This is an archive of news stories and research from the National Union of Public and General Employees. Please see our new site - https://nupge.ca - for the most current information.
Ottawa (19 Dec. 2022) — This month, British Columbia became the first province to take action against extra billing by a company involved in virtual health. An injunction was filed against TELUS Health, which provides a number of different health care services, for violating section 17 of the Medicare Protection Act. Section 17 prohibits companies and individuals from charging for health care services covered under Medicare.
The request for an injunction came after an investigation into complaints that people were unable to continue to receive primary care from family doctors who had moved to TELUS Health, unless they paid a $4,650 fee for TELUS Health’s LifePlus package. While TELUS Health claimed that LifePlus only provides services that aren’t covered by Medicare, an investigation discovered that people wating to see a doctor at a TELUS Health clinic were required to pay the fee for LifePlus.
The heath care services that TELUS Health owns include virtual clinics and bricks and mortar clinics. The LifePlus package included services at both bricks and mortar clinics and virtual clinics.
User fees allow the wealthy to buy their way to the front of the line
A basic principle of Medicare is that treatment should be based on need not wealth. A wealthy person with a minor problem shouldn’t be able to push aside someone with a serious problem who only has a modest income.
But when health care providers are allowed to charge user fees beyond what is provided through public health care systems that changes. Health care providers will put their most profitable patients first and low- and middle-income Canadians will suffer.
More investigations needed of attempts by virtual health care companies to introduce 2-tier health care
There are concerns that TELUS Health may not be the only company engaged in extra billing. NUPGE’s report on virtual health care and privatization illustrated how for-profit companies involved in virtual health care billing users directly or through private insurance plans for services covered by Medicare appear to violate the Canada Health Act.
There have also been concerns that virtual health companies are directing people to services where there are user fees instead of services covered by Medicare. In 2021, the Toronto Star reported that the default option for people using a virtual health care service run by a company called Maple was often text messaging. The problem was that people using that service were charged a user fee, while phone or video appointments were covered by Medicare.
As the NUPGE report describes, the Prince Edward Island government gave Maple a contract to provide a walk-in clinic for PEI residents without family doctors. There were times in October 2021 when that service, which was covered by Medicare, wasn’t available. However, while the Maple service covered by Medicare wasn’t available, the Maple virtual walk-in clinic that people had to pay a user fee to access was still available to PEI residents.
Governments must make virtual care part of the public system
The action to deal with extra billing by TELUS Health is good news, but it should only be seen as a start. As long as virtual health care is privately controlled, companies will be tempted to charge user fees wherever they can get away with it to maximize profits. What’s needed to protect and improve our public health care system is for virtual health care to become part of the public system so that we’re not dependent on private for-profit companies.