“Our core philosophy has always been to provide excellent health care for our patients. This has become increasingly challenging due to years of erosion of fees paid by government to physicians coupled with escalating operating costs borne entirely by physicians.”
That was the opening paragraph of an April 24 letter to patients by a group of practising ophthalmologists who, from personal experience, provide excellent eye care.
Nonetheless, I and other North Shore residents who contacted me have a real problem with the solution these practitioners have adopted – in part because added fees hit the most vulnerable patients right where it hurts the most.
In brief, the physicians have engaged the services of Toronto-based Doctors Services Group to administer many of the functions of our doctors’ offices.
As DSG sells itself to interested physicians at doctorsservices.ca, clients “implement our services to outsource the administrative burden associated with independently managing an Uninsured Service billing program.”
Discussed also are the ways in which DSG can help physicians “increase revenue, enhance efficiency and improve doctor-patient communication,” as well as the need for patients to be “educated about uninsured services.”
So now, whether or not patients use any of the uninsured services listed, DSG will be authorized to bill individuals an annual fee of $95. Couples are given a slight discount at $185.
The gamble for patients who balk at the fee is that they may end up having to pay item by item if the required services occur.
So what are some of the uninsured items included in the annual fee?
• Completion of drug benefit form for a third-party insurer - $71.40
• Conversation with an office RN - $82.50/15 minutes (limit 15 minutes/year)
• Letter to another physician at patient’s request - $75-$150
• Request for medical records – up to 20 pages/year – by the page
• Revenue Canada disability form - $75.
• Private insurer Sickness and Disability form - $100.
Now let’s take a look at the doctors’ side of the issue:
For decades now, whenever doctors’ fee disputes with government have been discussed in public, it has been common for fingers to be pointed claiming doctors already earn enough. To that, I always wanted to respond that out of those seemingly high annual salaries, doctors must pay for very expensive equipment and liability insurance, office rent and staff salaries. Physicians also spend longer hours doing often gruesome work that most of us wouldn’t dream of doing. So even if medicine is their chosen profession, can we manage without them?
Despite that grateful support for the care physicians provide, I still have a problem with the DSG solution.
Surely, if doctors have undergone “years of erosion of fees paid by government” the responsibility for that lies with their own negotiating bodies, not in the pockets of their patients?
Every time a for-profit group inserts itself into the health care system it is the patient, “educated” or not, who pays the piper.
Recently, cash-strapped British Columbians have complained about increased MSP premiums and well they might – not because doctors are paid too much, or because those premiums don’t give value for money but because the entire system needs to be overhauled.
If people were to demand that premiums be folded into, say, the income tax system, millions of dollars in collection costs could be put to better use.
Lastly, anyone who already pays $85/month-plus for an extended health plan, should ask what care they get for those dollars as compared to the vast array of services they could receive from an expanded universal health care system.
Understandable or not, this annual fee idea is just another toe in the door to a privatized health care system – a toe we should stomp on right out of the starting gate.
And on that sad note, we come to the close of my final column for the North Shore News. I cannot end without saying a sincere “thank you” to you and some other very special people: To Martin Millerchip who began it all by seeing in me potential I had not seen for myself. To the reader who said she felt my columns talked to her, not at her. To all of you who, by sharing your experiences and expertise, trusted me to tell your stories.
Most important of all, my thanks to North Shore families with children and youth who, faced with redevelopment evictions or learning challenges, still struggle to make their way in our often obstructive world; I will never forget your courage.
After 16 years with the multi-disciplinary Perinatal Programme of B.C. and later in various endeavours in the growing high-tech industry, Elizabeth James now connects the dots every second Wednesday on local, regional and provincial issues. She can be reached via email at [email protected]@shaw.ca.
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