(April 22, 2018)<\/p>\n
By: Edith Machattie And Rick Turner, Times Colonist<\/p>\n
The B.C. government is taking decisive action on an illegal activity known as “extra-billing,” bucking a years-long trend of ignoring illegal health-care fees charged to patients in B.C.<\/p>\n
On April 4, Health Minister Adrian Dix announced plans to enforce patient protections against extrabilling that have been on the books since 2003.<\/p>\n
This move comes along with news the federal government is fining B.C. taxpayers nearly $16 million as a result of extra-billing by some of B.C.’s doctors and private clinics in 2015-2016, with possibly more fines to come (for every dollar of extra-billing, the federal government claws back funding to the provincial government for public health care).<\/p>\n
Extra-billing refers to unlawful practices where doctors or private clinics charge a patient for a healthcare service that should be provided at no cost because it is publicly insured as necessary care. These services include medically necessary surgeries, diagnostic tests and visits to a doctor’s office.<\/p>\n
The minister’s plan to deal with this problem, along with recent government announcements about comprehensive investment and action to drive down public surgical and diagnostic wait times, represents a welcome new provincial direction for B.C. patients.<\/p>\n
In 2003, the former B.C. Liberal government passed legal measures intended to add teeth to the province’s ban on extra-billing to protect patients from illegal fees and protect the public purse from federal fines.<\/p>\n
But despite passing these measures in 2003, the province backed down from bringing the protections into force, following lobbying by some private clinics and doctors.<\/p>\n
Instead, the former government took a dramatically different approach: They effectively turned a blind eye to illegal extra-billing over the ensuing years.<\/p>\n
During that same period, the province also oversaw a steep decline in per-person health-care funding that left B.C. at the bottom of the pack compared to other provinces – allowing public wait lists for some key surgeries to grow to some of the longest in the country.<\/p>\n
With less public capacity to perform timely surgeries and MRI scans, and a government willing to ignore extra-billing, the private for-profit clinic sector in B.C. boomed to the second largest in Canada – charging patients unlawful fees for a range of medically necessary surgeries, MRI scans and other health services.<\/p>\n
A 2017 B.C. and Ontario\u00a0Health Coalition<\/strong>\u00a0research report found that 30 of the 34 private clinics surveyed in B.C. appeared to be extra-billing patients. Fees charged were often up to five times the legal limit. The majority of patients surveyed reported experiencing financial hardship as a result of paying private fees for necessary care, including struggling to afford necessities such as rent and groceries.<\/p>\n Similarly, a June 2017 Globe and Mail investigation confirmed extra-billing is widespread in B.C.<\/p>\n On top of the fact that the province has an obvious responsibility to better protect patients from illegal fees, the evidence is clear that wait times have only grown under a government approach of allowing public wait times to fall behind while ignoring illegal private fees.<\/p>\n In addition, the federal government appears newly committed to enforcing health-care law via large fines to offending provinces.<\/p>\n Clearly, bringing the 2003 protections into force is the right thing to do for patients and the public healthcare system.<\/p>\n Specifically, the new protections will: make it an offence for doctors and private clinics to extra-bill patients privately for medically necessary care; ensure patients are not liable to pay extra-billing charged by private clinics or doctors; create a complaint process for patients who have been extra-billed; and fine doctors up to $20,000 if they extra-bill patients.<\/p>\n The changes will make it easier for patients who are extra-billed to recover the fees, give the province the tools it needs to enforce the law, and ensure B.C.’s laws are in line with those in Alberta and Ontario.<\/p>\n