How well does your Ontario health insurance (OHIP) protect you from potentially life-changing illness? If you are little boy with speech difficulties, the answer is: you are SOL.

Last week, a four-year-old boy came to my office with his mom. I know them well. I delivered him and his brothers. He has a speech developmental problem called moderate verbal apraxia that requires two hours of intense speech therapy per week to help him learn to speak properly.

All of you reading this can certainly understand the stress and fears his parents face when they think of his future. In his early years at school he may be subjected to teasing and taunting. It is difficult enough for a child to verbally defend themselves but this is even more poignant for a child with speech difficulties. If left untreated, a child with verbal apraxia can have difficulties progressing through school, developing properly as an adolescent, forging normal interpersonal relationships, and eventually finding a job and becoming a functioning adult.

Early intervention is essential to prevent or mitigate many of these negative outcomes. You would think that the cost and burden of all of the above to the individual, the family, and to society would lead to the logical conclusion that our public health system should cover the cost of treatment necessary to help him. His parents are spending approximately $20,000 per year for his treatment ($200 an hour for the speech pathology sessions, two hours per week). To date, he is speaking better and is coming out of his shell.

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To put this in perspective, $1 billion will provide five million hours of service. Each child needs at least 100 hours per year. This would provide therapy to over 50,000 children. The reason I bring $1 billion is that Ontario has wasted billions of dollars that have been well documented by others in the media.

The government of Ontario talks a good game about providing universal healthcare coverage. The prevarication is breathtaking on the part of the health ministry. They promote prevention as the solution to reduce health care costs. They state that physicians tend to treat diseases as opposed to preventing them. However, the Ontario government is rationing health services, not keeping up with funding to match patient demand and care, and making it more difficult to prevent poor health outcomes. Here are some of the interventions that could be implemented that would reduce healthcare costs (in no particular order) and personal hardship over the long-term. Please keep in mind that the wasted billions of dollars would have made a huge dent in this list.

  • Speech pathology
  • Autism therapy
  • Evaluation for ADHD (full evaluation by psychologists) and learning disorders
  • Psychological services for adults and children. ¬†Psychologists are not covered under OHIP. It can,¬†in concert with medical therapy, improve outcomes.¬†It¬†has the potential to reduce the need to prescribe medications for less severe disease.
  • Vaccines to prevent human papilloma virus/cervical cancer for adults (Gardasil), shingles (Zostavax), and pneumococcal pneumonia (Prevnar)
  • HPV vaccine for boys
  • Treatment for hepatitis C¬†(New medications are out that cure the disease)
  • Physiotherapy and athletic therapy for limb and back injuries and rehab after surgery.
  • Home care services (limited availability and rationed up to a maximum number of hours)
  • DMARDS (Disease Modifying Agents for Rheumatic Diseases) used to treat inflammatory bowel disease (Crohns), psoriasis, connective tissue diseases, etc. These diseases cannot be prevented only treated and controlled.
  • Dentistry (Poor dental health leads to many systemic diseases)
  • Rapid access to MRI
  • Eye examinations for all ages instead of under 18 and over 65.
  • A myriad of other prescription medications not available to people on social assistance or for those without private health insurance, unlike our politicians who have this tier of coverage.

I am sure there are more that you have encountered but you get the general idea. It is unfortunate that the Ontario government only looks through the lens of the next election as their benchmark. They refuse to address the problem that out health care system needs an overhaul. We need to look to Europe and Australia/New Zealand to learn what has worked well with respect to health outcomes. Instead, ideology trumps evidence, people suffer, and parents pay the price of a new car every year to help their children. No stress at all. Welcome to the USA.

Barry Dworkin
Barry Dworkin is an assistant professor of family medicine at University of Ottawa, operates an active family/obstetric teaching practice of 25 years, and hosts the radio show "Sunday House Call." He loves to argue for cathartic health reasons.  

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