Ontario residents who spend the winter in Florida or head to the Adirondacks for skiing are totally on their own now when it comes to any medical costs that might occur during their trip.
As a cost-cutting measure, effective Jan. 1, the Ontario government eliminated the Out of Country Travellers Program from the Ontario Health Insurance Plan (OHIP), which is the government-operated health insurance system for Ontario residents. The only service that Ontario residents will continue to receive OHIP coverage for while out of Canada is kidney dialysis.
OHIP used to cover up to CDN$400 per day for higher levels of care and up to CDN$50 per day for emergency outpatient and doctor services. The argument made by the Ministry of Health for eliminating the program is that it wanted to reduce bureaucracy and better focus on insured services provided within the province.
This is not the first-time health insurance services for Ontario residents traveling outside the province have been cut. During the 1990s, the Conservative government of Premier Mike Harris reduced the CDN$400 per day to CDN$100 per day. The reduction was reversed by the succeeding Liberal government of Premier Dalton McGuinty.
The Ministry of Health is recommending that Ontario residents who spend time outside of Canada get private insurance to cover their medical expenses. It also noted that many people already have travel medical insurance coverage through their employee benefit plans or credit cards.
Many Canadian financial institutions or automobile clubs also offer short-term travel medical insurance. Even Loblaws, the country’s largest supermarket chain, offers travel insurance under its President’s Choice Financial brand.
The amounts that the Ontario government was covering for residents out of the country covered very little of the expenses a patient could possibly have to pay, especially when converted to US dollars from Canadian.
Let’s use the Claxton-Hepburn Medical Center in Ogdensburg as an example and pretend that a Canadian slipped and fell somewhere on the ice in a parking lot. Depending on the severity of the injury, the emergency department visit could cost anywhere from US$100 to US$1,182. An ankle x-ray costs US$248 and a knee x-ray is US$325. A spinal MRI is US$2,858. General surgery costs range from US$1,800 to US$5,000. Add another US$400 to US$1,200 if you think the patient should have anesthetic if they require surgery for injuries related to that nasty slip and fall.
The Canadian Snowbird Association, which represents Canadians who spend the winter months outside the country, is challenging the Ontario government’s decision in court on the grounds that it violates the Canada Health Act, the federal law that states how provinces are to administer the public health insurance system. The snowbird association alleges that the province is violating a part of the federal law that extends portability of coverage to citizens outside Canada.
Most Canadians who spend considerable lengths of time outside the country usually get additional health insurance. However, private insurance is more expensive or difficult to obtain depending on the age and medical conditions of individuals.
The elimination of out-of-country OHIP coverage by the Ontario government highlights several things about Canadian health care.
It is not “free” like many people believe it is. It is paid for by taxes, which are higher in Canada than in the United States.
It is also bureaucratic. There are multiple layers of administration and agencies in the system. Decision makers, whether they are politicians or civil servants can modify what services are covered.
As a result, Canadians are often as dependent on private insurance as Americans in order to ensure they can get the medical care they need. And like Americans without private health insurance, Canadians who are without it when traveling are in a risky, expensive position if something should go wrong.