Government unclear on whether it will comply with federal MRI rules
SASKATOON Saskatchewan has not decided whether it will continue a controversial program aimed at reducing medical screening wait times, even as an approaching federal deadline threatens to cut the province’s funding if it doesn’t make changes.
Provinces and territories have until April 1 to comply with Health Canada’s diagnostic services policy, which exempts patients from fees for medically recommended diagnostic procedures like magnetic resonance imaging (MRI) or CT scans, regardless of whether they’re done at a public or private facility.
But the province has not yet decided whether it will make any changes to its “two-for-one” system, wherein for-profit clinics can charge for MRI scans so long as they provide an equal number of scans to patients on the public waiting list.
If jurisdictions don’t comply, the federal government says it will penalize them by shaving recorded costs charged to patients off of federal transfer payments to offending provinces on a dollar-to-dollar basis, starting in March 2023 for the 2020-21 fiscal year.
When asked how the province would respond to the upcoming deadline, Ministry of Health spokesperson Colleen Book stated that the ministry’s acute and emergency services branch is aware of the legislation but does not “anticipate changes to our current private pay two-for-one provisions.”
When asked whether the ministry understood the potential financial consequences for maintaining the status quo and what the fiscal reasoning for the decision was, Book wrote back, “To clarify, we do not anticipate any changes however no decisions have been made at this time.”
The two-for-one system was introduced in 2016 to meet rising demand for MRIS in the province while minimizing costs to the burdened public system. Since 2016, there have been more than 2,300 patient-funded MRIS in the province.
The federal government says the two-for-one system allows patients with money to jump the queue for diagnosis, and consequentially for any subsequent health care.
“If an authorized provider has referred a patient for a medically necessary diagnostic test, the status of the procedure as a publicly insured service should not change simply because the service is delivered in a private clinic rather than in a hospital,” federal health minister Ginette Petitpas Taylor wrote in a 2019 letter to provincial and territorial health ministers.
It’s not known how much is spent on private MRIS in the province.
Provincial NDP leader Ryan Meili said continuing the program would be illogical, since its goal is to save costs. “To coin a phrase, this does not scan,” Meili said.
Meili is also a critic of the program’s track record. Since it was implemented, ministry data indicates wait times have not decreased.
The ministry says that’s largely because of the rising number of MRI referrals. In 2019, 46,180 patients were referred for an MRI, compared to 38,957 in 2016. More than 10,000 people currently await an MRI in Saskatchewan.
A 2017 provincial auditor’s report found issues with the twofor-one system, noting it had not helped reduce wait times, possibly because physicians were referring patients for MRIS when they were not required.
An upcoming auditor’s report in June is expected to examine the Saskatchewan Health Authority’s policies on patient referral. Provincial auditor Judy Ferguson has said her office plans to “follow up” on recommendations from that report.