British Columbia’s Medical Services Commission is seeking an injunction against Telus Health over its private, fee-based LifePlus health care program, saying it violates the extra billing provisions of the province’s Medicare Protection Act, according to documents filed in B.C. Supreme Court on Thursday.
About a million British Columbians are without a family doctor, which has fed into pressures in emergency departments and secondary care systems such as specialist access. The COVID-19 pandemic exacerbated these pressures, leading to shuttered emergency departments, cancelled elective surgeries and hours-long waits for ambulances.
Telus Health has argued that it is only seeking to alleviate pressures on the health care system through its LifePlus program, which charges patients thousands of dollars a year in membership fees for services it says are not covered through the province’s Medical Services Plan, or MSP.
B.C. Health Minister Adrian Dix said he directed the commission to review Telus Health in February after complaints made by the public of illegal extra billing.
“It’s very important to uphold the Medicare Protection Act, which is in place to preserve our publicly managed and fiscally sustainable health care system for British Columbia,” Mr. Dix said Thursday. “Access to necessary medical care should be based by needs and not on an individual’s ability to pay.”
Under Telus Health’s LifePlus program, patients pay about $4,882 for the first year and $3,882 for each subsequent year for what the company describes as preventive health care, according to a Nov. 8 e-mail from a Telus Health clinical enrolment nurse to a private investigator retained by the plaintiffs, submitted as part of the legal filings. The company says patients then have access to a multidisciplinary care team of independent contractors including family doctors, nurses, dietitians and kinesiologists, who offer services that are not covered by MSP. The LifePlus program has about 25 doctors and 4,000 customers in B.C.
Telus Health vice-president Juggy Sihota said Thursday the company had made numerous efforts to discuss the matter with members of the commission, but received no response.
“We’re really upset about this because we want to be able to, of course, address any outstanding issues that they may have regarding compliance,” she said. “And so we welcome the legal proceeding. We would have hoped that the government would be focusing their attention on fixing the significant issues of the public health care system here rather than firing bullets indiscriminately.”
Ms. Sihota added the company is disappointed in the route the commission has chosen, saying it felt “rather political.”
The commission is seeking a declaration that Telus Health is breaching the Medicare Protection Act; interim, interlocutory and permanent injunctions against facilitating the provisions of MSP-covered services by MSP-enrolled doctors at Telus Health facilities; and costs. Telus Health has 21 days to respond to the petition.
In an affidavit, recently retired Simon Fraser University professor Mark Winston wrote that his family doctor of 14 years had informed him last December that he would be closing down his family practice and joining Telus Health. Patients could either seek a new doctor or contact Telus Health to inquire about its fee-based membership, the affidavit said.
At no time did Dr. Winston’s former doctor, or Telus Health, inform him that he could continue accessing primary care services from the doctor without paying, he wrote.
Ms. Sihota disputed this Wednesday, saying all physicians that are part of the LifePlus service are welcome to continue offering primary care services to their own patient rosters, separate from their work with the LifePlus program.
“In fact, we enable them to do that at no charge on our premises,” Ms. Sihota said. “The services that we have them providing through the LifePlus program are for preventative care. If a preventative care patient is coming to use the service and has an insured service request, that physician is free to provide that care to that patient on their own accord.”
The Medical Services Commission is a nine-member statutory body consisting of three representatives from government, three from the Doctors of BC and three from the public. It manages the Medical Services Plan on behalf of the B.C. government in accordance with the Medicare Protection Act and Regulations.
The College of Physicians and Surgeons of B.C. notes that doctors can charge what’s called a “block fee” for uninsured services, but it must be optional for the patient. Doctors cannot require patients pay a block fee before accessing an insured or uninsured services; treat or offer to treat patients preferentially if they do pay it; or terminate a patient or refuse to accept a new patient because they refuse to pay it.
The college further states that doctors must charge a block fee for a period of no greater than one year, and that they must list, in writing, each of the services covered under the block fee, and how much each service would cost if paid on a fee-for-service basis, according to a practice standard.
Premier David Eby has spoken out in defence of the public health care system at recent health care announcements.
“Some are proposing to respond to [health care system] stress, that we undercut the principles of universal public health care and promote a pay-as-you-go approach, allowing the wealthiest to jump the line to the front, by buying their way to the front of the line,” he said Sunday at an announcement about expanding a program for international medical graduates.
“It’s not right. Buying your way to the front of the line doesn’t solve the line, it just changes who gets there first. Universal public health care is one of Canada’s great achievements. Everyone deserves the best possible health care. We can’t privatize our way toward a better health care system.”