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Ontario's move to scrap out-of-country health insurance was wrong, court rules

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canada-man

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TORONTO -- The Ontario government's move to axe its out-of-country health insurance program violates the Canada Health Act, a court ruled this week as it ordered the province to reinstate the coverage.

The province overstepped its bounds in eliminating the Out of Country Travellers' Program at the beginning of 2020, which reimbursed Ontario residents who experienced medical emergencies when outside of Canada, a three-judge panel with the Superior Court of Justice found.

"By totally eliminating the out-of-country reimbursement feature (unless pre-approval has been obtained) the impugned regulation clearly violates the portability criterion," reads the decision written by Justice Harriet E. Sachs.


If a province doesn't meet the portability pillar -- one of five pillars in the Canada Health Act -- after consulting with the federal health minister, Ottawa can "by order direct that the cash contribution to that province for a fiscal year be either reduced or withheld," the court said.

"In order to satisfy the portability pillar, a provincial plan must provide payment for insured services that are delivered while an Ontario resident is temporarily outside of Canada at a rate that is similar to what would have been paid if the service had been provided in the province," Sachs wrote.

The province, she noted, ignored three letters from the federal government expressing concern over the cancellation of the Out of Country Travellers' Program after Health Minister Christine Elliott announced the news in Spring 2019. The move followed a six-day public consultation.

She said at the time that the program was both costly and provided little value to taxpayers.

Elliott said the province spent $2.8 million to administer approximately $9 million in claim payments through the program every year.

The program covered out-of-country inpatient services up to $400 per day for a higher level of care, and up to $50 per day for emergency outpatient and doctor services.

The Canadian Snowbirds Association, which represents those who spend the winter in warmer parts of the world, challenged the move, calling it an "egregious violation" of the Canada Health Act.

The group is applauding the court's decision.

"The ruling affirms the right of Ontario residents to out-of-country emergency insurance coverage, as required by the Canada Health Act," said Karen Huestis, president of the Canadian Snowbird Association.

A spokeswoman for Elliott did not immediately respond to a request for comment, while a representative for the Ministry of the Attorney General did not immediately say whether the province would consider appealing the ruling.

This report by The Canadian Press was first published Sept. 25, 2020.

 

lomotil

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Historically, the US doctors had a field day with OHIP coverage, especially the snowbirds with all their geriatric medicine and healthcare needs down in Florida and Arizona. Most of the snowbirds that I have met are well healed and well medicated.
 

Indiana

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Great news.
I’m all for some modifications perhaps, but coverage definitely needs to be reinstated.
They do expect income tax from us when out of country.
 

lomotil

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Great news.
I’m all for some modifications perhaps, but coverage definitely needs to be reinstated.
They do expect income tax from us when out of country.
More power to the snowbirds if they can get it, but the Ontario Government is stupid to allow OHIP to cover them whilst out of country. Income tax paid while out of country should not entitle an Ontario resident to OHIP coverage in a foreign land. Is this ruling just for the snowbirds or for any Ontario resident abroad anywhere ? A can of worms has just potentially been opened, really opened, and it is no wonder that Canadians pay such high taxes because everyone is "entitled"
 

corrie fan

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The Canada Health Act clearly requires the provinces to cover out of country health expenses. If a province fails to do this the federal govt. can cut the health care funding they send to the province. They are only required to pay a rate similar to the cost at home. In the case of the U.S. the cost of medical care is much higher than the amount paid by the province so the patient must cover the difference themselves or through private insurance. If Ontario wants to eliminate this program I think they would have to get the federal govt. to agree to amend the Canada Health Act.
 

lomotil

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The Canada Health Act clearly requires the provinces to cover out of country health expenses. If a province fails to do this the federal govt. can cut the health care funding they send to the province. They are only required to pay a rate similar to the cost at home. In the case of the U.S. the cost of medical care is much higher than the amount paid by the province so the patient must cover the difference themselves or through private insurance. If Ontario wants to eliminate this program I think they would have to get the federal govt. to agree to amend the Canada Health Act.
Not necessarily, otherwise travel insurance would be not necessary. There are many examples of Canadians who got large medical bills for hospitals stays in America not covered by their provincial plans at all.
 

