Canadians heading to vote face sticker shock for primary care at private clinics

Ahead of the federal election, Canadians are worried about access to health care. Some private clinics, which are growing in number, charge thousands a year for primary care and out-of-pocket fees, as many people struggle with a soaring cost of living.

An estimated 6.5 million Canadian adults don't have a regular health-care provider like a family doctor or nurse practitioner.

Dr. Rita McCracken, a family physician in Vancouver and primary care researcher at the University of British Columbia, said the shift toward private, for-profit clinics continues while principles of the Canada Health Act hang in the balance this federal election. She was recruited by what she calls a boutique clinic, though she never joined.

The Canada Health Act prohibits charging for an essential medical service like primary care that is publicly available, because health care should be based on need, not income. Quebec is an exception due to a Supreme Court ruling. 

The private clinic option "takes me out of the public system where anybody has access if they are a patient of mine, and removes me and puts me behind a paywall, essentially," said McCracken. 

McCracken said the for-profit clinic provoked concerns for her, given that an average family doctor in her area looks after about 1,200 patients, while the recruiting corporation said she'd only take on 400 patients.

"What this corporation is trying to do is they are trying to say we're offering extra services, like for example massage services, but they have medicalized these extras," McCracken said. "I think they're walking a very fine line." 

The extras also include publicly "uninsured services" like executive physicals and medically unnecessary cardiac tests, McCracken said. 

In Barrie, Ont., Anisa Carrascal had a "terrific" family doctor in Toronto for 10 years, until the physician moved to a new, private clinic. Carrascal received an email from that clinic, notifying her that to continue with the physician, she'd have to pay $4,245 a year. 

"That was a bit of a sticker shock," Carrascal said.

The fee was based on a sliding scale according to factors such as patient age, she said.

Carrascal, who is also a nurse, called health care "an issue you cannot escape."

The 45-year-old's message to Canadians this federal election? "Think about 20 years in the future and vote accordingly."

At moments, like when Carrascal's seven-year-old daughter was sick with a respiratory infection, the mother said she returned to the email. She considered paying up, though never did.