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.
If Doug Ford’s doing it, it can’t be good so the thinking goes. But his idea deserves examination.
Private clinics can work if they are run by non-profit societies.
image: Kelly Funk
An example of a successful non-profit clinic is STEPS (Supporting Team Excellence with Patients Society) in Kamloops.
The clinic in Valleyview is owned and operated by the society. Doctors work on a collaborative basis. When my doctor went on maternity leave, another doctor took over. It’s a model that can be used elsewhere according to their website:
“[STEPS] was incorporated on April 11, 2017 as a British Columbia Society whose purpose is to lead innovation in the provision of interdisciplinary team-based primary health care with the goal of developing a successful model of primary care delivery that can be adopted by others.”
Ford unveiled his government’s plan on Monday. Ontario plans to increase the use of private clinics to tackle Ontario’s surgery waiting lists which is more than 200,000. He claims that clinics would be paid for by the public health system.
Ford says that 50 per cent of surgeries could be done outside hospitals.
Just how for-profit private clinics will be paid for by the public health system is a bit of a mystery. Surely he can’t be suggesting that public money go into the pockets of for-profit clinic operators?
Is Ford suggesting a familiar model by which doctors have operating on since the inception of Canada’s health care?
Some doctors make a good, well-deserved, living by operating private clinics. They bill B.C.’s MSP for each patient visit and if they get enough visits, there will be enough left over after paying staff, utilities, equipment and supplies, rent or mortgage, to live on.
But that model is broken. Not many doctors want to run the business of a private clinic in which they have to work long hours and squeeze in lots of patient visits.
Most doctors would prefer the STEPS model which allows for flexible working hours without the worry of operating a business.
It’s hard to imagine a for-profit private clinic operating with only the income of per-patient visits. They would have to grind through a lot of patients to make it work.
It hasn’t worked for many existing for-profit private clinics. They have had to resort to illegal measures.
“Private surgeries and medical imaging are big business in BC,” says Andrew Longhurst, researcher for the Canadian Centre for Policy Alternatives. “Over the last two decades, this for-profit sector has benefited from increased outsourcing of publicly funded procedures and unlawful patient extra-billing.”
For example, False Creek Healthcare Centre in Vancouver received $12.2 million in health care contracts between 2015 and 2020 despite having been audited by the BC government and found to have engaged in unlawful extra-billing, says Longhurst.
Kamloops Surgical Centre received $15.4 million between 2015 and 2020, also despite having been audited and found to have engaged in unlawful extra-billing. Interior Health continued to contract with the clinic during and after the period of unlawful extra-billing. CCPA Policy Note August, 2022.
Not-profit private clinics have demonstrated that they can function successfully to the benefit of patients and doctors alike. But a for-profit clinic funded by the public purse? Dream on.
Will Ontario’s plan to boost surgeries at private clinics work?
If Doug Ford’s doing it, it can’t be good so the thinking goes. But his idea deserves examination.
Private clinics can work if they are run by non-profit societies.
An example of a successful non-profit clinic is STEPS (Supporting Team Excellence with Patients Society) in Kamloops.
The clinic in Valleyview is owned and operated by the society. Doctors work on a collaborative basis. When my doctor went on maternity leave, another doctor took over. It’s a model that can be used elsewhere according to their website:
“[STEPS] was incorporated on April 11, 2017 as a British Columbia Society whose purpose is to lead innovation in the provision of interdisciplinary team-based primary health care with the goal of developing a successful model of primary care delivery that can be adopted by others.”
Ford unveiled his government’s plan on Monday. Ontario plans to increase the use of private clinics to tackle Ontario’s surgery waiting lists which is more than 200,000. He claims that clinics would be paid for by the public health system.
Ford says that 50 per cent of surgeries could be done outside hospitals.
Just how for-profit private clinics will be paid for by the public health system is a bit of a mystery. Surely he can’t be suggesting that public money go into the pockets of for-profit clinic operators?
Is Ford suggesting a familiar model by which doctors have operating on since the inception of Canada’s health care?
Some doctors make a good, well-deserved, living by operating private clinics. They bill B.C.’s MSP for each patient visit and if they get enough visits, there will be enough left over after paying staff, utilities, equipment and supplies, rent or mortgage, to live on.
