True Patriot Love - March 03, 2026


Ontario Healthcare EXPOSED？


Episode Stats


Length

10 minutes

Words per minute

144.8028

Word count

1,531

Sentence count

89


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

The Office of the Auditor General of Ontario just released a report recently that reads less like oversight and more like a warning flare. Doctors billed more than 24 hours in a single day. A tiny group of doctors are collecting millions annually with limited follow-up and weak enforcement behind the scenes.

Transcript

Transcript generated with Whisper (turbo).
00:00:00.000 The Office of the Auditor General of Ontario just dropped a report recently that reads less
00:00:09.360 like oversight and more like a warning flare. Doctors billing more than 24 hours in a single
00:00:15.200 day. Physicians billing all 365 days of the year. A tiny group collecting millions annually with
00:00:21.760 limited follow-up and weak enforcement behind the scenes. Now let's be clear, the vast majority of
00:00:27.360 doctors in this province work hard and play by the rules. This is not an attack on frontline
00:00:32.040 physicians. This is about a system that appears unable or unwilling to police itself. Because
00:00:38.140 here's the real question. How does a private credit card company flag suspicious spending in seconds
00:00:43.140 but our publicly funded health care system pays first and asks questions later? Why are recoveries
00:00:49.460 partial? Why do reviews take years? And why does oversight rely on complaints instead of modern
00:00:55.340 fraud detection tools? It isn't just about billing, it's about trust. And when families can't find a
00:01:01.500 family doctor, when ERs are overflowing, and when taxpayers are told there's never enough money,
00:01:07.340 we deserve to know every dollar is protected.
00:01:12.020 We found that as of 2024, an estimated 2 million Ontarians, or about 12 percent of the population,
00:01:20.060 did not have a primary care provider. Our audit found that the Ministry of Health and Ontario Health
00:01:26.300 did not consistently have processes in place to plan or oversee programs and initiatives that are
00:01:32.620 intended to improve patients' access to primary care providers. Our audit found that the province's
00:01:38.220 centralized matching program, called Health Care Connect, has not kept up with demand. The number of
00:01:45.820 Ontarians on the waitlist as of January 2025 represented only 11 percent of the estimated
00:01:52.060 number of Ontarians in need of a family practitioner. On Health Care Connect, there were more than 108,000
00:01:59.500 people waiting for more than a year to be matched with a doctor. We also noted that there was a failure
00:02:05.740 to coordinate physician recruitment at the provincial level, which has resulted in a fragmented and
00:02:11.980 competitive approach to recruitment across the province. We examined the government's oversight of
00:02:17.740 physician billings. We found that the Ministry lacks a modernized payment system and is not using data
00:02:24.220 analytics to detect potentially inappropriate physician billing. The Ministry of Health paid $19.5 billion
00:02:33.180 to roughly 35,000 physicians in 2024-25 through the Ontario Health Insurance Plan, or OHIP system.
00:02:41.820 The OHIP system, which has been in use since the 80s, cannot automatically flag potentially abnormal
00:02:48.540 billings for further investigation. We found that a system modernization initiative announced in 2023
00:02:55.580 has been delayed and is awaiting approval by the government. We observed that the Ministry relies
00:03:02.140 primarily on tips and complaints to trigger post-payment audits. We observed that only eight staff conduct
00:03:09.820 post-payment audits the same number as they did in 2017. In a 2024 analysis, the Ministry of Health noted
00:03:18.380 that between three to five percent of fee-for-service claims that they reviewed had potential anonymies.
00:03:24.380 We calculated, using their percentage and the $13.3 billion in fee-for-service payments made last year, that approximately $400 to $665 million could have these potential anomalies.
00:03:40.380 Our analysis of fee-for-service billing data between 2021 and 2024 found numerous examples of potentially
00:03:48.940 high-risk billings that were not audited by the Ministry. This included physicians billing more than
00:03:54.700 24 hours a day over 365 days in a year, billing for seeing more than 100 patients in a day, and where
00:04:03.180 their overall billing was significantly higher than their peers. We recommended that the Ministry utilize
00:04:09.900 data analytic tools to flag these and other high-risk payments for review.
00:04:15.020 The Ministry of Health agreed with all 19 of our recommendations.
00:04:18.700 Next is a Supply Ontario
00:04:20.940 PPE audit. Our audit noted that between 2021-22 and 2024-25, over 1 billion PPE items valued at
00:04:30.620 approximately $1.4 billion were written off.
00:04:33.980 At current rate of use, more of the stockpile is projected to expire in the coming years.
00:04:40.460 We found that the Province and Supply Ontario delayed disposing of unsafe inventory, or unusable
00:04:46.700 inventory, sorry. Between 2023 and 2025, they disposed of 780 million units through incineration.
00:04:55.500 We made six recommendations which Supply Ontario agreed with, including setting up an integrated
00:05:01.020 inventory management system to track and report on PPE on a timely basis.
00:05:07.660 Okay, here are the four most striking findings from the recent audit of the Office of the Auditor
