The province is risking large fines from the federal government by continuing to allow private health-care brokers to operate in B.C., according to NDP health critic Adrian Dix.
“B.C. is still vulnerable to being fined a huge amount of money by Ottawa because they’re allowing this to happen,” Dix told the Georgia Straight.
On December 13, the Ministry of Health released a report concluding that 1,100 patients improperly used third-party brokers to gain speedy access to magnetic resonance imaging scans at two Providence Health Care hospitals, St. Paul’s and St. Joseph’s.
The patients, who were seen during a four-year period starting in 2002, paid a fee for the scans. Most also paid a fee to one of 10 brokers.
“This type of arrangement for medically necessary procedures to beneficiaries is not permitted under the Canada Health Act, the Medicare Protection Act or the Hospital Insurance Act,” states the report, which says that paying such fees for queue-jumping constitutes extra billing under the Canada Health Act.
When this occurs, the report notes, the federal government normally reduces the health transfer payments by the total of the extra billing that has taken place during the fiscal year.
Dix claimed this amounts to a fine. “The reason why the government had to intervene to get them to reimburse the money was that [otherwise] they would be fined themselves by Ottawa,” he said.
The report recommends that within 90 days the patients be reimbursed the cost of the procedures, which Dix estimated would total about $750,000. He added that the losers in the situation are those who did not pay extra to go to the front of the line.
“The sad part is that all the people who were jumped over in the line get nothing,” he said. “They are the ones who really suffer. Sadly, it was those that paid to jump the queue that are getting reimbursed.”
While the report advises reimbursing the patients for the fees they paid for medical procedures, it stopped short of calling for a refund of the fees paid to the 10 brokers.
The report suggests that patients themselves contact the brokers if they wish to obtain a refund of these fees.
Dix said this is because the province has no authority to order the reimbursement of the brokers’ fees. “The private operators, because the government has no capacity to fine them, get to keep their money.”
The review team that produced the report noted that it did not have enough information to know whether there was a deliberate attempt by any officer or manager at the Vancouver Coastal Health Authority or Providence Health Care to violate provincial laws or Health Ministry policy. However, the report indicates a “breakdown in communications” between executive officers and the front-line managers responsible for operating diagnostic imaging at the two hospitals.
Patients who paid the fee were all classed as “priority 3”, meaning they would normally face a wait of between three and six months before being seen. After paying the fee, however, they were usually seen within two or three days, the report says.
Dix believes that the report’s findings are significant. “To have a major health-care provider, which itself is very much involved in all the manoeuverings around the future of St. Paul’s, fined for 1,100 violations of the law—that’s pretty serious business,” he pointed out.
According to Providence’s Web site (www.providencehealthcare.org/), the organization is “inspired by the healing ministry of Jesus Christ”. Among its values, says the Web site, is integrity: “We build our relationships on honesty, justice and fairness.”
This is my final column for the Straight. Over the last year and a half, I’ve enjoyed working with the Straight’s staff. Au revoir.