Another company that charges patients an annual fee for access to primary health care is facing legal action from the B.C. government.
The province’s Medical Services Commission went to the B.C. Supreme Court Wednesday seeking an injunction against Harrison Healthcare, which has a clinic in downtown Vancouver that charges adult patients $5,500 for the first year of care.
A statement from Health Minister Adrian Dix said the MSC’s court application alleges the clinic’s billing practices contravene the Medicare Protection Act.
Under the act, doctors who receive payments under the public plan may not charge a patient directly for any service normally paid for through the plan. Nor may a provider give preferential access to somebody in exchange for payment, or refuse to give insured care to someone who does not pay an extra fee.
"It is very important to uphold the Medicare Protection Act, which is in place to preserve our publicly managed and fiscally sustainable health-care system for British Columbia,” Dix said. “Access to necessary medical care should be based on need and not an individual's ability to pay.”
Harrison Healthcare did not respond to a request for comment by deadline.
The new clinics are named for Copeman’s son Harrison, according to a post Copeman wrote explaining why he wanted a “personal name” instead of a corporate one. “I wanted people to feel like they were getting a family doctor in the ‘old school’ sense,” he wrote.
“This would be a doctor that would be with them for life. It would be a doctor that knew their family well and cared about that family deeply. Although I believed we would have many doctors in the long run, I didn’t want to become ‘Doctors Inc.’ That didn’t feel right.”
The Vancouver clinic charges $5,500 for the first year of its “premier” service, then $4,500 for each year after that.
The website includes a statement explaining what the fees are for, appearing to anticipate the MSC’s legal challenge.
“Fees for programs are strictly for the uninsured components of care,” it says. “Any publicly insured services will be billed to the provincial health insurance plan by Harrison or by its physicians. Subscription to a Harrison program or service is not a precondition to access insured services.”
It also describes the premier service as “a comprehensive primary health-care offering” where a patient “will receive unlimited appointments and consultations with your Harrison team.” That team includes a personal physician, nurse or nurse practitioner, as well as a registered dietitian, exercise medicine specialist, personal care co-ordinator and mental health team advocate.
With representatives from the government, Doctors of BC and the public, the nine-member MSC manages the Medical Services Plan and is responsible for ensuring some $2.5 billion is spent in accord with the province’s laws and regulations.
In a Jan. 31 letter filed with the Harrison Healthcare court documents, MSC chair Robert Halpenny wrote to Copeman following up on earlier correspondence and informing him about the injunction application.
“The Commission has determined, based on all of the evidence available to it, that the manner in which Harrison Healthcare is operating its health-related programs, in particular its Premier, Foundations and Harrison Kids programs, is in contravention of the provisions of the Medicare Protection Act.”
In a Sept. 16 letter to Halpenny, Copeman had described himself and the other Harrison founders as “passionate supporters of Canadian public health care” and said the company was effectively a non-profit.
Staff were clear which services were insured and which were not and the company made changes to its website to clarify what clients were being asked to pay for, he said.
“It is not our intent to give the impression that clients are paying for a different standard of insured care,” Copeman wrote. “No person has been, or will ever be, refused insured medical services because they are not enrolled in a paid program.”
According to Dix’s statement, in 2018 the government changed the Medicare Protection Act to clarify the rules around extra billing, add protections for patients and introduce consequences for breaking the rules.
"We will allow the legal process to proceed as it should,” Dix said Thursday. “In the meantime, this government will continue to strongly defend our public health-care system."
Harrison Healthcare is the second company the MSC has taken to court over allegations of extra billing in recent months. In December it filed for an injunction against Telus, saying “The Commission has investigated and determined that Telus Health is charging for or in relation to MSP covered medical services such that a reasonable person would consider that the purchase of Telus Health’s services would result in preferential treatment or priority access to those services.”
BC Liberal Leader Kevin Falcon said it is hypocritical for the government to seek the injunctions against Harrison Healthcare and Telus Health allegedly extra billing.
“I think there’s a lot of hypocrisy, to be honest, in government when it comes to this whole issue of privately delivered health care,” Falcon said, noting that the government pays private clinics to provide some surgeries and other services. “If they didn’t do that, this government would have to acknowledge they would not even be able to come close to dealing with the massive waits and wait-time lists.”
Patients should be at the centre of government decision-making and should be looked after through a universally accessible and publicly funded system, he said.
Harrison Healthcare’s website says its Vancouver clinic is at capacity and it is working to establish a second one in the city and four more in other parts of the province. It also has a clinic in Calgary and says it is planning in the next few years to open one in Edmonton and two in Toronto.