There must be evidence that medical tests and procedures improve health outcomes for patients or they will be gone, as was the case with widespread vitamin D testing, Matthews told reporters Wednesday.
“If there isn’t evidence to support a procedure or test, we don’t want to pay for it,” she said on the way into a cabinet meeting. “Sometimes that will mean delisting.”
The vitamin D tests are now covered for patients only in rare circumstances and the province has saved $66 million.
Matthews cited “pretty interesting research” that more caesarean sections are performed in certain urban areas of Ontario than others.
“What that tells me is that we’ve got work to do to make sure that everyone is practicing the highest-quality medicine,” she said, before being asked if Ontario would no longer cover planned C-sections.
“We leave that to the experts. I get advice from people who are much, much more knowledgeable about this than I am.
“We’ll be taking a hard look at a number of issues.”
Later Wednesday evening, the government scrambled to clear up the ambiguity left by Matthews.
“There are no plans to de-list OHIP coverage of C-sections,” said spokeswoman Zita Astravas. “If the procedure is deemed medically necessary by a medical professional, OHIP will cover it.”
But it remains unclear what will happen with the C-sections Matthews was suggesting may not be necessary.
There are no statistics on planned caesarean operations — sometimes derided as “too posh to push” procedures — as opposed to emergency C-sections, when a baby is unable to be safely delivered naturally.
But former TD Bank chief economist Don Drummond, who is leading a high-profile commission on the restructuring of government services, told the Star last weekend that C-section births are “off the charts.”
According to the Canadian Institute for Health Information, Ontario has higher primary C-section rates than Canada as a whole. Most recent statistics from the Institute for Clinical Evaluative Sciences indicate more than 28 per cent of hospital births in the province are C-sections.
Women who give birth by C-section spend more time in hospital, often a few days, adding to costs in the health-care system. Some women opt to give birth at home with midwives, which further saves the system money and reduces the risk of mothers and babies contracting hospital-based infections.
“Giving birth is the main reason Ontario women are hospitalized, yet there is no medical reason to be hospitalized for a healthy labour or delivery,” said Katrina Kilroy, president of the Ontario Association of Midwives, which has been lobbying the government to fund birthing centres.
The group said cutting the number of C-sections in Ontario by 15 per cent would save $50 million a year.
Opposition parties said the government seems poised for its biggest delisting of services from OHIP since Premier Dalton McGuinty’s first budget in 2004.
That’s when the Liberals, facing an unexpected $5.6 billion deficit from the previous government, scrapped chiropractic care, optometrist visits and most physiotherapy from the list of taxpayer-covered services. The delisting led to a political furor because it came as the cash-strapped government introduced the Ontario Health Premium of up to $900 per person — sending a mixed message of citizens paying more for health care but getting less.
New Democrat MPP and finance critic Michael Prue said his party is worried about potential cuts from Matthews, who will make a major speech Monday on the future of health care as the government tries to get on a more sustainable financial footing.
“We all need to be concerned if they do make the cuts again that they made eight years ago — that’s going to be really be terrible for the health-care system,” Prue (Beaches-East York) told reporters.
While it’s “pretty obvious” Ontario needs to find efficiencies in health care, which now eats up almost half the provincial budget, Progressive Conservative MPP Peter Shurman said the government has to be careful.
“Efficiencies is not code for cuts . . . it’s how do we provide the best bang for the buck,” said Shurman, his party’s finance critic.
The Ontario Medical Association said it has been working with the government to find $240 million in savings, and is looking for more. Doctors are in contract talks with the government this year.
The Liberal government was elected in 2003 with Dalton McGuinty saying he had no plan to raise taxes. In his first budget, he implemented a health premium of up to $900 per person.
Original Article
Source: Star
Author: Ferguson
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