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With a federal campaign in full force grabbing the majority of the headlines, a significant threat to Canada’s most treasured national program is going largely unnoticed.

For many years, certain physicians and clinics have quietly been charging extra fees for health services. In some provinces, the frequency of such charges has been increasing. These include hidden charges for medications that are many times their actual cost or access fees of hundreds of dollars for examinations such as colonoscopies. Because these fees are for services that are covered by the health system, this is in effect extra-billing, a practice that is against federal and provincial law.

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In Quebec, Health Minister Gaétan Barrette has identified these fees as a problem, as have many others for many years. You might expect Barrette to clearly inform patients and practitioners that this practice is illegal and put an end to it. Instead, he is trying to regulate and “normalize” these fees, in direct contravention of the Canada Health Act.