5 question we are asking after the Medical Services Commission and Telus Health reach an agreement
In April, the Medical Services Commission (MSC) reached an agreement with Telus over its LifePlus plan. The commission initially issued an injunction against the company in December of 2022. The MSC alleged that Telus Health was unlawfully extra-billing patients for services covered under MSP through the LifePlus plan. The MSC has now dropped the injunction and says Telus is in compliance.
Going forward, Telus will no longer be able to charge patients a subscription fee for services covered under MSP. Instead, it will now provide services covered under MSP through Telus Health MyCare. Telus’ LifePlus plan will only provide uninsured services to existing patients.
The agreement comes after the Medical Services Commission initiated an audit into Telus at the request of Minister of Health Adrian Dix. Through a private investigator, the audit found that the Telus LifePlus plan was charging a subscription fee of $4,882 to access a doctor, which contravenes the Medicare Protection Act that prohibits extra-billing. Based on the results of the audit, the Medical Service Commission filed an injunction at the BC Supreme Court against Telus Health in order to stop the unlawful practice of extra-billing. This led to the BC government and Telus Health negotiating an agreement.
Private for-profit health care is encroaching from multiple avenues across BC. Elsewhere in the country, we’re beginning to see the shortcomings of private health. Take for example in Quebec where a newly released report from the Institut de recherche et d'informations socioéconomiques (IRIS) reveals a glaring disadvantage of a two-tiered health system: higher costs for the same procedures in the private system versus the public system. But despite the recent Telus agreement, questions remain. Here are five questions we are asking following the agreement between the MSC and Telus.
1. What are the terms of the agreement?
The terms of the agreement between the province and Telus remain unknown. During a press conference, Minister Dix stated that the details of the agreement won’t be made public. This lack of transparency around the agreement is a cause for concern if we want to ensure that decisions are being made in the best interest of patients.
2. Did Telus extra-bill patients through its LifePlus program and if so, how much?
At the centre of the injunction was the allegation that Telus’ LifePlus plan was charging patients a subscription fee for insured services. It’s worth noting that Telus’ LifePlus program consisted of 4,000 patients and 29 doctors, but still a dollar amount can provide some insight into the scale of the program.
3. If Telus extra billed, how will this impact Canada Health Transfer funding?
The federal government has withheld national health funding to BC on a dollar-for-dollar basis based on the amount of extra-billing happening in the province. They’ve relied on these clawbacks as an enforcement mechanism to reign in extra-billing and encourage the province to comply with the Canada Health Act. How then will Telus’ alleged extra-billing impact BC’s Canada Health Transfer funding?
4. What happens to the subscription people paid to access a health professional?
At the press conference announcing the agreement, the government made clear that the patients who paid for Telus’ LifePlus subscription will not be refunded. Under section 20 of the Medicare Protection Amendment Act, patients must be refunded for services they are extra-billed for. It reads: “20 (1) If a person pays for a service described in section 18, the person who charged for, or in relation to, the service, or for materials, consultations, procedures, use of an office, clinic or other place or for any other matters that relate to the rendering of the service, must refund to the person who was charged any amount paid that is in excess of the amount allowed by section 18.” Does the subscription qualify under section 20?
5. What does this mean for patients who lost their provider when they moved to Telus’ LifePlus plan?
In the fall of 2021, Mark Winston received a letter from his health care provider. He was told that if he wanted to continue seeing his doctor, he would need to enroll in Telus’ LifePlus plan and pay $4,650 for the first year. Telus has maintained that its LifePlus plan only ever provided and charged patients for non-insured services. Even so, a number of patients felt forced to pay for the plan to keep their doctor and many others lost their doctor when they moved to the plan.
While the province’s enforcement of the Medicare Protection Act to protect patients from being extra-billed is welcome, many questions remain about the agreement between Telus and the province. This instance demonstrates the back doors that private companies are finding wide open in our health care system. While this agreement sets an example going forward and closes the door on other health care providers who rely on the public system to deliver private for-profit care, this isn’t the end of private health care in BC.