Medical transport is an essential service, and properly so – it’s time to start treating it like one

Posted on August 13, 2015, 12:49 am
9 mins

PHOTOS: Medical air transport – an essential service too important to be left to private insurers and their ilk. Below: Amy and Amelia Savill (CTV News) and Alberta Health spokesperson Timothy Wilson (Linkedin).

So now we need to buy medical-travel insurance when we travel inside Canada?

Who knew?

Certainly not Amy Savill of High Prairie, 360 kilometres northwest of Edmonton, when she took off in July for a family reunion in Northern Ontario with, she believed, a couple months to go in her pregnancy, which was not the way things turned out for her or her baby.

Amy-AmeliaNot most of the rest of us either, I’d wager.

The executives of private medical insurance companies must be rubbing their hands with glee at the marketing potential in the scary publicity surrounding the story of Ms. Savill, who found herself stuck in Ontario in late July with neither that province nor Alberta anxious to take responsibility for the medical flight necessary to get her, along with her toddler, to a hospital in another community where her premature baby could be born safely and survive, and from there safely home to Alberta.

And now, because she’s a single mom from small-town Alberta without a high-paying job with all the benefits, Ms. Savill is having to fund-raise from strangers to pay for a $30,000-plus air ambulance ride to get to a hospital that could treat her baby? What’s wrong with this picture?

This happened because the health systems in Alberta and Ontario – not to mention all the other provinces and Ottawa – apparently don’t recognize that an ambulance ride when a patient’s life is in imminent danger is an essential medical service!

It’s certainly an essential service if the ambulance crews propose to go on strike, of course. Why, we’re all reminded in such circumstances, someone could die! But that apparently is another matter entirely to the Canadian bureaucratic mind which views ambulance services, on the ground or in the air, properly to be uninsured services and conveniently outside the scope of the Canada Health Act.

TWilsonWhen Ms. Savill went into early labour unexpectedly in Timmins, the local hospital decided it wasn’t equipped to treat a baby so premature, so they said mother and still-unborn daughter would have to be flown to Sudbury. However, we’ve been told – as if this were an excuse – that the air ambulance crew told her at the airport there might be a bill of $30,000 or so. What else was she suppose to do, hitchhike? What else would any of us have done in similar circumstances?

She opted to worry about the cost later, and the baby was born by C-section in Sudbury.

Obviously, on the face of it, it’s preposterous that an ambulance ride is an uninsured service. But since that’s the reality of Canada today as a variety of forces work hard to dismantle our public health care system piece by piece, this is an issue for a lot of Canadians, and not just pregnant moms. Seniors on vacation, healthy unemployed young people on the road looking for work, and anyone without a good medical insurance plan tied to present or past employment should be seriously concerned about this situation.

“This situation is not related to the patient’s condition or location,” explained Timothy Wilson, press secretary to Alberta Health Minister Sarah Hoffman.

“The Alberta government provides health coverage for services such as hospital stays and doctors’ visits for Albertans who are travelling in other provinces,” Mr. Wilson said in an email. “For example, the services this patient received in the hospital would be covered by the Alberta Health Care Insurance Plan.”

However, he stated, “Albertans are responsible for the cost of emergency ambulance services and inter-facility transfers when travelling outside the province.”

In other words, you could as easily be stuck with a huge bill just like Ms. Savill’s if you had a stroke or a car accident, instead of a baby, far from home in a remote part of Canada.

So do we now need to buy private insurance if we don’t have it by other means to deal with situations like this. The answer would appear to be … “Yes,” said Mr. Wilson, “we recommend that anyone traveling outside of Alberta, within Canada or abroad, should make sure they have adequate health insurance.”

Mr. Wilson noted that Alberta has some agreements with British Columbia and Saskatchewan to transfer patients close to the borders of their home provinces, and “we want to see whether there is a way to prevent this scenario from happening through reciprocal agreements with other provinces.”

But with most other Canadian provinces in the hands of market-fundamentalist ideologues, and a federal government that apparently doesn’t see much of a role for itself at all in such matters as health care, this doesn’t sound like a very hopeful prospect.

The Alberta government has indicated it will look for ways to ease the financial burden on Ms. Savill – who has been an effective advocate for her own family. But this is not enough.

I have believed for years that even a $300 bill for a local ambulance ride can cost vulnerable people their lives, when a relative hesitates to call 9-1-1 because of a fear of the financial impact. With the prospect of a $30,000 or even a $55,000 bill, that possibility becomes much less remote.

What would the Ontario ambulance crew have done if Ms. Savill had said he just couldn’t afford the ride? Left her at the airport?

