Politicians are calling for an end to out-of-pocket health-care charges after iPolitics/QP Briefing highlighted how a Canadian company is getting around public insurance regulations.

Maple, a Loblaw-funded virtual health-care company based in Toronto, is able to charge patients for doctor's visits by connecting them with nurse practitioners or doctors outside of the patient's province, meaning the visit isn't covered by provincial insurance. Patients go through a text-based chat before seeing a health-care provider, which is also uninsured.

Federal NDP Leader Jagmeet Singh said he's raised the issue with the federal government and will push it to close the "loophole" allowing Maple and other companies to charge for medically necessary services. He said it's a symptom of allowing private delivery of care.

"The Maple loophole is, of course, another major concern," Singh said. "These are things that we’re going to ... and have already raised with the government — that we need to fight back against this. We can't allow for more of this to happen and more privatization, which is just going to create more examples like Maple, and more out-of-pocket expenses."

Singh accused Prime Minister Justin Trudeau of hiding from the issue in a speech on Wednesday.

"While for-profit health corporations like Maple get away with charging Canadians' credit cards to access health care, Mr. Trudeau turns his back and pretends not to see," Singh said.

Singh, who holds the balance of power under the minority Liberal government, said he would consider withdrawing his party's support if he doesn't see enough action on public health care generally.

"We have the power to withdraw our support. We have the power to make things difficult for the government in parliament. We have many options. And all those options on the table," he said.

Conservatives won't stop until they've destroyed our public healthcare system.

Loblaw is profiting off empty stomachs, now it's your health.

Why are you allowing this to happen Justin Trudeau? pic.twitter.com/NSmf7h6brv

— Jagmeet Singh (@theJagmeetSingh) January 18, 2023

Singh's health critic, Don Davies, said Maple's business practices are the type of thing "we have to stamp out immediately."

Canadian healthcare is universal, publicly funded and comprehensive. It was built because Canadians realized that healthcare should be available to all, regardless of one’s wealth or station in life. This👇is exactly what we have to stamp out immediately. pic.twitter.com/L2xvzUB9G4

— Don Davies MP (@DonDavies) January 18, 2023

Private health care is always a touchy topic in Canada, but especially of late after the Ford government announced a plan to move more publicly funded procedures to for-profit surgical centres.

The feds are working on a sensitive deal with the premiers to increase health-care funding. Negotiations have ranged from amicable, to tense, to disastrous.

Recently, Trudeau has avoided criticizing the Ford government's private care expansion, positioning himself as a watchdog who is making sure it aligns with the Canada Health Act.

The offices of Trudeau and Health Minister Jean-Yves Duclos didn't have much to say about Maple when asked.

Trudeau's team was content to let Duclos' spokesperson issue a statement in response to QPB's request.

"The Canada Health Act ensures that all Canadians have reasonable access to medically necessary insured services based on need and not the ability to pay," Duclos' spokesperson, Guillaume Bertrand, said.

"Our government will continue to work with provinces and territories to make sure our investments are used in the best interest of health workers and patients, and in a way that respects the principles of the Canada Health Act."

Bertrand didn't say whether the feds would consider stepping in over the so-called "Maple loophole," or whether the issue could come up in funding negotiations.

One Liberal, however, was outspoken. MP Michael Coteau, who was a minister under Kathleen Wynne's Ontario government, expressed his outrage. He called for an "immediate" end to Maple's out-of-pocket charges.

The Ontario Government is now allowing a Loblaws funded company to charge $69 per patient visit for virtual appointments. This extra fee has to be paid directly by the patient

This is on top of the OHIP payment.

This needs to stop, immediately. #onpoli https://t.co/cDlW70GWhU

— Michael Coteau (@coteau) January 17, 2023

Coteau was wrong on one point: Maple charges patients directly instead of billing OHIP, not on top of the provincial insurance. It also provides some OHIP-covered services for which it does not bill patients.

Also, the company has existed since the days of the Ontario Liberal government that Coteau was a part of. An archived version of its FAQ page notes that it charged patients back then as well.

Registered Nurses Association of Ontario (RNAO) CEO Doris Grinspun said she also has concerns with people being charged for medically necessary services.

"This is the slippery slope that has been happening illegally in this country, and in Ontario," she said.

The Ontario Medical Association, representing the province's physicians, said it "cannot speak to exactly what Maple is doing, but in Ontario billing for services that are uninsured is permissible in certain circumstances."

The Ontario Nurses Association sent a previous statement criticizing the Ford government's private-friendly plan.

Maple CEO Dr. Brett Belchetz, an ER physician, Fraser Institute fellow and former McKinsey consultant, has been busy hitting back at critics on Twitter.

"All the noise we are hearing about private vs public care in Canada is designed to distract us from the fact that our health-care system is breaking, ranked 2nd worst in the developed world and to make you mad at someone other than the people that broke it over several decades," he tweeted.

All the noise we are hearing about private vs public care in Canada is designed to distract us from the fact that our healthcare system is breaking, ranked 2nd worst in the developed world and to make you mad at someone other than the people that broke it over several decades. pic.twitter.com/Mbp9I0OARz

— Dr. Brett Belchetz (@brettbel) January 19, 2023

Jagmeet Singh pushing federal government to close ‘Maple loophole’ letting companies charge for doctor visits

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