Butler1000

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From what i understand because of the Byzantine billing system in the USA and how few were actually using it it was actually costing more money to administer than they were paying out.

Im not sure what a better solution is by the piddly amount paid out in relation to healthcate costs in the USA but when a program is that underutilized there shoukd be a better compromise
 
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nottyboi

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This move was saving about 0.92 cents per tax payer and a big handout to private insuance companies by DOFO. I am glad the courts stuffed it up his big stupid ASS. It would have been much smarter to offer a base and enhanced coverage and charge people for the extra coverage, small air travel levy and make it revenue neutral or positive. Typical conservative "its too hard to fix so lets kill it"
 

nottyboi

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More power to the snowbirds if they can get it, but the Ontario Government is stupid to allow OHIP to cover them whilst out of country. Income tax paid while out of country should not entitle an Ontario resident to OHIP coverage in a foreign land. Is this ruling just for the snowbirds or for any Ontario resident abroad anywhere ? A can of worms has just potentially been opened, really opened, and it is no wonder that Canadians pay such high taxes because everyone is "entitled"
its part of the Canada Health act and covers anyone. You are clearly not smart enough to realise this impacts you directly when you go on trips as all your out of country insurance gets more expensive when the govt made this change.
 

lomotil

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its part of the Canada Health act and covers anyone. You are clearly not smart enough to realise this impacts you directly when you go on trips as all your out of country insurance gets more expensive when the govt made this change.
Many of the snowbirds are on multiple medications and medically compromised. The Florida and Arizona physicians love the OHIP coverage and have been known to seriously abuse. Furthermore during a pandemic in a place like Florida where the COVID-19 is more rampant than anything in Canada, if the snowbirds are stupid enough to wish to head to Florida then let them finance it and not contribute to increasing the already obscene tax rate in Ontario and the rest of Canada. Also some snowbirds are more entitled than others it seems and get the Ontario government to pay for much more than they should while other snowbirds are left out. DOFO is aware of the corruption that is going on with OHIP and US physicians and certain privileged snowbirds, you don't seem to be up on it.
 

nottyboi

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Many of the snowbirds are on multiple medications and medically compromised. The Florida and Arizona physicians love the OHIP coverage and have been known to seriously abuse. Furthermore during a pandemic in a place like Florida where the COVID-19 is more rampant than anything in Canada, if the snowbirds are stupid enough to wish to head to Florida then let them finance it and not contribute to increasing the already obscene tax rate in Ontario and the rest of Canada. Also some snowbirds are more entitled than others it seems and get the Ontario government to pay for much more than they should while other snowbirds are left out. DOFO is aware of the corruption that is going on with OHIP and US physicians and certain privileged snowbirds, you don't seem to be up on it.
Its $15M a year..get a grip. GEEZ
 

VIPhunter

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More power to the snowbirds if they can get it, but the Ontario Government is stupid to allow OHIP to cover them whilst out of country. Income tax paid while out of country should not entitle an Ontario resident to OHIP coverage in a foreign land. Is this ruling just for the snowbirds or for any Ontario resident abroad anywhere ? A can of worms has just potentially been opened, really opened, and it is no wonder that Canadians pay such high taxes because everyone is "entitled"
Interesting take. I'm more comfortable with Snowbirds who worked their collective asses of, and after many years suffer from 'thin blood' (and need the warmth) getting basic OHIP coverage, far more than nonworking bums who live in Ontario, yet are net takers from government.

