N.B. bill to allow Medicare to cover some surgeries outside hospitals

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Legislation introduced in New Brunswick to allow surgeries outside of hospital
WATCH: Legislation was introduced Wednesday to allow for some surgeries to be completed outside of hospital. The changes are intended to increase capacity for some surgeries. But as Silas Brown reports, there is worry about the possibility of increased private involvement in the health-care system. – Oct 26, 2022

A piece of proposed legislation would extend Medicare coverage to some surgical procedures and radiology services performed outside of hospitals.

The changes will allow a recently announced pilot project to fund cataract surgeries at an ophthalmology clinic in Bathurst to move ahead and could eventually include more procedures. Health minister Bruce Fitch says the cataract program could expand province-wide in the future, but it’s hoped to slash the waitlist for the procedure in the Chaleur region significantly.

“The good point about this is it frees up two days of surgery in the hospital for more complicated things like hip, knee, some oncology surgeries,” Fitch told reporters.

It’s hoped that the province will eventually expand what sort of surgeries can take place in clinic settings, but when asked for details Fitch said they were mostly procedures that made him “squeamish” to talk about, but confirmed that colonoscopies could be one of them.

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The bill would also allow Medicare to fund services at private radiology clinics, a change the government has yet to announce and that the minister didn’t mention during first reading or when speaking with reporters.

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Earlier this year premier Blaine Higgs said that the province would look to increase private sector delivery of health-care services to help address the growing crisis in the healthcare system.

Liberal health critic Rob McKee says his party is glad that the changes don’t appear to create a pay-for-service model, but worries that private surgical clinics would suck resources away from the public system.

“We know that human resources is the biggest need facing the health-care crisis right now and if we’re going to be competing for the same employees whether it be in hospital or in clinics it could raise challenges,” he said.

Green leader David Coon worried that the changes would open up the possibility of corporate involvement in the healthcare system, something he says the province should steer away from.

“It’s hugely problematic because it opens the door to corporate-owned surgery centres and that is not how people want to get their health care,” he said.

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The government is also facing criticism for what procedures won’t be funded in clinic settings. New Brunswick is the only province in Canada that doesn’t fund out of hospital surgical abortions and that is unlikely to change according to Fitch.

“We had asked the regional health authorities to tell us what the waitlists are, tell us what the expectation of services are and they came back to us saying that there’s not a waitlist, that you can obtain the procedure in a very quick and expedient way,” he said.

“That wasn’t like cataract where there was an 18 month wait or beyond.”

McKee says it doesn’t make sense to equate the two procedures and with surgical abortions only available in two cities in the province, access needs to improve.

“There are access issues throughout the province. It’s interesting that he would say there’s not a waitlist for abortions, it’s not they type of service that youre going to wait a year in advance for a service, it’s something that you need timely,” he said.

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