Is Two-Tier Health Care Growing in BC? The Tyee

Two seniors were told they would need to pay $4,600 each to keep seeing their 
            family doctor after he moved to a Telus clinic.
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Andrew MacLeod February 28 – 2022 / TheTyee.ca Andrew MacLeod is The Tyee’s Legislative Bureau Chief in Victoria and the author of All Together Healthy (Douglas & McIntyre, 2018). Find him on Twitter or reach him at amacleod@thetyee.ca.

[Excerpt] At 84, Lieta Robinson had a tough choice to make after receiving a letter from her doctor.

She and her 88-year-old husband could start looking for another doctor, joining the roughly 760,000 British Columbians who aren’t attached to any primary care provider. Or they could each pay an annual fee to stay with him when he moved to a Vancouver clinic owned by the telecommunications company Telus.

“We are really upset,” said Robinson. “We’re seniors, and we’ve had good health care, but this has kind of upset us.”

She and her husband had been with Dr. Geoffrey Edwards for some 36 years, staying with him as he moved from clinic to clinic, from Burnaby to Kerrisdale. They are in “pretty good health,” but at an age where they need care from time to time.

According to the letter the couple received from Edwards, the fee for each of them would be $4,600 for the first year, then $3,600 for each year after that.

While Robinson and her husband could afford the fees, she said, the wider implications bothered them.

“This is most disturbing if doctors are going to give up their general practice and go into something like this,” she said. “If everybody did this, then what happens to our health care?”

Edwards didn’t return calls by publication time. The clinic he is moving to operates using a model that has been described as being in “a legal grey area.” The model has long been contentious.

Under the Medicare Protection Act, doctors who receive payments under the public Medical Services Plan may not charge a patient directly for any service normally paid for through public insurance.

Telus has spent more than $2.5 billion expanding into health care, seeing it as a way to differentiate itself from its telecommunications competitors and grow revenues.

It bought clinics operating under the brands Medisys, Copeman Healthcare and Horizon Occupational Health Solutions in 2018.

Telus said the annual fees patients like Lieta Robinson face if they want to stay with their doctors are not for necessary services covered by the provincial Medical Services Plan. They are for services that the public system doesn’t cover, Telus said in an email.

Telus said most of the doctors working in its clinics “continue to work in the public sector seeing patients for MSP-covered primary care services.” In fact, the company argued, by focusing on wellness the clinics help “alleviate the burden on our overall health-care system” by keeping people healthy. 

The Copeman clinic, now owned by Telus, made the same argument in 2006 when the Medical Services Commission began an 18-month investigation that eventually concluded the clinic was operating legally.

One person who didn’t buy the argument was Adrian Dix, then opposition health critic, now health minister. He said the private clinics were undermining the basic principles of public health care.

Is Two-Tier Health Care Growing in BC?

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