If you believe in universal coverage single payor Health Care, what the fuck does it matter if a few people spend their winters in Florida?
 

lomotil

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Interesting take. I'm more comfortable with Snowbirds who worked their collective asses of, and after many years suffer from 'thin blood' (and need the warmth) getting basic OHIP coverage, far more than nonworking bums who live in Ontario, yet are net takers from government.

If you believe in universal coverage single payor Health Care, what the fuck does it matter if a few people spend their winters in Florida?
The snowbirds have enough coin to look after their health needs in a foreign land. If Florida is ok, then why not Arizona, Hawaii, or anywhere else ?? More power to them if they can get the province to foot the bill and let the greedy and unscrupulous American Healthcare system go to town and feed at the trough. You are way of base with respect to if they work hard or not previously as healthcare is not a retirement right!
 

VIPhunter

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The snowbirds have enough coin to look after their health needs in a foreign land. If Florida is ok, then why not Arizona, Hawaii, or anywhere else ?? More power to them if they can get the province to foot the bill and let the greedy and unscrupulous American Healthcare system go to town and feed at the trough. You are way of base with respect to if they work hard or not previously as healthcare is not a retirement right!
Huh?

Is healthcare a right or not? Make up your mind. If healthcare is a right, then OHIP is bound to pay the equivalent of treatment costs in Ontario in other Canadian and world jurisdictions. (not the total, but the OHIP equivalent costs)

If healthcare is not a right, or people with means are supposed to cover their own costs, why should they be responsible for the healthcare costs of slackers?

You can't have it both ways.
 

lomotil

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Huh?

Is healthcare a right or not? Make up your mind. If healthcare is a right, then OHIP is bound to pay the equivalent of treatment costs in Ontario in other Canadian and world jurisdictions. (not the total, but the OHIP equivalent costs)

If healthcare is not a right, or people with means are supposed to cover their own costs, why should they be responsible for the healthcare costs of slackers?

You can't have it both ways.
My interpretation of the Canada Health Act (CHA) is that Canadians from cradle to grave are entitled to basic healthcare while in Canada with the Provinces and Territories sharing reciprocity. The CHA does not have a user fee so that “slackers” are entitles to the same level and standard of care as those in the highest tax bracket. OHIP is under the CHA. I have news for you which is that there are snowbirds who are slackers, have been on Ontario Works for decades and are now down in Florida and Arizona. Should they be cut off from the other snowbirds for OHIP coverage by your trend of thought and line of reasoning. The CHA does not mention privilege based on any factor such as work history, age, taxes paid, incarceration, criminal records etc . Those who wish to venture out of Canada do so at their own risk whether it is for leisure or business and should take out private healthcare insurance and not expect the Canadian Nanny state to underwrite their foreign healthcare needs.
 

VIPhunter

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My interpretation of the Canada Health Act (CHA) is that Canadians from cradle to grave are entitled to basic healthcare while in Canada with the Provinces and Territories sharing reciprocity. The CHA does not have a user fee so that “slackers” are entitles to the same level and standard of care as those in the highest tax bracket. OHIP is under the CHA. I have news for you which is that there are snowbirds who are slackers, have been on Ontario Works for decades and are now down in Florida and Arizona. Should they be cut off from the other snowbirds for OHIP coverage by your trend of thought and line of reasoning. The CHA does not mention privilege based on any factor such as work history, age, taxes paid, incarceration, criminal records etc . Those who wish to venture out of Canada do so at their own risk whether it is for leisure or business and should take out private healthcare insurance and not expect the Canadian Nanny state to underwrite their foreign healthcare needs.
So Healthcare is not a right then. That's fine, I'm all for many private options.

What, difference is it if OHIP pays it's base level to PEI, BC, A US Hospital, a French, Turkish, or Mexican hospital?

A citizen is either covered, or s/he's not. Leaving the country for a while for fun or work, is hardly an unusual occurrence.

(I think you have a bit of pent up envy regarding people who travel for fun.)

