Canadian Doctors for Medicare, Canadian Health Coalition, and the Canadian Federation of Nurses Unions urge Prime Minister Justin Trudeau to act now to protect Medicare. Say no to for-profit health providers and private insurance companies and work with Minister of Health to release long-promised Canada Health Act Interpretation Letter on virtual, nurse practitioner care
November 19, 2024 – Organizations representing physicians, nurse practitioners, nurses, health workers, and patient advocates are calling on Prime Minister Justin Trudeau to act now to prevent a growing threat to Medicare. After more than 18 months of waiting, Canadian Doctors for Medicare, the Canadian Health Coalition, and the Canadian Federation of Nurses Unions urge the Prime Minister to work with Health Minister Mark Holland to immediately release the long-promised Canada Health Act (CHA) Interpretation Letter clarifying that virtual care and nurse practitioner care are medically necessary services for which patients must not be charged.
With over 6.5 million Canadians lacking access to a family doctor, virtual care and nurse practitioner clinics have become valuable additions to primary care services. However, because the 40-year-old CHA does not explicitly address either, for-profit health care providers and private insurance companies are exploiting this gap to bill Canadians out-of-pocket. With provincial and territorial governments choosing to be unresponsive, this situation risks further descent into a two-tier health care system. Charging for medically necessary health care – whether by billing patients or through their employer-funded private insurance – contravenes the spirit and intent of the CHA.
“In a country that highly values our universal health care system, there is no way to justify charging patients for what has become an essential mode of health care delivery,” said Dr. Melanie Bechard, Chair of Canadian Doctors for Medicare.
Indeed, expanding access to primary care through public funding of nurse practitioners would benefit our system. Virtual care has also already become widely used and highly rated amongst both patients and health care providers. A study of one hospital’s virtual pediatric emergency care service during the COVID-19 pandemic showed an estimated $890,000 savings to the health system in 18 months of use.
When past evolutions in care led to patient charges, federal health ministers have issued clarifications of the CHA’s intent and application through interpretation letters to provincial and territorial counterparts.
“Public health care can innovate, whether it is through virtual care or nurse practitioners, while respecting the crucial principles of the Canada Health Act,” said Steven Staples, National Director of Policy and Advocacy for the Canadian Health Coalition. “It is time for the Prime Minister to work with the Minister of Health to take action and protect people from being charged for medically necessary services.”
The opportunity for corporate, physician, and or practitioner profit should never drive health policy decisions. Over the last 18 months, both Minister Holland and former Minister of Health Duclos promised to release an interpretation letter because of this concern. Still, Canadians are forced to wait.
“Nurses and health care professionals have expanded their roles over the last 40 years to better serve Canadians. It’s time for the administrators of the Canada Health Act to follow suit and protect patients.” said Linda Silas, President of the Canadian Federation of Nurses Unions. “Privatization is a growing concern in Canada and we need to protect public health care.”
Upon release of the CHA interpretation letter, those who have private workplace insurance would not lose access to virtual care or nurse practitioner services. Instead, provincial and territorial governments, together with the federal government via the Canada Health Transfer payments, would pay for these services, just as they are required to publicly fund all other medically necessary care. In addition, the 29 million Canadians who do not currently have private workplace insurance would also be able to access these services without having to pay out of pocket. Canadians who already pay for health care services through tax dollars must not be asked to pay again when they need care.
Now is the time to act. Release of the CHA Interpretation Letter will be a win for patients and a win for our public health care system by strengthening access to primary care. If the Prime Minister is going to boast about Canadian Medicare abroad like he did on the Stephen Colbert show, he and his government must tangibly defend it at home.
“Better is always possible, Prime Minister” said Dr. Bechard. “I implore you to work with the Minister of Health to immediately release the long-awaited CHA Interpretation Letter and protect Canadian Medicare.”
About Canadian Doctors for Medicare
Canadian Doctors for Medicare (CDM) is a national, evidence-based, and non-partisan association of physicians working to protect and strengthen our country's publicly-funded health care system.
About the Canadian Health Coalition
The Canadian Health Coalition comprises citizens, frontline workers’ unions, community groups, students, and experts who share a commitment to preserve and expand public health care.
About the Canadian Federation of Nurses Unions
The Canadian Federation of Nurses Unions (CFNU) is Canada’s largest nurses’ organization, representing frontline unionized nurses and nursing students in every sector of health care and advocating on key priorities to strengthen public health care across the country.
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For more information or to arrange a separate interview please contact:
Christopher Holcroft, Empower Consulting for Canadian Doctors for Medicare
Phone: 416-996-0767
Email: [email protected]
