A Princeton, B.C., woman’s challenges in getting a lifesaving lung transplant have put a spotlight on what advocates say is inequity between rural and urban access to health care.
On Monday, Christina Derksen-Unrau told Global News she had to take herself off the transplant list after being told she would need to prove she had tens of thousands of dollars in the bank to fund a four- to six-month post-care stay in Vancouver.
Advocates say Derksen-Unrau’s case is far from unique.
Every year thousands of patients living in rural B.C. communities must travel from their homes to major centres where specialized care exists.
While some supports are available, those patients are largely required to go out of pocket for expenses, including accommodations.
“It creates a lot of anxiety and struggles on top of just trying to survive,” said Jacqueline Podeils, co-lead of the Lung Transplant Housing Support Group
“It’s not fair, because if you lived in Vancouver you don’t have this crazy exuberant fee associated with a transplant, which honestly is around $50,000.”
Researchers have studied the care gap between rural and urban British Columbians.
For those living in small communities, patient outcomes are often worse, their stress level is higher, and they pay a higher financial premium to access health care, said Dr. Jude Kornelsen, an associate professor at UBC’s Department of Family Practice.
According to a recent study Kornelsen published, rural patients facing even a short stay were spending about $2,200 out of pocket for a procedure, including transportation and accommodation costs.
Just 14 per cent said they were getting financial help, while 80 per cent said they had trouble paying the costs. Six in 10 said the travel portion itself negatively affected their health.
“It requires a long day on the roads, it requires an overnight stay at a hotel, it usually requires a partner or somebody to accompany you who may or may not have to leave work,” she told Global News. ”
“There’s significant organizational challenges, and with those come significant financial costs.”
Kornelsen said those patients also face higher social costs, including social isolation, the lack of community support and the lack of culturally-appropriate care for Indigenous patients.
Kornelsen acknowledged that in most cases, there simply isn’t the capacity to provide complex specialized care in rural communities, but that doesn’t mean those patients don’t deserve help.
“There is going to be need for travel,” she said. “What we are arguing for is reasonably subsidized travel for people who need to leave.”
Transplant patients face the largest challenge, given the long recovery time and the need for close monitoring which requires them to stay close to specialized hubs.
Vancouver’s housing crisis has meant their biggest financial burden is accommodations.
The B.C. government says there are programs in place and grants available to reduce the costs, but advocates say in a city with few hotel rooms and a razor-thin vacancy rate there are no good options and not enough subsidies.
“We have dramatically expanded travel supports in other areas, for example, cancer. We have multiple programs both from non-profits and from the government to support people in these circumstances,” Health Minister Adrian Dix told Global News, Tuesday.
“I think it’s reasonable for people to say you should streamline that and make it easier, but I think what I would say is when people need care the people at BC Transplant go out of their way to make sure they get it.”
Heart, liver and kidney transplant patient groups have secured housing for some people requiring stays in Vancouver.
Lung transplant patients, however, are only eligible for up to $1,500 a month in support, far short of what’s needed to secure a place to stay near the hospital.
Other programs like Hope Air can offer travel and accommodation support, but only for stays of up to two weeks, Podeils said.
“When hotel prices go up and there is a shortage, that really affects you,” Podeils said. “There is here-and-there programming, but there is a very large gap it is not tending to.”
She wants to see the province step in to fill the gap, both in the form of subsidies for patients who must travel, and the provision of affordable temporary housing near hospitals for patients.
It’s an approach Vancouver City Councillor Pete Fry supports.
Fry recently spearheaded a Vancouver motion asking city staff to look for opportunities for long-term patient accommodations as a part of its rezoning process.
The motion is also headed to the Union of B.C. Municipalities in an effort to press the province for help on the issue.
“How do we build hotels that can accommodate the needs of folks who have to travel for lifesaving treatment?” Fry said.
“We know there is a real discrepancy and disparity and it is inequitable … and we need to even that gap.”
Meanwhile, in Princeton, Derkersen-Unrau said she has been flooded with offers of accommodation and financial support after her story aired Monday evening.
She has also spoken to her transplant coordinator, who informed her that after some tests she can get back on the lung transplant list.
“They just all made it happen,” she said.
“‘Thank you’ doesn’t cover it. You are literally saving my life and I could say ‘thank you’ a million times over, but I am doing this to enact change so that no one else finds themselves in this position.”
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