Provinces urged to end newcomer waits for public health insurance amid pandemic

By Colin Perkel

THE CANADIAN PRESS

TORONTO _ Hundreds of doctors, nurses and activists are calling on provincial governments to ensure immediate access to free health care for new arrivals in light of the COVID-19 pandemic.

In an open letter to Ontario Premier Doug Ford and Health Minister Christine Elliott this week, the group OHIP For All says urgent action is needed in light of a looming public health emergency in Canada.

“We are deeply concerned about these pre-existing barriers to health care for uninsured individuals in Canada, and the potential public health implications in the context of a pandemic,” the letter states.  “As a group of health-care providers and community members, we call on all levels of government, health institutions, and public health leaders to act now to ensure care for everyone.”

Typically, new arrivals in Canada have to wait at least three months to access provincial health coverage. The newcomers include Canadians returning from longer stretches abroad, recent immigrants, some temporary foreign workers and international students, and undocumented workers. In some cases, people who have lost identity documents may also have trouble getting coverage.

Definitive numbers are hard to come by, but estimates suggest a significant number of people in Canada are in a non-coverage situation, said Dr. Arnav Agarwal, an internal medicine resident with the University of Toronto and core member of OHIP For All.

“The estimates would say something between 200,000 and 500,000, with more estimates on the upper end,” Agarwal said in an interview.

Ontario Health Minister Christine Elliott said the government was moving to scrap the wait period only for returning Canadians, but anyone needing health care would get it.

As of Thursday, Canada has seen more than 700 cases of COVID-19. Ten people have died, most of them in British Columbia. Ontario has recorded upwards of 250 cases and two deaths. Experts say the highly contagious virus poses little risk to most people. However, the elderly, those with underlying health conditions, and the marginalized face a much higher risk.

OHIP For All’s main concern is that those in need of health services might stay away, be denied care, or be forced to pay out of pocket and end up with large debts.

“We must recognize that people experiencing symptoms associated with COVID-19 will seek care through community clinics and hospitals, and therefore these sites must also be free and accessible to all,” the group’s letter states.

Society as a whole is at risk if everyone, regardless of immigration or other status, has no ready access to the health-care system, Agarwal said.

“The health and well-being of our community as a whole relies on the well-being of every individual in it,” Agarwal said. “When you recognize that this is such a substantial portion of our community, it makes it all the more important to ensure that they have access to testing as well as to the right supportive care.”

About 1,000 people and organizations have signed the letter urging coverage for the uninsured.

The letter calls on governments to ensure COVID-19 assessment centres have an explicit policy to be free and accessible to all, regardless of immigration status. It also wants similar unrestricted access to community clinics and hospitals.

The public, the groups says, must also be informed that assessment and care is available to everyone for free.

Private clinics would harm ‘ordinary’ people using public system in B.C.: lawyer

By Camille Bains

THE CANADIAN PRESS

VANCOUVER _ A legal challenge by the owner of a private clinic providing scheduled surgery for  “affluent” patients should be denied because it is based on a flawed constitutional argument, a lawyer for the B.C. government says.

Jonathan Penner said Tuesday that Dr. Brian Day’s bid to have the province strike down provisions of the Medicare Protection Act prohibiting double-billing amounts to an  “unlawful business model.”

Penner told B.C. Supreme Court Justice John Steeves that Day’s legal team has called the province’s position shocking, adding that’s based on a disregard for patients who can’t afford private care at clinics, such as the Cambie Surgery Centre, opened by Day in 1996.

“In my submission what truly is shocking is this complete and utter disregard for the situation of anyone who is not in a position to come up with the funds to pay them to provide rapid surgical services,” he said.

“They seek the privileged, those few privileged British Columbians who require scheduled surgery and have the resources to pay for private care,” Penner said, adding  “ordinary” people would have less access to care under a two-tier system Day has proposed.

The frail and elderly, patients with complex conditions, and those with severe mental illness and/or substance-use issues would be particularly disadvantaged because regulating a public-private system that could invite American-style insurers would come at a high cost and take money away from public health care, he said.

