Ontario and the Three Month Wait Policy: A Call for Removal

Ontario and the Three Month Wait Policy: A Call for Removal
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Ontario and the Three Month Wait Policy: A Call for Removal
Introduction: The Issue
The province of Ontario currently enforces a three-month wait policy on new immigrants, returning Canadian citizens, and residents who have lost documentation before receiving health coverage. Included in this group are refugees and persons who have been denied asylum, as well as those who have lost their official documents (e.g. passports), such the mentally ill and the homeless. Similarly illegal immigrants are not allowed access to publicly provided health services. However, this policy has received widespread condemnation from healthcare professionals, who argue that the three-month wait puts the health of the affected groups at risk and contributes to the ongoing poor health levels in Ontario. This research paper presents evidence from previous studies which support the call for the removal of the three-month wait policy.
Historical Background of the OHIP and the Three-Month Wait Policy
Public health insurance in Ontario was first implemented in 1959 under the Ontario Hospital Services Commission. The Ontario Medical Services Insurance Plan (OMSIP) was introduced in 1966 to cater for the medical needs of individuals who lacked the ability to pay for private medical insurance as a result of unemployment, old age, and poor health. The Ontario Health Services Insurance Plan (OHSIP) replaced OMSIP, and merged the private insurance providers- 35 at the time, under a single public platform with standardized regulations (Health Canada, 2012). This move was intended to align healthcare with public administration requirements as well as universal principles by providing affordable healthcare to the majority of citizens. The Ontario Health Insurance Plan was introduced in 1972, and brought to an end the involvement of private insurance companies in healthcare insurance.
The three-month wait period was not a new invention of public healthcare under the OHIP. Prior to its implementation, private healthcare insurance providers imposed the three-month wait policy for new residents. In fact, the policy was a constant feature in previous provincial healthcare insurance policies dating back to 1959 and which the OHIP adopted the policy into public healthcare. The three-month wait policy is also in accordance with the Canadian Health Act, which specifies the period of three months as the maximum time that uninsured persons can wait after assuming residence in Canada before qualifying for public health insurance.
Funding for OHIP
The Ontario Health Insurance Plan is funded by taxes from the residents/working residents and businesses of Ontario, in addition to fund transfers from the federal government (Health Canada, 2012). Employed persons pay a tax premium in proportion to their total annual earnings (Sherrard, 2004). There also tax revenues paid by employers (through a payroll healthcare tax), although small businesses are exempted.
Eligibility for OHIP
In order to qualify for the Ontario Health Insurance Policy, one must be a permanent Canadian citizen, or should have been residing in Ontario for 153 days in a given 12-month duration (Health Canada, 2012). During this duration, individuals are expected to register for private health insurance. For Canadian citizens or residents immigrating from other Canadian provinces, their medical costs are paid for by their previous provinces of residence until the three-month wait period is over.
Government Position on the Three-Month Wait Policy
The Policy Saves the Government Money
The government supports the policy because it is presumed that it saves money by not being liable for the healthcare of new residents in the three months they wait to qualify for OHIP (Bobadilla, 2013). The Minister for Health and Long Term Care, Hon. Deb Mathews, is quoted by the Toronto Star that the three-month wait window “saves Ontario $90 million per year and the government has no plans to change the policy” (Javed, 2011). However, the government has not illustrated how this saving is achieved, and neither is its position supported with empirical evidence (Goar, 2014). Certainly, the government has not considered the fact that when people do not access medical care immediately they get sick and instead choose to wait for the three-month wait period to lapse so they can use free public healthcare, their condition worsen and therefore need extensive and more expensive medication once they become eligible for OHIP.
The Three-month waiting period deters persons who wish to use public healthcare although they do not intend to stay in Ontario for long.
From an administrative point of view, the Ontario government would be justified to attempt to avoid processing papers for immigrants intending to stay briefly. By enforcing the three-month wait period or the requirement for permanent residency, the government discourages people with short-term plans. However, the government should be able to address this problem by using applicants' personal information to determine whether they are potential long term residents. For instance, new residents and immigrants who have taken up jobs or students who have enrolled in learning institutions are likely to stay for a longer period.
Uninsured individuals can access healthcare through Community Health Centers (CHCs) where it is not necessary to produce provincial health cards.
It is true that Ontario's community health centers cater for many uninsured persons. However, these centers were established more than four decades ago, and they were not created with this responsibility in mind. The responsibility came about by default as a result of immigration patterns, and government policies and other administrative barriers that continue to limit access to public healthcare by uninsured individuals (Caulford & D'Andrade, 2012). Thus, the argument that community health centers can take care of the needs of uninsured persons fails to consider issues that are pertinent to healthcare such as resource allocation and capacity to handle serious medical cases.
Healthcare Challenges under the Ontario Health Insurance Policy
One problem caused by the OHIP is that it places a big burden on community-level healthcare providers, who are forced to cater for the uninsured persons. As a result of the restrictions put in plac...