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  • Writer's pictureDr. Sandor Demeter

Charging Manitobans for Routine Medical Tests

It has been over three years since multiple media outlets reported on a private Winnipeg clinic charging Manitobans for essential health services (i.e. CBC, CTV, Global, WFP). Apparently, Health Canada was notified and they were going to discuss the issue with the Province. However, the practice continues and has expanded.

Private clinics are charging Manitobans for otherwise publicly funded diagnostic tests such as ultrasound (US), echocardiography or echo (i.e. ultrasound of the heart), and bone mineral density testing (i.e. DEXA BMD).

Prota Clinic offers a variety of uninsured health services in addition to routine US and echo tests for $500 and $650, respectively.

For comparison, both of these services are publicly covered by MB Health with physician professional fees being $143.25 for echo and $47.55 for a representative US procedure (i.e. abdominal US) with an additional $44.45 added if a physician performs the routine US exam (source: Manitoba Physician’s Manual, April 1, 2020). These values are considerably less than what Prota Clinic charges patients.

There is a loophole that may allow Prota Clinic to charge Manitobans for routine US, and perhaps echo, services. That is, they are providing US services outside of a hospital and in a facility that is not approved by the Minister as per Section 17 of the Health Insurance Act, Excluded Services Regulations. That is, if a facility is “approved” by the Minister then the US study would be publicly funded but if it not “Minister approved” it is not covered – go figure?

In my opinion, and irrespective of this loophole, charging patients for routine publicly funded services is not in keeping with the spirit, if not the letter, of the Canada Health Act.

I have revisited this issue with MB Health, the College of Physicians and Surgeons of Manitoba, media outlets and other key stakeholders. My letter of concern has been acknowledged and I am awaiting follow up.

MB is one of only two provinces, the other being Newfoundland and Labrador, that does not allow US services to be publicly funded in private clinics. It would be very convenient for Manitobans to add US to current publicly funded, but privately owned and community based, x-ray and laboratory clinics.

It is interesting to note that the vast majority of Manitoba, if not Canadian, Family Physicians offer publicly funded services via their private clinics. This is not a new model of service delivery.

The majority of patients going to HSC or St. B for US tests could be appropriately scanned in the community without the hassles of paying for hospital parking and navigating through complex large health care institutions .

Apparently, Shared Health is operating a publicly funded outpatient US clinic, as an extension of the HSC US Department, in a former Quick Care Clinic on Jefferson Ave. This is one step closer to providing more convenient and efficient diagnostic US services to Manitobans.

As another example, Body Measure offers a variety of health and lifestyle services including DEXA derived bone mineral density (BMD). Manitobans should be aware that there is a publicly funded Provincial bone density program offering clinical DEXA BMD services in Winnipeg and Brandon. The MB Health combined professional fee for a DEXA BMD with fracture risk assessment is $70.75. Body Measure charges $149 for the first DEXA scan and $99 for subsequent tests within 6 months. It is noted, and based on Body Measure’s web site, their DEXA results offer more information than just BMD (e.g. body fat composition).

If your Doctor is worried about your bone density the Provincial DEXA BMD program is available without charge to patients.

In short, Manitobans deserve better. It would greatly benefit MB patients if routine studies, such as US or echo, were offered in the community without directly charging patients.

Manitobans should resist policies that privatize the provision of routine, otherwise publicly funded, health care.

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