Updated CMA recommendations on private care soften language, but maintains opposition to fees for primary care

The Canadian Medical Association (CMA) has issued its final list of policy recommendations on how Canada should balance the role of private care in the public healthcare system, softening some of its language but maintaining its opposition to user fees for primary care.In the draft version of this document released in July for consultation with the public and stakeholders, the CMA had called on governments to start “clamping down” on jurisdictions that allow for the charging of fees to access primary care already covered under the public healthcare system.The new version nixes the “clamping down” language and simply states that charging fees to access publicly insured primary care “should not be permitted.” In addition, the updated recommendation also calls for an “implementation plan” to “properly offset changes involving providers that are currently charging for these services.”“When patients can’t access timely care, one proposal has been to permit private insurance for medically necessary services,” the CMA said in a news release Tuesday. “But evidence from other countries shows the introduction of private duplicate health insurance creates significant inequities to access health care, draws resources away from the public system and leads to higher overall health spending.”However, the co-founder of a major private virtual care company says he’s “extremely disappointed” with the updated policy.“These new CMA recommendations are remarkably out of touch with the current needs of Canadians at a time when 6.5 million people do not have a primary care provider, and pay no heed to the harm they may inflict on the 10 million Canadians who rely on employer-funded virtual care,” Dr. Brett Belchetz, CEO of Maple, said in a statement to the Medical Post on Wednesday.Over the summer, Dr. Belchetz had circulated a Change.org petition calling on the CMA to end its opposition to private virtual care and instead advocate support for private insurance benefits that cover these services. In an August National Post op-ed, Dr. Belchetz had also taken issue with the CMA’s third draft recommendation, which had called for prohibiting or restricting “duplicative insurance models whereby people can purchase private insurance to access medically necessary services already covered under the Canada Health Act.” Dr. Belchetz argued that this measure could put at risk existing workplace virtual care coverage and other ways Canadians currently access care that isn’t supported by the public health system. However, this recommendation remains unchanged in the new version.“[The CMA’s] policy approach prioritizes fear-mongering and ideology over facts and disparages the role that employer-funded care has played in reducing strain on our public health system,” Dr. Belchetz said in a statement to the Medical Post on Wednesday.The CMA has also modified its language when it comes to physicians opting out of the public healthcare system. In the draft recommendation, the association said physicians should be able to opt out if: patient access to care is not compromised;physicians disclose conflicts of interests; andit can be shown that opting out would improve access and increase the capacity of the healthcare system. The new recommendations have struck out the third point and only ask for the first two.Other recommendations from the CMA’s new policy include universal access to medically necessary prescription drugs, more investments in team-based primary care and establishing a chief health accountability officer.

Updated CMA recommendations on private care soften language, but maintains opposition to fees for primary care

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