The Federal government has been told to recommit themselves to the principles, criteria and enforcement of the Canada Health Act by a group representing 450,000 seniors in Quebec. Through a petition for a writ of mandamus filed with the Federal Court of Canada a group of patients’ advocates aim to obtain a court order forcing the Federal Health Minister to fulfill a statutory duty as indicated in the Canada Health Act – to prevent extra-billing of Quebec patients.
The Federal government is responsible for ensuring the provinces and territories abide by the Canada Health Act (CHA) when they deliver health care. However, in the past 10 years there has been very little monitoring of the CHA.
While there are gross violations happening across Canada — such as the extra-billing of patients — the federal government has turned a blind eye. Last year, Quebec’s National Assembly legalised extra-billing by passing Bill 20. In concrete terms, it means that it is now common in the province to pay for medically necessary services such as over $500 for anesthesia when having a colonoscopy or $80 for eye drops during the treatment of macular degeneration.
The conditions the provinces and territories must respect to obtain the Canada Health Transfer is clarified in the CHA: Article 18 specifies that a province or territory is not entitled to full compensation for extra-billing, article 20 which sets out that extra billed fees will be deducted dollar for dollar from the federal contribution.
In May 2016, the Réseau FADOQ, a group of Quebec seniors with 450,000 members, filed an application to the federal court of Canada for a motion of mandamus. This motion is to force the federal government to take measures to stop the extra-billing of Quebec patients, which is prohibited by the CHA.
The Reseau FADOQ, lawyer Jean-Pierre Ménard and patients.
The case is supported by several national, provincial and local coalitions, citizens’ groups, patient advocate organizations, doctors’ associations, unions and clinics, including the Canadian Health Coalition, Canadian Doctors for Medicare, Council of Canadians, CUPE, Coalition solidarité santé, SCFP-Québec, Fédération interprofessionnelle de la santé du Québec, Alliance des associations de retraités, Association médicale du Québec, Regroupement intersectoriel des organismes communautaires de Montréal, etc.
The CHC’s involvement in this case
On May 3rd 2016, the Canadian Health Coalition was at a press conference in Montreal to show its support of the Réseau FADOQ’s application to the federal court of Canada.
In the Fall of 2016, the plaintiffs dropped the case in light of actions taken by the Federal Health Minister who asked the Quebec Health Minister to end all extra-billing practices immediately, specifying that the federal health transfer payment to the province would be reduced if the province did not comply. On September 14 2016, the provincial Health Minister announced that his government would soon table a legislation to end extra billing.
Public Health Care Advocates Call on the Federal Government to Take Action to Stop Extra-Billing Practices in Quebec (CHC press release, 2016)
Frais accessoires: Le réseau FADOQ exige une action immédiate et concrète pour les patients (FADOQ press release in French only, 2016)
Frais accessoires : le bras de fer avec Gaétan Barrette se poursuit (FADOQ press release in French only, 2016)