Critics say the BC government is creating a de facto two-tier system in which BC’s wealthiest can pay for faster medical treatment.
The BC government has handed out at least $393 million to private, for-profit surgical and medical imaging companies since 2015 to provide services within the public system, while ignoring illegal billing practices, according to a new report from the Canadian Center for Policy Alternatives. British Columbia branch.
Critics say this creates a de facto two-tier system in which BC’s wealthiest can pay for faster medical treatment.
The report comes at a time when British Columbia’s health care system is collapsing due to understaffing and a shortage of family doctors, and when the debate over private health care s is escalating in the wake of last month’s decision by the British Columbia Supreme Court regarding the additional billing that will likely head to the Supreme Court of Canada.
Health policy analyst Andrew Longhurst’s report, released Wednesday, shows health authorities across the province have paid hundreds of millions of dollars to private, for-profit clinics known to engage in overbilling, an illegal practice in which clinics bill patients privately for medically necessary procedures that are already covered by the public health care system under Medicare.
This system, Longhurst said, allows wealthier patients to skip the queue by privately paying for needed health care.
Longhurst found that the for-profit sector has benefited from increased outsourcing of publicly funded procedures due to long waiting lists for surgeries in the public system. The Department of Health has increased spending on private clinics by 57% since 2015-2016, according to the report titled “The Concerning Rise of Corporate Medicine.”
British Columbia has 14 private MRI clinics, where patients can pay around $1,000 for medical imaging. MRI scanners are exempt from the BC Medicare Protection Act. There are also 45 private surgical clinics operating in the province.
Longhurst said the B.C. government still contracts with several private surgical clinics that have been audited for overcharging practices.
For example, False Creek Surgical Centre, one of the largest private clinics in British Columbia, received $12.2 million in payments to health authorities between 2015-2016 and 2020-2021, despite a recent government audit. of British Columbia which revealed that the clinic was overcharging, according to the report. said. The clinic was acquired by a private Toronto investment firm, Kensington Capital Advisers, in 2019.
According to a September 2019 email exchange between the former owner of the False Creek clinic and Deputy Minister of Health Stephen Brown, obtained by Longhurst through a freedom of information request, the owner expresses its gratitude that the provincial government will provide “long-term, guaranteed volume contracts that will allow us to make an informed decision on the sustainability of this economic model.
Health Minister Adrian Dix stressed he was a longtime champion of the public health system and said only 3% of publicly funded surgeries – 13,000 of the 340,000 surgeries performed each year in British Columbia – are performed in private clinics.
Dix said the province nearly doubled the number of publicly funded MRIs in three years, from 170,000 to 300,000, which he called a “breathtaking” increase, and bought three surgical clinics private to increase surgical capacity.
As for the False Creek Surgical Centre, Vancouver Coastal Health terminated the contract with the center in 2018 and only restarted it when the new clinic changed its practices to comply with British Columbia laws, a said Dix.
The Department of Health announced in April that Island Health had spent $11.5 million to purchase two private surgical centers in Greater Victoria and Nanaimo to increase the number of surgeries and endoscopies available to residents. of Vancouver Island.
Ontario sees private clinics as the key to reducing surgical wait lists. Last week, Doug Ford’s Conservative government announced it would increase state-funded surgeries at private clinics.
While contracting out to private medical services can reduce pressure on the public system in the short term, it also has long-term consequences, Longhurst said. This exacerbates staffing shortages by drawing health care workers away from the public system through better salaries, he said.
Research shows that private medical services are more expensive and fail to reduce long-term wait times. For example, the report analyzed the cost of knee surgeries for injured workers through WorkSafeBC and found that they cost nearly four times as much at a private clinic—$3,222—compared to $859 at a public hospital.
BC Green Party MLA Adam Olsen said the erosion of the province’s public healthcare system has created the ecosystem for private clinics to thrive, which is “very concerning”.
“Now they can charge a premium for the service they provide because the government is desperate,” Olsen said. “Not only does this jeopardize the universal and equitable healthcare system, but it actually means that [the government is] pay a premium for services that he should provide himself.
In July, the three judges of the British Columbia Court of Appeal were unanimous in saying that the province’s ban on extra-billing doctors and limits on private health insurance do not violate the Constitution. However, the judges also recognized that people are suffering and dying from waiting too long to receive necessary medical care.
The case, which is likely headed to the Supreme Court of Canada, was brought by Dr. Brian Day of the Cambie Surgery Center and argues that regulated private surgical services and private health insurance could reduce pressure on the system public and provide a “safety valve”. to patients facing long waits.
In February, Dix asked the Medical Services Commission to review complaints about Telus’ LifePlus program and other paid private services to determine whether those services create a two-tier system allowing some to skip the queue. ‘waiting. This review has been completed but has not yet been made public.