British Columbia is a geographically large and diverse province with significant rural areas and communities not within a reasonable distance to enable access to medical services that should be available to all British Columbians.
Access isn’t just a community issue for the people living in rural and remote communities; it’s a business issue for companies in those communities. Access to health services and/or medivac services, if needed, go a long way to help businesses in rural and remote communities to recruit and retain workers. These kinds of services also help rural and remote communities to attract and retain businesses and industry – a vital part of economic development.
All British Columbians (emphasize business/industry) should have access to equitable health care. Currently rural British Columbians are significantly discriminated against in accessing emergency services and basic health and wellness services.
In the event of an emergency or life-threatening condition a patient will be medivac’d to a facility capable of treating the condition. Upon release, patients are simply let go with no return to their home community. Anecdotally, we hear patients are often released with next to no clothing, no funds, and no assistance. In addition, many services are not offered in rural communities such as cancer care, maternity, diagnostic services, etc. While people and businesses in rural and interior BC understand not everything can be offered in every community, the feeling is patients in rural and remote areas are expected to cover their own costs. In remote communities, such as Fort Nelson, expectant mothers are required to leave the community 4 – 6 weeks before their due date. This is at an out-of-pocket cost of thousands of dollars, adding stress, taking employees away from work and family, and if there are other children in the family additional measures must be considered. There is a significant burden to business as well as employees, including the spouses, are impacted and require more time away. It additionally puts an unfair financial burden on families.
Patients requiring cancer care or other services, even if eligible for the Travel Assistance Program are still responsible for all incidental costs:
“The Travel Assistance Program (TAP) helps alleviate some of the transportation costs for eligible B.C. residents who must travel within the province for non-emergency medical specialist services not available in their own community.
TAP does not provide direct financial assistance to patients for travel costs or make travel arrangements for patients. Meals, accommodation, mileage, fuel and local transportation expenses are not included in TAP and are the responsibility of the patient. There is no reimbursement for travel already taken.”
The following is taken from the Province’s guidelines:
The Medical Services Plan (MSP) provides the following benefits:
- medically required services provided by a physician enrolled with MSP;
- maternity care provided by a physician or a midwife;
- medically required eye examinations provided by an ophthalmologist or optometrist;
- diagnostic services, including x-rays, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon;
- dental and oral surgery, when medically required to be performed in hospital (excluding restorative services, i.e.: fillings, caps, crowns, root canals, etc.);
- orthodontic services related to severe congenital facial abnormalities.
The above noted benefits that are provided by the Medical Services Plan are really only equitably provided if you live in an urban centre.
We have seen cases of individuals requiring cancer care to choose no treatment simply because they could not afford the cost related to travelling to another community. When Medivac’d out due to medical emergencies, we have seen patients released from hospital with no funds to return home and no support, and too often in a condition where they should have assistance.
This has been recognized in many papers and recommendations for many years. Most recently the Select Standing Committee on Finance and Government Services in the “Report on the Budget on the Budget 2020 Consultation” recommended that:
Rural and Remote Health Care:
59. Provide equitable access to health services in rural and remote communities, including better addressing travel costs and ensuring access to reliable, timely medivac, air ambulance and emergency services and public transportation.
The Chamber Recommends
That the Provincial Government ensures all British Columbians have access to equitable health care by:
- Improving Medivac services to:
ensure timely access to care
provide for return to community;
2. Improving Financial Assistance for Out of Community Services by:
Providing for at-home maternity care or financial / living assistance if expectant parents have to leave community; and
Improving the Travel Assistance Program to provide reasonable expenses for patients who must travel for medical services not provided within their community.