Letters / Correspondance

University fee for student health services

Canadian Medical Association Journal 1996; 155: 1036
Concerning the article "Does university fee violate CHA?" (CMAJ 1996; 155: 208 [full text]), I raised similar concerns with the University of Toronto when I was a graduate student there in 1992. After the passage of legislation banning the charging of "block fees" by physicians, the College of Physicians and Surgeons of Ontario mailed to all physicians a statement on annual fees, which clearly indicated to patients that "you do not have to pay an annual fee. You are allowed to pay for each service which is not covered by OHIP [Ontario Health Insurance Plan] one by one."

I wrote the following to the assistant vice-president of student affairs.

If the University of Toronto continues to make the health services incidental fee compulsory, what is it that allows the university not to call this an annual fee? Frankly, I do not think the university has a right to charge this fee under the present legislation and its interpretations.

It took more than 5 months and a reminder letter to receive a reply, which included the following explanation.

My inquiries have led me to conclude that the fee we are charging is not ruled out by the document you have received from the College of Physicians and Surgeons.

University health service fees are, in fact, fairly common in Ontario universities. They have been discussed with the officials who manage OHIP payments and have not been objected to. We interpret the fee not as a fee for "noninsured services" in the sense of the College's policy but rather as covering much more. It is a fee to cover the costs of putting the health services in place for the health promotion activities and other nonmedical services that are implied by the mandate of a university health service.

Although I found this answer less than satisfactory, I did not pursue the matter because of course-work pressures. Perhaps the Society of Graduate Students at the University of Western Ontario will have more energy.

Monir Taha, MD, CCFP, MHSc, FRCPC
Saint John, NB


| CMAJ October 15, 1996 (vol 155, no 8) |