Doctors demand action on private health insurance

TORONTO, March 12 /CNW Telbec/ - Canadian Doctors for Medicare today called on the federal and provincial governments to immediately take all necessary steps to stop the spread of private health insurance for medically necessary services in British Columbia.

"The recent exposé that Acure Health Corp is selling 'Medical Access Insurance' for services already covered under Medicare undermines the public
health care system to the detriment of the vast majority of Canadians, and contravenes the Canada Health Act", said Dr. Danielle Martin, Chair of Canadian Doctors for Medicare.

"It is illegal in British Columbia to sell private duplicate insurance for services already covered by MSP. If it turns out that ACURE has been
collecting illegal insurance premiums, the money should be returned to the consumers," said Dr. Martin.

"It's not ethical to collect illegal payments from unsuspecting patients," said Dr. Bob Woollard, a CDM Board member and head of Family
Medicine at the University of British Columbia. "If it turns out that opted in physicians are unaware that they have been collecting private insurance payments from Acure for MSP insured services, they, too, should return their fees," added Dr Woollard.

"Those who think private health insurance is a panacea for our system should take a look at the Australian experience. The major beneficiaries there have been higher income Australians, private insurance companies, private hospitals and medical specialists - and not the wider Australian community," said Dr. Martin.

In a 2004 study, Leonie Segal of Monash University`s Centre for Health Economics found evidence that Australia's heavily subsidized private system has been "wasteful, inefficient and inequitable". The estimated cost of government policies to support it total more than $2,500 million. Among Segal's findings:

- Private insurance has been largely ineffective and inefficient as a
means of taking pressure off the public system
- Competition for physicians and nurses may make it harder for public
hospitals to meet patient needs
- Where a private system runs alongside a universal public system,
private hospitals have no incentives to provide a full range of
services, thus they can focus on more profitable services

"There is a concerted campaign by the proponents of commercialized care to ignore this type of evidence and try to convince Canadians that private health insurance is the way out of Canada's health care 'challenges'," said Dr. Martin. "The only way to do that is to keep plugging the suggestion that the system is failing, and that it is in 'crisis'. Yet despite its challenges, the evidence shows that a universal single payer system is fairer and more cost-effective than other ystems of providing care, and is massively supported by Canadians."

In its 2006, in its discussion paper "It's About Access", the Canadian Medical Association reviewed all the evidence and found:

- Private insurance for medically necessary physician and hospital services does not improve access to publicly insured services
- Does not lower costs or improve quality of care
- Can increase wait times for those who are not privately insured; and
- Could exacerbate human resource shortages in the public system.

Last year the Canadian Centre for Policy Alternatives released a study showing how successful initiatives in team-based care in B.C., Alberta, Saskatchewan and Ontario have produced dramatic cuts in waiting times for surgery, which can undoubtedly be emulated across the country.

"This is where the focus should be," said Dr. Martin, "not on trying to decimate our current system, which Canadians are justifiably proud of, so that insurance companies and private hospitals can increase their profits at the expense of average Canadians."

For further information contact:
Dr. Danielle Martin, Board Chair, Canadian Doctors for Medicare, (416) 351-3300

Health insurance company under fire

Calgary firm's policy called queue-jumping

Michelle Lang, Calgary Herald

Published: Wednesday, March 12, 2008

A Calgary company selling private medical insurance is at the centre of controversy in British Columbia, where critics claim it encourages patients to circumvent surgical waiting lists.

The government is investigating whether the service is even allowed under provincial law.

Acure Health Corp. offers insurance plans that send patients to a private clinic if they face a wait longer than 45 days in the public health system for a wide range of procedures -- from cataract surgeries to heart operations. The company sells the packages in B.C., Alberta and three other provinces.

The B.C. Ministry of Health said this week it's probing whether the company's services are permitted under the province's Medicare Protection Act, which prohibits most private medical insurance schemes.

The B.C. New Democrats and Alberta-based Friends of Medicare, meanwhile, say the insurance plan amounts to so-called queue-jumping for wealthy patients.

"It's another chink in the armour in terms of protecting public health," said Suzanne Marshall, executive director of Friends of Medicare.

"It's offering those who can afford it an alternative when those needs should be met by the public system."

But officials with Acure Health defended their insurance plan Tuesday, saying it's in compliance with all legislation. They also argued their patients are not queue jumping because the company takes its clients out of the public system for service at private clinics.

"You don't get involved with a program like this without making sure you comply fully with provincial and federal legislation," said Jim Irwin, a vice-president with Acure Health.

"We obey the law of the land."

Legislation in B.C., Alberta and several other provinces prohibits private insurance for medically necessary services. The law may, however, allow patients to buy insurance when the procedure is performed outside of their home province or when their surgeon has left the public health system.

Acure Health said the company ensures it is operating in accordance with legislation by sending patients with claims to private clinics in other jurisdictions for treatment.

Alberta Health officials said Tuesday this practice appears to be in compliance with provincial laws.

"Things that go on outside of Alberta, we have no control over," said Howard May of Alberta Health.

In B.C., however, ministry officials said they have been reviewing the legality of the company's services for months.

Health Minister George Abbott released a statement saying his department is considering referring the matter to the province's Medical Services Commission, which administers the Medicare Protection Act.

"The ministry has recently received legal advice on this matter and government is now considering our options for moving forward to address the potential concerns," Abbott said in the statement.

Acure Health's Irwin is confident the review won't find any problems with the company's services and said there have not been any issues in other provinces where the plan is sold, including Saskatchewan, Manitoba and Ontario.

mlang@theherald.canwest.com