This is a great opportunity for Alberta’s NDP government to lead by example and do what needs to be done in Canada now, and work out the interprovincial agreements later. No Albertan should ever have to worry about the financial impact of calling an ambulance. Nor should any other Canadian.

That’s especially true of a mother with a new baby. Here’s what the 1989 United Nations Convention on the Rights of the Child has to say: “In all actions concerning children, whether undertaken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interest of the child shall be a primary consideration.”

I have added the italics. Obviously this includes all essential medical services, including medical transport, not just the ones well-off men in Ottawa and the provinces have decided are worthy of coming under the Canada Health Act or public health insurance coverage at home.

Medical transport is rightly viewed as an essential service everywhere in Canada, not as an excuse to enrich profitable insurance companies. It’s time to treat it like a real essential service – starting here in Alberta.

This post also appears on Rabble.ca.

7 Comments to: Medical transport is an essential service, and properly so – it’s time to start treating it like one

  1. Northern Loon

    August 13th, 2015

    Hopefully this will be an obvious change for the NDP. To better provide for Albertan’s who require ambulances in the province and that Rachel can then work on the other provinces to provide reciprocal agreements.

    Reply
  2. Jerrymacgp

    August 13th, 2015

    Sadly, there is likely little the Alberta government can do about this in Ontario. In Alberta, however, costs for inter-facility transfers to a higher level of care, whether by ground or air, are already covered, provided it is ordered by the attending physician in the sending hospital. So-called “repatriation”, i.e. returning to one’s home community hospital following more advanced treatment, may not be, especially if it is to be by air. So, a scenario similar to this family’s would not occur here (although I confess I don’t know with any certainty how an out-of-province resident would be treated from a billing standpoint).

    On the other hand, EMS calls to 911 are not covered, and I have had many clients cite cost as a deterrent to calling 911, even for signs and symptoms of a possible heart attack. Some other provinces do provide some subsidy of EMS costs, but Alberta isn’t one of them.

    Reply
  3. political ranger

    August 13th, 2015

    yeah, let’s not herr harpenfurher off to easy on this one either

    Health care in Canada is funded by the national gov’t, through transfers. If and only if the 5 fundamental characteristics of the Health Act are followed by the provinces; that includes “portability”. You should be able to go clear across this once great nation and have the same access to medical services at any location.

    The market ideologues will pass on any amount of funds to subsidize their for-profit medical services schemes, but to actually provide services …? Not so much.

    This is disgusting, and scary. If there is a better example of why conservative gov’ts, at any level, are anti-citizen and only pro-corporate, I haven’t seen it.

    Reply
  4. Bill Doyle

    August 13th, 2015

    If the federal government fulfilled its responsibility for the Canada Health Act the provinces would not have to nickel and dime medical services

    Reply
  5. Sam Gunsch

    August 14th, 2015

    Why this injustice exists? The concept of Fairness is lost on the rich of Alberta, due in large part to the gift of fossil fuel resources.

    So, I’m arguing that the elites who dominate economic and political AB discourse, thus who are driving political choices mostly advocate from ‘the veil of opulence.’

    http://opinionator.blogs.nytimes.com/2012/08/12/the-veil-of-opulence/?_r=0

    excerpt: Society is in place to correct for the injustices of the universe, to ensure that our lives can run smoothly despite the stuff that is far out of our control: not to hand us what we need, but to give us the opportunity to pursue life, liberty and happiness. The veil of ignorance helps us see that. The veil of opulence keeps us in the dark.

    excerpt: Those who don the veil of opulence may imagine themselves to be…extremely successful business entrepreneurs. They vote and set policies according to this fantasy.

    excerpt: The idea behind the veil of ignorance is relatively simple: to force us to think outside of our parochial personal concerns in order that we consider others. What Rawls saw clearly is that it is not easy for us to put ourselves in the position of others.

    A tough truth for AB’s elite who have mistaken the source of the success as their own initiative and talents, when it’s been the excessive extent of the black gold we found under our feet.

    Born on third base thinking they’ve hit a triple: Albertans who’ve prospered from fossil fuel resources given away to them.

    Reply
  6. Raj

    August 15th, 2015

    There’s a variety of services that could be covered by Medicare but are not. This is one–physiotherapy and psychotherapy have limited coverage as well. Despite this, government healthcare expenditures are growing at a rapid rate, and we get far less for our money than every OCED country other than the United States. People often blame administrative costs, but administrative costs in total are less than the annual increase in health care spending. There’s no point whining about what the government isn’t spending on when the whole reason we can’t afford covering medical transport and other necessary services is because a whole pile of money has gone to massive increases in provider salaries. Those proclaiming the NDP as potential saviours on issues like this should think twice–if the root cause of the problem is high provider costs, then the NDP is only likely to make this issue worse given how beholden they are to unions.

    Reply

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