CARP launches a campaign to get rid of red tape

CARP Action Online readers reject bureaucratic arguments against reimbursing people for out of province health care expenses – and CARP responds with a campaign to red flag red tape.

CARP Action Online readers reject bureaucratic arguments against reimbursing people for out of province health care expenses. 81% of the 669 readers who answered our online poll said that the Ontario government should reimburse people despite incomplete paperwork.

However, their support was not unlimited. 79% would set a monetary limit on what would be covered. About one-third would hold the line at no more than $50,000, one third would take it up to $100,000 and one-third would go as far as $500,000. 21% would set no upper limit.

The judgment of our readers is clear. They expect our public health care system to provide the care they need when they need it and if not reasonably available in Ontario, they expect the government to pay for it if they have to go out of province. While some may set some monetary limits, they will not accept bureaucratic excuses.

CARP red flags red tape

CARP is launching a campaign to get rid of the red tape that prevents Ontario residents from being reimbursed for out of country medial treatment that they could not get in Ontario. The culprit is the requirement for prior approval which few people know about and even fewer are able get when their medical condition is so severe that all they are thinking about is getting treatment.

At least two cases have come to our attention – Sylvia De Vries, who had an 18 kilogram cancerous growth removed and Lindsay McCreith, who had a malignant brain tumour removed. Neither got prior approval but applied for reimbursement after the emergency was over. (To read more, click here.)

The Ministry of Health has changed from its former practice and is now strictly enforcing the prior approval requirement and refusing to reimburse them.

Had prior approval been obtained, both operations would have been covered under the out of country medical treatment program. I.e. the substantive requirements were met – the denial is based purely on the procedural requirements.

The requirement for prior approval is the subject of nearly 80 appeals before the appeals boards held in limbo pending a decision in the divisional court.

CARP is asking that the Minister of Health and Long Term Care:

1. Exercise his discretion to reimburse Sylvia De Vries and Lindsay McCreith, and others in their position, for their out of country medical expenses.

2. Review the prior approval procedures for reimbursement of out of country medical expenses and remove the undue procedural barriers.

3. Improve the public communications with patients about the requirements of the out of country medical treatment program.

CARP will be writing again to the Minister of Health and Long Term Care and launching a concerted effort to ask the Minister to act. Please check our website to keep up to date on the issue and for ways you can take action or to tell us about your own stories with OHIP red tape. In the meantime, you can add your voice either on the issue generally or in support of reimbursement for Sylvia De Vries and/or Lindsay McCreith by sending an email to [email protected] or by calling (416) 327-4300.