00:05:12.620 General of Ontario regarding physician billing under OHIP. Physicians billed more than 24 hours in a
00:05:19.100 single day was the first issue that came up. The audit identified cases where doctors submitted claims that
00:05:24.700 exceeded 24 billable hours in one day. Some physicians also billed services all 365 days of the year.
00:05:32.620 These patterns were flagged as high risk and implausible, yet not all were formally investigated.
00:05:39.020 Here's another issue. Extremely high annual billings concentrated among a small group. A small number of
00:05:45.340 physicians, especially in certain specialties such as pain management, billed several millions of dollars
00:05:51.420 in a single year. The top earners billed amounts approaching 10 million annually. The Ministry had
00:05:56.940 limited evidence that all of these cases were subjected to a thorough review. Here's a major one. A
00:06:03.980 weak and outdated oversight system. The Ministry of Health relies heavily on reactive measures such as
00:06:10.780 complaints and tip-offs rather than proactive data and analytics to detect abnormal billing patterns.
00:06:17.900 The billing review system was described as outdated and not fully effective at identifying inappropriate
00:06:25.100 claims in real time. And the other major issue that the Auditor General's Office found, limited
00:06:31.180 recovery of improper payments. Even when questionable billing was identified, recovery of funds was
00:06:37.580 inconsistent. In some cases, negotiated settlements resulted in the province recovering only a portion
00:06:44.060 of the identified overpayments. Formal reviews can take years to conclude reducing accountability and deterrence.
00:06:52.780 These are all major flaws in our health care system. And by the way, none of those have anything to
00:06:59.260 do with frontline workers such as nurses, health care professionals that help people in their homes, and
00:07:05.980 all kinds of other parts of our health care system that are going to be affected when Ford makes these cuts.
00:07:12.060 The complexity of the treatment that some people get causes certain things to overlap with each other. So,
00:07:19.580 for example, you might go in for one procedure which requires several different treatments for that one
00:07:26.060 condition. So, you have a condition, it requires several different treatments, and those treatments occur
00:07:31.660 under various different billing codes. So, there can be a considerable amount of overlap in that specific
00:07:37.900 situation which you mentioned. But you should keep in mind, more importantly, that over the course of a year,
00:07:44.380 there are approximately 200 million bills that get sent into the Ministry of Health in a typical year.
00:07:51.820 Those are reviewed. 99% of them have no issues.
00:07:57.340 Now, instead of going after physician over billing, the current changes Ford's government is moving toward are
00:08:02.460 system-wide funding restraints, meaning less money flowing to the hospitals and public health,
00:08:07.340 which affects nurses, staff, and patients directly. Government is tightening health care budgets,
00:08:12.780 not targeting doctors' billing. Rather than saying, we'll cut payments to doctors, the province has directed
00:08:18.220 hospitals to plan for much smaller funding increases over the next few years, closer to 2% annually, which is
00:08:25.100 well below rising costs. Hospitals can't cover rising costs, and with that, are cutting jobs and beds. In fact,
00:08:31.820 hospitals are already cutting staff and beds. Unions report that at least 1,000 hospital workers
00:08:38.300 have been laid off in regions like the GTA, Hamilton, and Ottawa. And facilities are already struggling with
00:08:45.340 funding shortfalls. Staffing cuts like these directly affect patient care and capacity. And of course, more
00:08:51.660 wait times and worse care is predicted. Analysis warned that these cuts could lead to longer wait
00:08:56.780 times for surgery, rushed care, overcrowded hospitals, and a lack of enough staffed beds, even before
00:09:04.540 this future cut happens. Public health programs and services are also on the chopping block. Community
00:09:10.780 health and public health units have faced funding reductions in the last few years already. And this
00:09:16.300 will lead to cuts in services like disease prevention programs, sexual health clinics, outbreak
00:09:21.580 response, clinic inspections, student nutrition programs, and on and on and on, all while
00:09:27.740 abusive billing eats up millions and millions of dollars in our health care system.
00:09:32.940 When I started this today, I was talking about over-billing, about the Auditor General flagging
00:09:37.340 weaknesses in Ontario's oversight of physician payments. And let's be clear, accountability matters.
00:09:42.780 Every public dollar should be tracked, audited, and justified. But what's happening now isn't a
00:09:48.460 targeted crackdown on waste. It's a broad restraint. Hospitals are being told to tighten belts while
00:09:53.900 costs rise, staffing remains short, and wait times are already stretched. If there are problems in the
00:10:00.700 system, fix the problems, modernize the billing system, strengthen audits, go after fraud where it
00:10:06.300 exists. But don't quietly squeeze the front lines and call it reform. Healthcare isn't an accounting
00:10:12.860 exercise. It's the difference between a staffed bed and a hallway stretcher, between timely surgery and
00:10:19.260 months of waiting. And if we're going to cut, we better be honest about who's actually paying the price.