Waitlists for patients requiring palliative care as well as emergency and urgent services would also increase under such a system because doctors, anesthesiologists and nurses would be lured to clinics allowing them to earn money in both the public and private systems, he said.

Penner suggested physicians should no longer be enrolled in the Medical Services Plan if they choose to work in for-profit clinics.

Day, an orthopedic surgeon, has hinged his decade-long legal battle on arguments around patients having a right to pay for services if wait times in the public system are too long.

He has maintained that four plaintiff patients have been deprived of life, liberty and security under the Charter of Rights and Freedoms after suffering harms from waiting for surgery in the public system before they sought care at his clinic.

Penner called that argument “political theatre” and said Day’s legal team has failed to identify whether any harms the patients may have endured were related to wait times in the public system.

Hanna Davis, a lawyer for the federal government, said Day’s assertion that private health insurance could enable patients to access care at clinics like his would not apply to people who can’t afford premiums, especially if they have pre-existing conditions.

The same applies for employer-based insurance, which also would not be available to those who are retired, unemployed or not provided with such options at their workplace, she said.

Regardless, the underlying principle of the Canada Health Act is based on access to care based on need, not ability to pay, Davis said.

A two-tier scheme would weaken the public system, which would be left to deal with more complicated health-care cases while private clinics would take on easier surgeries as part of what is referred to as  “cream skimming,” she said.

The Canada Health Act does not explicitly require provinces to prohibit duplicative private insurance as a condition of federal health funding, she said.

“However, all Canadian provinces have either voluntarily prohibited or effectively restricted private health duplicative insurance as one of the main safeguards to protect the integrity of the public health-care system.”

Requiring people to have their own insurance would amount to discrimination against those who wouldn’t be eligible for it, Davis said.

When Day opened his clinic, he said surgeons who worked in hospitals were not getting enough operating-room time and profit was not his motive.

However, the facility has been operating since 2003 in violation of unproclaimed provisions of the provincial Medicare Protection Act.

Health Minister Adrian Dix announced in 2018 that the government would begin to fine doctors $10,000 for a first offence if they charged patients for publicly available services and that the “don’t ask, don’t tell” approach that allowed private-clinic surgeries and diagnostic tests to continue would no longer be permitted.

Day won an injunction at the B.C. Supreme Court that ordered the government not to enforce that section of the act until his constitutional challenge is dealt with.

Canada’s independent insurance complaint resolution service appoints new
Regional Head of Communications and Marketing for Western Canada

Read more

Most people have health insurance coverage during their working years, but their employer picks up at least some of the cost. For retirees, the economics of buying similar coverage may not add up. Here’s why.

Read more

His coverage officially lapsed on April 1. He was diagnosed with cancer on May 23.

Read more
Digital tools in insurance benefits can help employers improve employee morale & health

Digital tools in insurance benefits can help employers improve employee morale & health

NEWS PROVIDED BY

RBC Insurance

Highlights:

  • 72 per cent of working Canadians would perceive their employer more positively if their employer offered a virtual care or telemedicine solution through its group benefits, a more common belief held among millennials (78 per cent).
  • Interest in virtual care for mental health services is highest among younger Canadians (18-34), more than half of whom are likely to use it to consult mental health practitioners (53%) and for video/telephone mental health counselling (51%).
  • It’s important for employers to recognize this preference among younger working Canadians as these workers tend to rate their employer, job satisfaction and mental health significantly lower than older generations.

TORONTO, Jan. 21, 2020 /CNW/ – Three-quarters (72%) of working Canadians indicate that they would perceive their employer in a more positive light if their employer offered virtual care/telemedicine, a service which would eliminate the need to leave work or home, according to a recent RBC Insurance survey. This perception is driven mostly by younger working Canadians (18-34) who are the most likely to indicate that a virtual care offering would improve opinions of their employer (78 per cent compared to 60 per cent of those 55+). This is significant as younger working Canadians tend to rank job satisfaction, employers and mental health the lowest among all working Canadians.