What if they are travelling to the US for work, (of course the company will have Health insurance) but Both the employee and the pay Ontario tax. The employer pays a payroll healthcare tax, and the employee may even pay a health care premium.

It would be absolutely wrong to suggest that this person (working for a living) is not entitled to the same coverage as a slacker who does not work, just because the employee gets sick in another country, and the slacker happens to reside in Ontario.

This should be obvious to anybody who understands the intention of the CHA.
 

lomotil

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So Healthcare is not a right then. That's fine, I'm all for many private options.

What, difference is it if OHIP pays it's base level to PEI, BC, A US Hospital, a French, Turkish, or Mexican hospital?

A citizen is either covered, or s/he's not. Leaving the country for a while for fun or work, is hardly an unusual occurrence.

(I think you have a bit of pent up envy regarding people who travel for fun.)

What if they are travelling to the US for work, (of course the company will have Health insurance) but Both the employee and the pay Ontario tax. The employer pays a payroll healthcare tax, and the employee may even pay a health care premium.

It would be absolutely wrong to suggest that this person (working for a living) is not entitled to the same coverage as a slacker who does not work, just because the employee gets sick in another country, and the slacker happens to reside in Ontario.

This should be obvious to anybody who understands the intention of the CHA.
The Ontario government should give their full financial undivided attention to health care in Ontario for Ontarians, “slackers” included. There is much work to be done in improving the healthcare right in Ontario, the government is running a deficit, the pandemic notwithstanding, before worrying about paying for the healthcare needs of Ontarians who choose to travel abroad. Travel insurance is available for that reason. Do the other provinces foot the bill for their citizens abroad or do most other countries, I don’t think so ? No where in the CHA does it guarantee privilege based on employment status or taxes paid or encourages discrimination against social service recipients or “slackers”. You argument would not stand up in court.
 

VIPhunter

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The Ontario government should give their full financial undivided attention to health care in Ontario for Ontarians, “slackers” included. There is much work to be done in improving the healthcare right in Ontario, the government is running a deficit, the pandemic notwithstanding, before worrying about paying for the healthcare needs of Ontarians who choose to travel abroad. Travel insurance is available for that reason. Do the other provinces foot the bill for their citizens abroad or do most other countries, I don’t think so ? No where in the CHA does it guarantee privilege based on employment status or taxes paid or encourages discrimination against social service recipients or “slackers”. You argument would not stand up in court.
I can't see why your argument would stand up in court either (in fact it didn't)

You have not answered my question: Why is the citizen/tax payer who cross some arbitrary line on a map any different than the others?

Oh, yeah, he's not!

You, and I say this respectfully, have a very narrow view of what it means to be a citizen.



(And most provinces do pay out of country costs...They do NOT 'foot the bill' they pay the same rate they would at home, or to other provinces.)

 

lomotil

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I can't see why your argument would stand up in court either (in fact it didn't)

You have not answered my question: Why is the citizen/tax payer who cross some arbitrary line on a map any different than the others?

Oh, yeah, he's not!

You, and I say this respectfully, have a very narrow view of what it means to be a citizen.



(And most provinces do pay out of country costs...They do NOT 'foot the bill' they pay the same rate they would at home, or to other provinces.)

I hope that the Ford government wins on appeal.
 

Butler1000

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I can't see why your argument would stand up in court either (in fact it didn't)

You have not answered my question: Why is the citizen/tax payer who cross some arbitrary line on a map any different than the others?

Oh, yeah, he's not!

You, and I say this respectfully, have a very narrow view of what it means to be a citizen.



(And most provinces do pay out of country costs...They do NOT 'foot the bill' they pay the same rate they would at home, or to other provinces.)

The major issue is it cost more to administer than the monies actually paid out. Mostly due to the Byzantine healthcare payment systems in the USA. We are literally talking about I think 10 million total paid out but more to make the payment.

I would rather the patient pay it out then apply for a tax credit here. It would save the money and still get the coverage done.
 
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