📹 1991 small change
digital health care + consumer protection
A policy decision from 1991 could be leaving people that pay out of pocket for a medical consultation via health tech without meaningful consumer protection. 📟
Did you know that services regulated under health professionals legislation (the Regulated Health Professions Act, 1991 “RHPA” and health profession Acts (i.e. Medicine Act, 1991) in Ontario are exempt from the province’s Consumer Protection Act (CPA)?
When you sign a contract with a business or individual to buy or lease products or services, including subscription agreements and Internet agreements, the Consumer Protection Act protects you from unfair practices.
So, because the CPA is concerned with things like unfair prices and consumer agreement requirements, there could be a gap for virtual health services. 🏥
The logic behind this gap seems to be because health professions are self regulating - i.e. physician services are exempt from the Consumer Protection Act because the College of Physicians and Surgeons of Ontario regulates how they deliver services, including the agreements they enter into and how they promote those services. However, this legislative scheme was last updated 30 years ago, well before subscription models of digital health care were contemplated.
In some ways, the fact that health professions are regulated by professional colleges provides a platform for robust consumer protection. But in no way have these institutions demonstrated that they are prepared to regulate virtual care frameworks where patients may not even be physically located in Ontario. This is [yet another] example of how easily legislative environments can become outmoded in light of digital innovation. Not a huge deal - just something that happens. However, regulators need to stay on top of this stuff and practice ‘radical incrementalism’ - frequently updating of our laws so that they are responsive to contemporary realities.
As it stands, this gap is pretty great for virtual health services providers that are not held to the same standard under the CPA and it sucks for consumers, who technically have no recourse if a health/med-tech firm screws them.
Examples of virtual health services include:
Virtual care services covered by the Ontario Virtual Care Program are not insured under the Health Insurance Act (HIA), which means individuals or their third party plans pay for them directly.
Here’s the question: if colleges regulating health professions are inept at regulating digital tools that are truly *different* modes of providing care, does that exemption from 1991 still work to protect people in Ontario that are now consuming health services out-of-pocket? 🤷🏽♀️
OR
should they be brought back under consumer protection legislation when they provide services that (a) are not publicly funded and/or (b) look and feel a lot more like consumer products than health care? 🤷♂️
Robin Shaban and I point to how the provinces are uniquely positioned to take on the monopsony power of gig work platforms in The Conversation.
I got to comment on a recent Loblaw acquisition for the Toronto Star (!).
Join us for a hybrid event happening on April Fool’s to celebrate the 50th anniversary of Policy Options.
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