“Many working Canadians face time constraints when visiting health practitioners, constraints that include wait times to see specialists like psychologists and psychiatrists, the availability of a healthcare practitioner and the ability to get time off work,” says Julie Gaudry, Senior Director of Group Insurance, RBC Insurance. “Younger Canadians are even more likely to face these types of obstacles, so by implementing innovative programs such as virtual care or telemedicine, employers can alleviate some of the challenges, which in turn can help increase employee health and morale.”

The survey also found younger Canadians are more likely to value virtual care for mental health services including consulting mental health practitioners and/or video/telephone counselling than their older counterparts. This is important since younger Canadians are also more likely to report lower levels of wellbeing and mental health than older Canadians. Among 18-34 year-olds, 57 per cent say their mental health is good or excellent, compared to 79 per cent of those older than 55.

Table – Use of virtual care for mental health services among working Canadians

Age

18-34

35-54

55+

Would use virtual care to consult mental health practitioners

53%

52%

39%

Would perceive their employer more positively if offered virtual care or telemedicine

78%

74%

60%

“With our Onward by Best Doctors program we’ve already seen the power of virtual care. It has improved access to mental health experts and shortened recovery times for plan members with mental health related disability claims,” said Gaudry. “And by using virtual mental health care to help plan members and their families address their mental health concerns earlier and faster, we can potentially prevent someone from becoming so unwell that they are no longer able to work.”

The value of digital tools extends beyond health care delivery to managing insurance benefits. Two-thirds (66%) of working Canadians indicate that they prefer a mobile app to manage and access their insurance benefits as opposed to using paper mail, telephone, or even online services. Once again, this preference is highest among younger Canadians, particularly Millennials, while less than half of Baby Boomers echo this sentiment (18-34 77%, 35-54 66% vs. 55+ 48%).

Given that nine in ten working Canadians (94 per cent) are more likely to work for an employer that cares about their overall health and wellbeing, HR leaders should look for value-add digital services when it comes to group benefits that can help promote employee morale and health, such as:

  • Making Employee Assistance Programs more accessible – Look to employee assistance programs that make support available digitally to address their most common work/life challenges (caregiving, divorce, grief, etc.) that may affect work performance.
  • Offering virtual healthcare options – Support an employee’s mental and physical health by providing access to experts and resources through virtual care such as a Cognitive Behavioural Therapy program that uses digital education, videos and assignments with support from a therapist to help users meet their goals.
  • Providing digital tools to make it easier to understand/use benefits Consider a mobile app that employees can use to manage insurance benefits and learn more about the services and programs available to them.
  • Personalizing wellness programs: The survey also found that the majority of working Canadians (80 per cent) report that their overall wellbeing would improve if their employer were to offer a personalized wellness programthat is customized to an individual’s specific wellness and health related interests and goals.

About the RBC Insurance Survey
These are some of the findings of an Ipsos poll conducted between May 7 and May 10, 2019, on behalf of RBC Insurance. For this survey, a sample of 1501 employed Canadians aged 18+ was interviewed. Weighting was then employed to balance demographics to ensure that the sample’s composition reflects that of the adult population according to Census data and to provide results intended to approximate the sample universe. The precision of Ipsos online polls is measured using a credibility interval. In this case, the poll is accurate to within ± 2.9 percentage points, 19 times out of 20, had all employed Canadians aged 18+ been polled. The credibility interval will be wider among subsets of the population. All sample surveys and polls may be subject to other sources of error, including, but not limited to coverage error, and measurement error.

About RBC Insurance
RBC Insurance® offers a wide range of life, health, home, auto, travel, wealth, annuities and reinsurance advice and solutions, as well as creditor and business insurance services to individual, business and group clients. RBC Insurance is the brand name for the insurance operating entities of Royal Bank of Canada, one of North America’s leading diversified financial services companies. RBC Insurance is among the largest Canadian bank-owned insurance organizations, with approximately 2,900 employees who serve more than five million clients globally. For more information, please visit rbcinsurance.com.

SOURCE RBC Insurance

Subscribe To Our Newsletter

Join our mailing list to receive the latest news and updates from ILSTV

You have Successfully Subscribed!

Pin It on Pinterest