Ontario patients are being illegally charged hundreds—sometimes thousands—of dollars for medically necessary procedures at private clinics, according to a damning report released Tuesday by the Ontario Health Coalition. The watchdog group’s investigation has sparked renewed concerns about healthcare accessibility amid the province’s ongoing expansion of private delivery models.
The report documents dozens of cases where patients faced unexpected bills for services that should be fully covered under provincial health insurance. In one particularly troubling instance, a 67-year-old Toronto resident was charged $1,800 for cataract surgery at a private eye clinic, despite the procedure being covered by OHIP.
“What we’re seeing is a systematic circumvention of Canada’s healthcare principles,” said Natalie Mehra, executive director of the Ontario Health Coalition. “These clinics are essentially creating a two-tier system where those who can afford to pay jump the queue, while everyone else waits longer in the public system.”
The coalition’s investigation identified problematic billing practices at 28 facilities across the province, with the highest concentration in the Greater Toronto Area and Ottawa regions. Charges ranged from $75 “administrative fees” to over $5,000 for certain orthopedic procedures.
Health Minister Sylvia Jones defended the province’s oversight mechanisms, stating that the government “takes allegations of improper billing very seriously” and encouraging patients to report such incidents to the ministry’s fraud hotline.
However, critics argue that the province’s recent push toward more private delivery of publicly funded services has created confusion about what patients should expect to pay. NDP health critic France Gélinas called the findings “deeply concerning” and demanded stronger enforcement of existing regulations.
“The Ford government is allowing these clinics to operate with minimal oversight while patients are left holding bills they should never have received,” Gélinas said at Queen’s Park.
Legal experts note that under the Canada Health Act and Ontario’s Commitment to the Future of Medicare Act, clinics are prohibited from charging patients for services covered by provincial health insurance. Facilities found violating these rules can face significant penalties, including fines of up to $25,000.
The report comes at a particularly sensitive time, as Ontario continues to expand the role of independent health facilities in addressing surgical backlogs that worsened during the pandemic. The province has maintained that this expansion will remain within the public system, with OHIP covering all medically necessary procedures.
Patient advocates are urging greater transparency and enforcement. “Most people don’t know their rights when they’re handed a bill in a medical setting,” said Maria Rodriguez of the Patient Rights Association. “They assume if a healthcare provider is charging them, it must be legitimate.”
The coalition has called for immediate ministry intervention at the identified facilities and a moratorium on further privatization until stronger safeguards are in place.
As Ontario’s healthcare system continues to evolve, the fundamental question remains: can the province effectively harness private delivery while ensuring equal access and preventing the erosion of Canada’s single-payer model?
