents will not be allowed to walk into private,
for-profit MRI clinics when they open in the next few months and simply put
down cash for diagnostic tests, Health Minister Tony Clement said Thursday.
Clement acknowledged that MRI services can be directly purchased from
private MRI operators in Quebec and Nova Scotia but argued that governments
in those provinces "have a different interpretation of the Canada Health Act
than Ontario does.
"Ontario feels that the Canada Health Act is quite clear - that diagnostic
services, MRI services, CT services, X-rays are medically necessary
services" which must be paid for by the provincial health insurance program.
Patients requiring the diagnostic tests will have to present their health
cards at the clinics so that procedures will be covered by the Ontario
Health Insurance Plan.
The Ontario government in its June budget announced it will allow 20
privately owned and operated MRI clinics and five CT clinics to open in the
province beginning as early as this fall.
Clement said the new clinics will be able to accept private cash payments
but that will only happen after hours and in situations where the tests
aren't medically necessary, such as when people need full MRI scans for
insurance purposes. Those same rules currently apply to existing MRIs in
hospitals, which also do after-hours insurance work to earn extra cash, he
said.
"Right now under the current rules, (people can) go to the doctor, say 'I
need a body scan for the insurance for the company I work for' ", the
minister said. "The doctor would sign a form saying it is not medically
necessary (and) that individual would then go to a hospital MRI in off
hours, have the scan done and pay for it."
The same rules will apply to the new clinics, reiterated Clement, who warned
that "if there's evidence of queue jumping they (the clinics) lose their
licence."
Clement's comments on the last day of a Conservative caucus retreat in
Sarnia, Ont. came the same day the Vancouver-based Fraser Institute released
a study suggesting patients across Canada face "significant" waiting lists
for computed tomography (CT) scans, magnetic resonance imaging (MRI) and
ultrasound scans.
The median wait across Canada for a CT scan was 5.2 weeks. The median wait
for an MRI was 12.4 weeks and the median wait for an ultrasound was 3.2
weeks.
Clement, who said the government's request for proposals for the new clinics
has yet to be issued, said the whole point of the new clinics will be to
improve access to diagnostic services.
"This is all about accessibility for our patients, reducing the wait times.
We reserve the right as a government to assess whether it improves
accessibility, whether it improves the ability to get appropriate diagnostic
services.
"If it does not meet those criteria we're not interested."
But the Ontario Health Coalition released a report Thursday saying evidence
indicates that opening for-profit clinics would, at best, have minimal
impact on waiting times.
The report, which reviewed the use of for-profit MRI and CT clinics in other
provinces, said there is a higher risk of poorer quality in stand-alone
for-profit clinics than in hospitals and it is less expensive to expand
services in the public sector than to pay for-profit clinics to start new
MRI services.
The report said for-profit clinics draw critical personnel away from the
public health care system and there is a higher incidence of medically
inappropriate referrals when doctors have a financial interest in such
clinics.
In Alberta, British Columbia, Quebec and Nova Scotia, for-profit clinics
allow people to queue jump without respect to medical need, the report also
said.

Southam News