But that model is broken. Not many doctors want to run the business of a private clinic in which they have to work long hours and squeeze in lots of patient visits.
Most doctors would prefer the STEPS model which allows for flexible working hours without the worry of operating a business.
It’s hard to imagine a for-profit private clinic operating with only the income of per-patient visits. They would have to grind through a lot of patients to make it work.
It hasn’t worked for many existing for-profit private clinics. They have had to resort to illegal measures.
“Private surgeries and medical imaging are big business in BC,” says Andrew Longhurst, researcher for the Canadian Centre for Policy Alternatives. “Over the last two decades, this for-profit sector has benefited from increased outsourcing of publicly funded procedures and unlawful patient extra-billing.”
For example, False Creek Healthcare Centre in Vancouver received $12.2 million in health care contracts between 2015 and 2020 despite having been audited by the BC government and found to have engaged in unlawful extra-billing, says Longhurst.
Kamloops Surgical Centre received $15.4 million between 2015 and 2020, also despite having been audited and found to have engaged in unlawful extra-billing. Interior Health continued to contract with the clinic during and after the period of unlawful extra-billing. CCPA Policy Note August, 2022.
Not-profit private clinics have demonstrated that they can function successfully to the benefit of patients and doctors alike. But a for-profit clinic funded by the public purse? Dream on.
The glossy ad in arrived in my mailbox within days of reading that Health Canada was clamping down on private clinics offering cell injection treatments. The ad was for a seminar on Regenerative Medicine at five interior B.C. locations. The one in Kamloops was on Monday, July 15, 2019.
image: The Mandarin
The ad didn’t make clear what Regenerative Medicine was but it looked like cell injection from the information given.
“Learn from the most significant medical breakthrough in natural medicine this century,” claimed the ad. They ask: “Do you suffer from knee pain, back pain, osteoarthritis neuropathy join pain, COPD.”
The ad provided disclaimers. “Regenerative Cellular Therapy is considered experimental. It has not been evaluated or approved by Health Canada. It is not offered as a cure for any condition, disease, or injury,” and “We want to be transparent with you and disclose that this therapy is experimental/unproven and not everyone responds to the therapy.”
Fair enough but what, exactly, are the treatments?
It was only after phoning the number in the ad that I was given a website where I could find out more about the Regenerative Medicine and Anti-Aging Institute. RMAAI appears to be located in Washington State. While thin on details, the website says:
“At RMAAI we offer premiere regenerative medicine. The foundation of regenerative medicine includes growth factors, cytokines, proteins and mesenchymal stem cells. These are a fundamental piece of our natural and holistic approach to your healthcare needs.”
According to Wikipedia, mesenchymal stem cells can grow into other cells such as bone cells, cartilage cells, muscle cells, fat cells.
Regenerative Medicine, it turns out, is the harvesting of your own stem cells and re-injecting them at the site of injury with the hope that they will replace injured cells. I guess if I had attended the seminar, I might have found this out.
Health Canada has declared cell injection clinics to be illegal.
While the therapy is promising, Health Canada has a number of issues with the way cell therapy is administered at commercial clinics.
Michael Rudnicki, director of Canada’s Stem Cell Network, agrees that while there stem cell research is promising, it is not ready for clinical use. Referring to the banned clinics, he says:
“These treatments are unproven. These clinics are for profit. They are not research enterprises (Globe and Mail, July 10, 2019).”
Health Canada’s has medical and legal issues with the clinics.
The transfer of my own cells back into my body seems safe. Not so, says Health Canada because the procedure can introduce bacteria or viruses and stimulate unwanted immune reactions and tumour formation. “Indeed, a number of serious adverse events have been associated with use of autologous [self] cell therapies and strategies to mitigate these risks are needed,” says Health Canada.
The legal issue is that cell injections fall under the Food and Drugs Act. As such, they are classified as drugs and must be authorized for use in Canada. In addition, principles for labelling and quality control must be adhered to and the devices used to process the cells have to be classified under the Act.
I asked if RMAAI by email if they intend to offer seminars on cell injection therapies. As of the time of publication, I had no reply.
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