Bring private clinics into the healthcare fold

With no walk-in clinics in many cities such as Kamloops, the last thing the B.C. government needs to do is crack down on existing private ones. They should be integrated into our healthcare delivery system.

image: CTV Vancouver

But no, our health insurance commission is taking Telus Health to court.

There are three Telus Health Care Centres clinics in Vancouver and one in Victoria with plans to expand. They are not walk-in clinics but they could be.

They charge for sessions with mental health specialists, Clinical Psychologist and Registered Dietitian. It will cost you up to $225 per session.

True, BC’s Medical Services Plan (MSP) will cover the cost of some of these specialists but only when referred to by your family doctor. And with a million British Columbians without a family doctor, your chances of seeing a specialist are close to zero.

Telus Health is not breaking the law by charging for access to these specialists because they are not covered by MSP.

In principle, those who can pay should not have greater access to health care than those who can’t.

But Telus provides free health care for things not covered by MSP through their “Health for Good” programs. They provide access to primary and mental health services for homeless and marginalized persons through Mobile Health Clinics and online sessions.

The B.C. Medical Services Commission claims that Telus’ LifePlus program is breaking the law by charging patients for services that should be publicly covered.

Maybe so. The court case is ongoing and depends on just what is covered by MSP.

The Medical Services Commission’s claim is based on a probe done by a private investigator, a would-be patient. The investigator was told they would have to pay an annual fee to see a family doctor, which isn’t allowed under the Medical Protection Act.

The act ensures access to necessary medical care should be based on need, not an individual’s ability to pay.

The case against Telus Health is complicated by the fact that Telus Health provides free online consultations to B.C. residents covered under by MSP. You can choose the doctor you want to see, book a time, and have prescriptions made.

Telus Health denied the accusations, saying its program is only trying to relieve pressure on the public system.

A spokesperson for the LifePlus program says its fees — $4,650 in the first year and $3,650 in subsequent years — are not for primary care and “strictly” for uninsured services like dietitians, kinesiologists and other health and wellness needs.

If true, LifePlus is operating within the Medical Protection Act.

I have proposed the construction of medical clinics based the model used by BC Housing to address the housing shortage. Clinics would be built by “BC Clinics” and handed over to non-profit societies who would rent out space and pay the mortgage.

Now I would include Telus’ privately-run clinics to provide healthcare for all. They would bill MSP as any doctor would. The province would pay Telus for the operation of the clinic.

It might seem outrageous that the province would pay for the operation of private clinic but not considering the cost of building and staffing clinics –which we desperately need.

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Provinces come to their senses and accept healthcare money

Ordinarily, provinces only want one thing from the feds –money.

So when the feds offer money in exchange for something, provinces are reluctant to accept.

All that has changed now that Canada is facing a shortage of health care workers and operating rooms.

image: Canada’s premiers

Other than universal health care, Canada has no central control of health delivery. It’s delivered by the provinces and overseen by the feds.

The provinces provide most of the funding for health care whereas the feds only contribute 22 per cent. It used to be greater. At the inception of health care in 1957 the feds paid 35 per cent. In the late 1970s, it dropped to 25 per cent.

The provinces do the heavy lifting while the feds try to initiate county-wide programs like dental care.

It’s a recipe for tension, an awkward and inefficient way to run a universal health system. Medicare would be easier to administer if it wasn’t fractured into fiefdoms. Other countries do a better job.

In Australia, the federal government funds and controls health care, There, the feds control the purse and the programs.

However, the crisis in our health care system has caught everyone’s attention, federally and provincially.

Conditions which the provinces rejected are now being reconsidered. It’s a new era of reciprocity; more of a forced marriage than cooperation.

The new era has left health ministers unfamiliar with the new terrain. First, they were willing to accept federal money last November when provincial health ministers met with their federal counterpart in Vancouver.

Then premiers nixed the deal, presumably because they didn’t like being told what the money would go for.

Now provinces are sensibly reconsidering the federal offer in exchange for some reasonable national goals.

In recent negotiations, Federal Health Minister Jean-Yves Duclos said there has been a “change in tone and direction” from the provinces and territories to accept Ottawa’s demands to modernize data sharing, reduce backlogs in surgeries and diagnostics, retrain and hire more nurses and use medical clinics to handle millions of Canadians without family doctors.

It’s an offer the provinces can’t refuse.

Duclos is using a divide and conquer strategy. Ontario’s premier Ford was the first to break from the pack of provinces. Ford announced that Ontario is willing to accept Ottawa’s key demands, including a national health data system.

In addition to that compromise on Ford’s part, the feds are negotiating special deals with Ontario that would see Ottawa transfer $70-billion to the province over the next decade.

And now Ontario is willing to have transfers for specific programs. Some of this money would be earmarked under a bilateral agreement for home care and building long-term care facilities to reduce the stress on hospitals,

Ford insists that he is not breaking in solidarity with other provinces. He insisted that any bilateral agreement would not come at the expense of other provinces and territories.

Then Quebec Premier François Legault said he also is ready to share data on the province’s health care systems.

Just wait, the rest of the provinces will come to their senses and follow.

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