Liam MacDonald is the director of policy and government relations for the Canadian Chamber of Commerce.
Recently, Health Canada has painted Canadians who use employer-funded virtual health care as queue-jumpers seeking preferential access. When asked about how the government might approach the future of virtual primary care paid for by employee benefit plans, Health Canada spokeswoman Anne Génier said in an e-mail to The Globe and Mail that private health insurance is meant to be complementary to medicare. “It is not meant to allow those Canadians with private insurance through an employer benefit plan to jump the queue for insured health services or to receive preferential or faster access to care over those waiting in the public system,” she wrote.
This stance might appear less tone-deaf if we actually had a functioning public health care system that provides easy and timely access to medical care. Unfortunately, as any Canadian who has recently sought medical treatment knows, this is not the case. Wait times at overcrowded emergency rooms across the country have skyrocketed – reaching a nightmarish 22 hours on average in Ontario last December – and more than six million Canadians do not have a family doctor.
Against this backdrop, employer-funded access to virtual care stands out as an innovation that has increased access to timely primary health care for about 10 million Canadians who now have access to this type of care. Far from the elitist queue-jumpers they have been painted as, they are everyday individuals working in all sectors of the economy. Employer-funded virtual care is also saving governments money – approximately $52 on each physician visit, according to recent data from Sun Life – and reducing the strain on our health care infrastructure. These are savings that can be reinvested into the public system to improve the delivery of care. Moreover, when these services are used, they also benefit those who do not directly have access to them, keeping people with common ailments out of overcrowded ERs and walk-in clinics and reducing wait times for everyone else. It is therefore extremely perplexing to watch Ottawa try to tear employer-funded virtual care down.
It is important to note that services that have user fees, and those that are paid for by employers as part of benefits plans, have been consistently conflated. It is hard to defend the practice, virtual or otherwise, of charging patients for care. But patients using virtual care through their benefit plans are not paying out of their own pockets, and the existence and growth of these services are more an indictment of our public system than anything else. If, after all, Canadians didn’t have to wait unreasonable amounts of time at public clinics or ERs for basic treatment, or if the public system provided virtual care on similarly competitive terms, Canadians would not need – and they should not need – to have benefit plans that pay for this type of care.
The existence of employer-funded virtual-care services creates no losers. It expands access to care for employees; it benefits employers who have a vested interest in supporting employees’ health and well-being; it takes pressure off public health infrastructure. The only loser is perhaps the misguided and outdated ideology that holds that the private sector has no role in the delivery of medical care under any circumstance, simply on account of it being the private sector.
In 2023, then-minister of health Jean-Yves Duclos announced that he would issue a letter of interpretation regarding the Canada Health Act, in order to address the growing trend of private physical and virtual care clinics charging patients out-of-pocket for services that would normally be free in the public system. According to the current Minister of Health, Mark Holland, this interpretation letter is set to be issued in “short order.” One would hope that employer-funded virtual care would be spared in this letter from any characterization that it violates the spirit of public health care provision in Canada.
When it comes to virtual care paid for by employers, it is hard to see how the principles of the Canada Health Act are being violated. These services – to be absolutely clear – impose no out-of-pocket costs on patients who benefit from them. They are completely (that is, 100-per-cent) free.
With the well-known challenges facing our medical system, Ottawa needs to adopt a common-sense approach to health policy. Preventing employers from offering access to virtual-care services in their benefits plans will achieve nothing but the further deterioration of Canadians’ access to timely medical care, which is already unacceptably poor. Ottawa can provide an exemption for employer-provided virtual care in its interpretation letter, while addressing the real problem of out-of-pocket charges for medical services. That would be the most sensible choice.