B.C.’s medical watchdog probing whether TELUS Health program creates ‘two-tiered’ health care

British Columbia’s medical watchdog is reviewing a TELUS Health program over concern it is contributing to a “two-tiered” health-care system that allows some patients to cut in line by opening their wallets.

Health Minister Adrian Dix confirmed Wednesday that the Medical Services Commission was asked a while ago to look into whether the private, fee-based TELUS Health LifePlus program has created disparity in patient access to critical services.

“It’s not that they’re charging for supplementary services … the question is whether or not the services have that value,” he explained. “It’s critical, I think, that medically necessary services go without user fees because to do otherwise is to have two-tiered health care and that’s not acceptable.”

In a written statement, TELUS Health said it responded to the B.C. Medical Services Commission’s request in March. Its care centres aim to “alleviate the burden” on B.C.’s health-care system, it said, and in addition to completing a yearly preventative health assessment, clients have access to health professionals, such as kinesiologists, physiotherapists, psychologists and dieticians.

All participating physicians are independent contractors, the corporation explained, and choose how much time to dedicate to the public-funded primary care portion of their practice.

“TELUS Health does not charge for any primary care services,” wrote Sonya Lockyer, vice-president of TELUS Health Care Centres and Pharmacy. “The LifePlus program fees are strictly for the preventative care modalities noted above, which are provided by a multidisciplinary team that is not publicly-funded.”

TELUS Health, she added, is “fundamentally-opposed” to fast-tracking publicly-funded health services for a fee.

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Mark Winston, a beekeeping professor at Simon Fraser University, told Global News he lost his physician of 15 years to TELUS Health last fall. He was told he would need to enrol in the LifePlus program for $4,600 in the first year, and pay more than $3,000 annually after that, he said.

“It really was a nightmare trying to find a new primary care physician or practitioner,” he said. “It’s such a bad primary care system that physicians are bailing out to go to private care systems and leaving the rest of us in the lurch.

“I just didn’t feel comfortable not participating in the Canadian universal health-care system, and buying my way out of a very creaky system that needs to be fixed.”

Winston found a new physician after several months, he added, but only through a personal connection.

Nearly 1 million patients in B.C. are without a family doctor. Doctors of BC President Dr. Ramneek Dosanjh said privatized programs like LifePlus could be a “potential risk” to creating “more divide.”

“I think it does speak to economic class and people who can pay for services or have a different type of access,” she explained. “What I think is very important are the principles of universal health care and attachment, but also about equity.”

The province needs to work with doctors to build a more robust health-care system, she added, that doesn’t result in patients or doctors seeking greener pastures in another program. It also needs to improve working conditions and pay for physicians, while reducing the required paperwork and clinic management costs, she said.

“Especially with the levels of morale distress and physician burnout that we’re seeing, people can’t continue to do the type of care they were already providing,” Dosanjh explained. “Doctors like to provide different types of care and how they practice is variable and we need to be able to go to them with a menu of compensation possibilities.”

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Dix said the province needs to make simpler contract models that give doctors options to move between fee-for-service care models and public health care.

Since 2017, he added, alternative payments to doctors whose services are not delivered through fee-for-service models have increased from $500 million to about $750 million. It’s an increase of about 15 per cent every year for the past three years, he said.

Dix said he and the premier have had “significant sessions” with Doctors of BC in the past few weeks to “work through the issues.”

He expects answers from the Medical Services Commission on the TELUS Health LifePlus program before the end of June.

Editor’s note: This is a corrected story. A previous version used an image of a Telus clinic that is not part of the LifePlus program.