VICTORIA - The controversy about patients paying $1,400 to jump the waiting lists for MRIs - and having the tests done in a public hospital - shows how far B.C. has allowed the basic principle of public health care to be eroded.
At the heart of our system is a commitment that health care will be provided based on need. That’s why the Canada Health Act bars extra billing for any medically necessary treatment covered under the public plan.
The MRI scandal shows that principle was abandoned.
St. Paul’s Hospital allowed a private broker, Timely Medical Alternatives, to buy time on its machine and use its technicians to help people jump the waiting list. For $1,400 you could buy your way to speedier, better treatment than your neighbour. Two children might be diagnosed with an illness that required an MRI and placed on a waiting list together. A family with money could buy an immediate MRI scan, while the other child waited and perhaps suffered.
Canadians have so far decided that’s wrong. It is, in fact, illegal.
But B.C. governments, NDP and Liberal, have allowed the expansion of private clinics and companies that facilitate queue-jumping for people who can pay. There are about two dozen clinics in the province that offer faster treatment for people with money. They can operate mainly because the government chooses to turn a blind eye to the Canada Health Act violations.
The Liberal government can’t claim ignorance. Less than three years ago former health minister Colin Hansen introduced a bill aimed at upholding the Canada Health Act and ending two-tier care in the province. It was important to plug the loopholes and make it clear that B.C. wouldn’t tolerate extra-billing, Hansen said.
The bill was debated and passed by the legislature. MLAs decided it was necessary to protect medicare.
But then Premier Gordon Campbell said the government wouldn’t put the law into effect. It remains in limbo; Campbell has never explained why the government passed a bill to protect medicare one month and abandoned the next.
The government has known two-tier health care was increasing, but chose not to act.
That’s allowed companies like Timely Medical Alternatives to expand. The business started in 2003 to sell better health care to people who could pay for it. Some activities are clearly within the Canada Health Act. The company arranges surgery in Washington State, for example, for people who don’t want to wait for a knee replacement.
Others, like the MRI deal with St. Paul’s Hospital, aren’t.
Timely Medical Alternatives gives the B.C. government great marks for its “acceptance of private alternatives.” The business rates provinces based on their willingness to tolerate deals like the MRI arrangement. B.C. gets a six out of 10; Alberta gets three. The rest of the provinces get a one rating.
And the company is unabashed in crediting government for its success.
People are driven outside the public health-care system because it is performing poorly, the company says. ”Many Canadians wait unreasonably long for treatment of life-threatening conditions,” the company says. “Every year, scores of Canadians die while on long waiting lists for needed surgery.”
Timely Medical Alternatives is brutal in assessing government’s failure to pay for needed MRI scans. The real purpose is to make surgical wait times appear shorter than they are, the company says on its website. Patients aren’t added to surgical waiting lists until after they have the necessary MRI scans. If government provided the test promptly, then there would be more people “officially” waiting and wait lists would look worse.
Patient care is sacrificed so the truth about wait times can be concealed, the company explains.
Health Minister George Abbott says he’s investigating the queue-jumping at St. Paul’s.
But based on past practice, don’t hold you breath waiting for any real action. If the Campbell government was concerned about two-tier care, it would have acted long ago.
Footnote: NDP health critic Adrian Dix effectively raised the issue, producing a patient who has paid $1,400 and walked into St. Paul’s for an almost immediate MRI, while people in the public system were waiting for months for access to the same machine.
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5 comments:
Good article Paul and so true. I needed a MRI a few months ago. The specialist listed me as urgent. He also suggested I might have to go into the private system as the wait list could be six months. After that he would then put me on his wait list in the rotation he choses by the seriousness of my conditiona,fter the MRI I checked the private system here in Victoria. How busy are you I ask? Very busy. If you get the doctors request in this morning you can get done this afternoon. Similar story at False Creek but a few days longer. So these guys set up a private business supposedly with their money and pay somebody some money and after charging big dollars slip you into St. Paul's Hospital mid morning. Pretty shifty but there are bucks to be made. I do recall when the ex Socred Health Minitser set up the first private MRI when the NDP were in power.The excuse then was it was private and the customer was paying a private company so it didn't impact of the public system. By the way, I waited for a bit, made sure I was on a cancellation list and one day someone couldn't get to the hospital that day. I did. It was above board and in the system. But I sure was tempted to go to False Creek as I hurt like heck. To misuse equipment we the tax payers paid for, to make a private company a profit is very wrong. I await the news that somebody doesn't work there any more Some person with less money is still waiting for those openings at St. Paul's. Put a technician on the late night shift and wait lists plummit. But Hospital authorities don't want to spend the bucks bottom line. I'm now on a different wait list with 2,000 people for some steroid injections that might be sufficeint to not have a operation. False creek is offering the operation for only 7,000 dollars. Plus 500 dollars for a consultation. Big bucks for somebody without too many loose dollars.
The same thing just happened to an aunt, who was sickened by the scam but in too much pain not to pay.
This is happening all over and people are catching on. The public is also rapidly losing all respect for the doctors and the CMA, who are now cheering on the downfall of our system so that they can make even more money off their patients' suffering.
Hold on a second - what exactly is wrong with people paying for MRIs other than that it doesn't seem fair to you? If somebody pays to get an MRI from a private provider, it's money that the government doesn't have to pay, and it's also one fewer person in the queue for government-funded MRIs. The question of "fairness" is specious - is it fair that people with more money can afford fancier cars, or can eat out more frequently? Health care really isn't that different. Of course, the caveat here is that private providers shouldn't be competing for resources with the publicly-funded program. If a private provider purchases an MRI system, that's great - it increases the resource pool. If it's paying for time on a publicly-funded unit that wouldn't otherwise be operating because of funding/resource considerations, I'd say that's acceptable - it ensures that we're maximizing use of the resource. If hospitals are displacing public patients to get the cash offered by private brokers, that's unacceptable. Finally, the issue with MRI waiting lists points to the need for more research into cheaper medical imaging systems. MRI has revolutionized diagnostic capabilities, but the expense is staggering. Imagine how our health care would be improved by a system that could be used routinely like a heart monitor!
Let's not mix apples and oranges or MRI at a private company versus cooking a deal with some hospital to use time on a public machine. If those business guys arn't taking a lot of the lolly off the top, I would be most surprised.so are we getting fair price for our machinery? NO.
So if a person goes, to a private clinic, here or out of province, or country and pays the shot, go right ahead. Most of us won't or can't afford to do that. But keep your little fingers off the machines we all paid for, and to be used for the public syste. It was reported the hospital made 40,000 by renting out the machines. Just hire another techy or two and run them 24 / 7 and guess what? No more need for private companies as the lists would fade away. and no more reason to rent out our stuff
The sunday evening news on CTV tells us anoher hospital has been used to do citizen paid for MRI's. Baldrey was being asked about it. alledged was used a lot. The Minister was twisting and turning and will no doubt get right on it. The opposition critic even got asked a question or two. Man oh man, is our medical system under close control by this government. Youbelieve that, well I know of a bridge for sale
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