Public Values

Extra-billing for day surgeries continues in Vancouver

Government inaction leading to increasingly unequal and inaccessible health care.

Rally protests extra-billing practices at the Cambie Surgery Centre in BC.August 28, 2012: Health care workers, community groups and Canadian Doctors for Medicare gathered on August 20th to protest extra-billing practices at the Cambie Surgery Centre in BC.

The clinic had been audited by the Medical Services Commission and found to have extra-billed patients in contravention of the provincial Medicare Protection Act.

Medicare advocates are calling on the provincial government to take swift action against the clinic to ensure that the principles of equity and accessibility are preserved in the single-payer health system.

  "Those with the means to pay for their own health care will be less willing to pay taxes to support our single-payer public system."

The Hospital Employees' Union (HEU), the Canadian Union of Public Employees' health care division in British Columbia, also published the following opinion piece in the current issue of the HEU Guardian.

Audit unveils evidence of massive extra-billing (Guardian, Summer 2012)

This past July, BC's Medical Services Commission announced that it had uncovered evidence that two private clinics had illegally extra-billed patients for publicly insured medical procedures.

The audit of 468 procedures, carried out at the Cambie Surgery Centre and the Specialist Referral Clinic, found that 205 of them — or more than 40 percent — involved direct charges to patients in violation of the Medicare Protection Act.

But despite the blatant violation of the provincial Medicare law, there will be few if any consequences for the private clinics or their medical director, outspoken private health care booster Dr. Brian Day.

Day has made it clear that his clinics will continue to extra-bill patients even though the Commission says it will pursue a court injunction to stop this practice.

The provincial government, for its part, won't take any additional action of its own to enforce the law.

On the other hand, Day is pursuing a constitutional challenge against the Medicare Protection Act arguing that patients should be allowed to pay privately for surgeries.

Private health care advocates like Day argue that by allowing those with the means to pay privately for their surgery, waitlists in the public system will be shorter for the rest of us.

But surgeons and OR nurses are in short supply — and they can't be in two places at the same time. So the result of private pay will be longer waits in the public system — and expedited access for those who are wealthy or desperate enough to pay for it.

While the public system is not perfect, it generally provides access to health services based on need rather than on personal wealth, paid for collectively through our taxes.

If private health care proponents like Day succeed, those with the means to pay for their own health care will be less willing to pay taxes to support our single-payer public system.

HEU first called for an audit into Day's billing practices 12 years ago. More than a decade later, isn't it time for politicians to take decisive action on an issue that is so fundamental to the future of Medicare?

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The problem with profit-driven health care

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  Audit of of private clinic in BC reveals epidemic of extra-billing

Posted: September 29, 2012

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