The Canada Health Act May Already Be Dead

Are Loblaw and George Weston destabilizing monopolies or visionary pioneers?

I recently came across an argument that the two publicly traded companies, George Weston Limited and its subsidiary Loblaw Companies Limited are becoming so dominant in so many critical sectors - and collaborating so closely with various levels of government - that they’ve become something of a threat to the social order.

Full disclosure: like many Canadians, I’ve had both good and bad experiences with Weston-related companies over the years. And I’ve never forgiven them for their President’s Choice brand chocolate flavored soda back in the 90s. Really? Chocolate soda?

The particular point that got my attention was Weston’s relationship with Maple. It took me a moment to recall that Maple is a Canadian for-profit provider of medical services. A quick search through old emails confirmed that my automobile insurance policy came with introductory access to Maple - although I’ve never actually used it.

We’ll get back to Maple in a minute. But first we’ll address the market dominance issue.

Are the Weston Companies Monopolies?

No.

They certainly enjoy considerable scale, but they barely qualify as A-list corporate players. Even if you combined the market capitalization of Weston ($17.2 billion) with Loblaw ($31.6 billion), they still wouldn’t rank among the top ten Canadian companies. And while they have strong revenues, their operating margins aren’t even in the top 100.

Sure, Weston owns a lot of supermarkets, but they’re far from alone in that business. Their competition includes Empire Company (Sobeys, Safeway, FreshCo, etc.), Metro, Costco and, of course, Walmart.

Similarly, their control of Shoppers Drug Mart is significant, but even with its recent purchase of the Pharmasave brand, their combined 2,000+ locations would hardly overwhelm the 1,400+ locations owned by McKesson Canada (Guardian and IDA), Costco’s 108, and however many of Walmart’s 402 Canadian stores offer pharmacy services.

Do Weston Companies have access to too much of our data?

Yes.

Through the data generated by millions of transactions involving their PC Optimum points program, Weston probably has enough consumer behavior information to warn you when the socks you just took out of that drawer won’t match the shirt you’re thinking of ordering on Amazon.

Jokes aside, it really is scary. But having said that, whatever Weston knows about us is no scarier than what’s already collected, stored, and monetized by credit card providers, smartphone vendors, Amazon…and the government. I don’t believe Weston is making things noticeably worse.

Have the Weston Companies broken the law?

Probably. Which large business hasn’t at some point? Why do you think they retain all those lawyers?

But the original arguments primary focus was on Weston’s impact on the letter and spirit of the Canada Health Act. So that’s what we’ll explore.

The Act established a mechanism governing the transfer of federal funding for the administration of universal healthcare run by the provinces. Provinces are not obligated by the law itself, but their federal funding depends on compliance.

One of the key principles of the Act requires the public administration of all services. That is, only a non-profit public authority is eligible to deliver services.

But there have always been exceptions. There are a few grandfathered institutions that were allowed to continue to exist as private businesses. In the Toronto area, the most famous of those is the private Shouldice Hernia Centre in Markham.

And extra-billing or user charges - while forbidden by the Act - are commonly collected disguised as administrative fees or through the delivery of unnecessary tests and procedures to supplement government payments for insured services.

At first glance, Maple would appear to have gone much further down the road to privatization and, as of 2019, they already had many hundreds of thousands of patients. Membership costs $79.99 each month, although that money will also go towards any services you end up consuming.

To Canadian ears, Maple’s billing schedule sounds expensive. A 15 minute appointment with a pediatrician, for example, will cost $150. They won’t charge a patient for services that are covered by provincial plans, but it seems that most of what they offer - including text message consultations and sessions with out-of-province doctors - is not covered.

Maple’s website documentation goes to great pains to emphasize how they only bill patients for services that are not offered by provincial plans. Sometimes that will be because the delivery method (text messages) or practitioner (out-of-province doctors) aren’t covered. While I could imagine this could one day be tested in court, on the face of it, it appears legal.

Does Maple place universal healthcare at risk?

Yes. And no.