Private Care in BC: Charging for Access to a Publicly Funded Doctor?

Private care in Canada and BC is a hot topic. Our universal healthcare has been in jeopardy over the past couple of years and here at BC Health Care Matters we firmly believe in access to publicly funded healthcare for all Canadians, regardless of their income or social status. In BC, our elected officials maintain that they are not going to allow the privatization of healthcare, but will they allow buying access to public healthcare? We’ve seen various forms of private health care emerge in our province and we have questions. Is this sector properly regulated? Is the government watching and monitoring what these private companies are doing? Are these companies exploiting the desperate residents of BC in need of healthcare? Are they exploiting and burdening the already crippled health care system?

We recently saw that the government has finally taken action against Telus and their LifePlus program for potentially violating the Medicare Protection Act. Telus’s Life Plus program is not the same as their Telus Virtual Care services where you can get an appointment with a doctor on their mobile app. This LifePlus program offered personalized health care from a team of medical professionals which included public system MSP billing doctors, in exchange for an annual fee of $4,650 for the first year and $3,650 for subsequent years.

According to the Petition to the Court, the Medical Services Commission claims Telus Health breached Section 17 of the Medicare Protection Act which “prohibits anyone from charging another person for, or in relation to, a medical service covered by the Medical Services Plan (MSP)”. Basically, a clinic or physician enrolled in the public system cannot charge a patient for the MSP service they provide. They can’t require a patient to pay a monthly or yearly fee, nor can they require the patient to become a paying member in order to see an MSP enrolled doctor for services covered under MSP. 

This move by the government is an important step in making sure that our public medical system and patients are not being exploited. It is illegal and unethical for private companies or clinics to stand to benefit at the expense of our healthcare system and patients’ health. However, Telus Health is not the only company allegedly engaging in this type of behaviour. We are concerned that there isn’t enough being done to ensure the current legislation is followed. There are multiple private clinics in the province that seem to operate in a similar fashion and potentially breaking the law.

Fees to see a public doctor in a private clinic?

One clinic in Vancouver, offers a “premium health care program” that promises a customized health care assessment and unlimited appointments with a “personal physician”, a nurse, registered dietician, exercise medicine specialists and other health care professionals. The clinic also promises “access to a vast network of international specialists”, and “no-cost expedited MRI and CT imaging when medically necessary”.

Another private clinic that specializes in offering geriatric care to patients over 55 years old, promises to offer comprehensive health examinations and follow up care by a dedicated team of doctors and other health care professionals. The clinic also partners up with specialists in Washington state and promises their rates to be “very affordable”. A third clinic offers a range of memberships where the client gets access to a physician and other health care professionals, personalized care and ability to have laboratory and specialist referrals. The membership costs to these clinics range between $2,400 to almost $5,000 per year.

According to the Medicare Protection Act, a patient cannot be charged in order to receive MSP-covered services from an MSP-registered doctor. The majority of the doctors at the private clinics we looked at were registered with MSP, as verified in the MSP Blue Book for 2021/2022. The College of Physicians and Surgeons of British Columbia and the Canadian Medical Association Code of Ethics and Professionalism prohibits against discrimination based on “age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status”.

Most private clinics seem to have a boilerplate disclaimer posted on their websites claiming that the fees for their programs are for non-insured services and that they are not a precondition to access insured services. Non-insured services are services not covered by MSP and can include certain services provided by doctors, as well as acupuncture, physiotherapy, counselors, and other services provided by health care professionals. In other words, the fees these clinics are charging is supposed to be for uninsured services and not for seeing a doctor. 

Despite this, when calling the clinics to inquire about potentially seeing a doctor without enrolling in a membership program, we were told we won't be able to. Our experience was very similar to Michael Campbell, the private investigator hired to find out if Telus Health was breaking the Medical Protection Act. In a few instances we were told very explicitly that we must join a program and pay the membership fee in order to have access to their MSP enrolled family doctors. One clinic claimed it’s up to the physician to decide whether they will see non member patients, but at the moment of the call all the physicians’ practices were full. It would be interesting to know how many patients not enrolled in their membership programs and not paying annual fees are being seen by family doctors at this clinic.

Why is this happening?

This begs the question: if Telus Health was found to potentially be in breach of the Medical Protection Act by requiring a membership and annual fee to see an MSP enrolled doctor, why are these clinics allowed to do the same? 

Are these clinics operating in accordance with current legislation? 

Is there any authority that ensures laws are not being broken?

Is enough being done to prevent such clinics from potentially operating in violation of current legislation? 

Are the patients being lied to when they are told they have to enroll as a paying member in order to see the doctor and if so, are they entitled to anything to right this wrong?

To learn more about the issues with these so called private clinics check out Private Health Care on the Public Dime?

Resources

To report any inappropriate medical billing practices, file a complaint with the BC Billing Integrity Program Complaint.

To file a complaint regarding a physician licensed to practice in British Columbia visit the College of Physicians and Surgeons of British Columbia.

To submit an anonymous tip or share your story, visit our Anonymous Tip page.