Tuesday, July 31, 2012

Why won't McGuinty stop health care (and card) fraud?

Last week, I was shocked to hear on the news, as were a lot of people in Ontario, that there are still 3.5 million of the old red strip, no expiry date Ontario Health Cards.    And that the government is doing nothing about it.   The green photo cards should have phased out the reds -- in 2000.

What's even more worrisome -- front line health care workers and back billing offices aren't either.   It's bad enough there are still 300,000+  more helath cards than residents which opens up the opportunity to commit fraud.    But the law stipulates that if you change your address or marital status, you must get a new photo health card.   Period.   I know several people who have made multiple moves, continue to use the card and get no hassle, which shocks me.

ER type care, I can understand -- there should never be refusal to care, regardless of proof of coverage from any Canadian juridisdiction, or private insurance from elsewhere.

But lab tests?   X-rays?  Regular check ups at a methodone clinic -- especially those who have moved several times since they got their last card?    What's wrong with this picture?    I've seen too many doctors just swipe the red card without even checking for other ID or their real name.    The risk of impersonation is way too big here.

So there are really two tracks to this.    A hospital or doctor or lab can take the card but they must tell the patient they must get a health card.   Once a proven residence is offered to match it up, or any other address for that matter (even a mail drop at a social services centre) the card is flagged and a written notice is sent to the patient to report to the DMV (which handles the applications along with driver's stickers and licenses) to have it updated or the card will expire -- or, even better, have the digital picture taken at the doctor's office right there and then and the old card cancelled.    (The letters can be sent in the language of the patient's choice, there were 30 or more last time I checked).

Since driver's cards are updated every 5 years along side the photo health cards, that should be the sunset period.    Since many of us average about one or more visits to some kind of health care, that's plenty of time to whittle down the excess cards.    A seven year inactivity period to let the cards lapse is way too long, with respect to Pointy Head.   Now that the Boomers are starting to collect Old Age Security, health care costs will skyrocket.   We need to fight fraud -- even the temptation to commit it -- every way we can.

No comments: