Let's close the Marda Loophole and end two-tier family medical practices

Clinics like Marda Loop operate in a grey area offering services that are covered, and not covered, by the Canada Health Act and giving non-members limited access.

Fighting to save Universal Health Care at Queen’s Park. Photo credit: Ontario Health Coalition

If you want to know what’s going to happen in Ontario’s public health care system, all you have to do is look to Alberta because Doug Ford is following the same playbook.

The Marda Loop Medical Clinic has opened its doors in Calgary. Dr. Sally Talbot-Jones owns the clinic which boasts a patient service representative and a medical aesthetician.

Skin care and aesthetics are some of the uninsured services offered. Family medicine, senior and prenatal services are some of the insured services that are available.

The clinic charges patients a membership fee. A range of fees are offered to fit a variety of family sizes and compositions. An individual adult pays $2,200 annually; one adult with dependent children pays $2,400 per year, while two adults and their dependent children pay $4,800 annually.

Reduced wait times and longer patient appointments are among the benefits membership buys. The clinic offers services to non-members one day a week. By doing so, Marda Loop avoids contravening the Canada Health Act because technically, their services are still ‘available’ to everyone.

Under the Canada Health Act, individuals cannot be charged for medically necessary services. Provinces and territories that allow extra billing have health care funding clawed back by the federal government.

Clinics like Marda Loop are operating in a grey area by offering services that are covered, and not covered, by the Canada Health Act. They also get around the federal legislation by offering services to non-members – albeit on a very limited basis.

During COVID the use of virtual medicine spiked. Some provinces and territories were charging user fees to access this medically necessary service. Some provinces also began charging fees for diagnostic testing which is a necessity under the health act.

Ford made the political choice to ignore the federal legislation and began charging user fees for diagnostic testing as well as access certain physicians and surgeons — most notably, knee, hip and cataract surgeons.

Since 2018 the federal government has been reminding provinces and territories that extra billing contravenes Canada’s Health Act and that funds will continue to be clawed back until the practice ends.

Primary care is literally the backbone of the entire medial system. For every dollar invested into primary care, a full $10 is returned.

Preventative medical interventions including universal dental, vision, mental health services, and pharmacare, means fewer doctor and emergency room visits. That lessens the strain on the overall health care system because conditions are assessed and addressed before progressing too far.

Doctors charging membership fees and extra billing claim the two-tiered system lessens wait times. Reality is, these clinics only speed up access for those who can afford to pay; drain the public system of personnel and resources; and place a massive strain on an already over burdened public system.

User fees create a ‘them’ and ‘us’ scenario that will give rise to those receiving free services being ushered in the back door to a potentially less opulent waiting room before receiving a standard appointment rather than the longer visits available exclusively to paying members.

If enough of us tell federal Health Minister Mark Holland that we want this Marda Loophole closed then we can stop the privatization of family practices.

Leadnow.ca is circulating a petition to close the two-tier health care system loophole. Sign and share the petition by clicking this link.