Alberta-based advocacy organization Friends of Medicare and the Opposition NDP say the province needs to put a stop to a Calgary clinic planning to charge annual fees for faster access to a physician.
“It’s a concerning precedent,” Chris Gallaway, executive director of Friends of Medicare, said in an interview Tuesday.
“If this is allowed and they go ahead with it, other clinics will look at doing the same thing. That undermines our public health-care system, and it undermines access to primary care.”
Starting Aug. 1, the Marda Loop Medical Clinic has informed patients by email that it will still see patients for free one day a week, but the other four days will be dedicated to patients who pay annual membership fees such as $2,200 for an individual and $4,800 for a family.
For that money, the clinic promises faster access to the clinic physician, along with other perks and services, including extended sessions, at-home blood tests and discounts on related services such as physiotherapy.
The email from physician and clinic owner Dr. Sally Talbot-Jones tells patients the decision was made to provide better care in response to patient concerns about long waits for appointments.
Talbot-Jones did not immediately return a request for comment.
The Canada Health Act dictates universal access to publicly funded health services, but Gallaway questioned whether one day a week of service equates to universal access.
“Using a loophole to charge a membership fee to restrict that access or to give priority access is unfair. It goes against the Canada Health Act and the spirit of what our public health-care system is supposed to be,” Gallaway said.
“We think the provincial government needs to step up and act to not allow this to happen.”
Calgary medical clinic offers controversial ‘membership style’ service
Health Canada says charging patients a fee to gain faster access to a family doctor would be violating medicare laws.
The federal agency says it is working with the province on this and says Alberta risks losing federal transfer health payments if it doesn’t do something about it.
In a statement, Health Canada says the Marda Loop fee plan equates to preferential access to insured health services and, therefore, violates the universality provisions of the Canada Health Act.
NDP health critic David Shepherd and Opposition NDP Leader Rachel Notley called on Premier Danielle Smith on Tuesday to pass legislation to stop such membership-fee plans.
Shepherd said that given that the family doctor is the gateway to referrals for more specialized testing and treatment, a further bottleneck there would have an exponential effect on the rest of the system.
“We know that Albertans are facing longer waits in the emergency room. We know that Albertans are facing four to six weeks just to get a basic appointment for a basic blood draw,” Shepherd said.
“What we will see is further erosion of the system that we’ve seen under the (United Conservative Party). In fact, we will see that on steroids.”
In a joint statement from the premier and Health Minister Adriana LaGrange, they said they have become aware of a clinic advertising services already covered by provincial health care, advertisements that suggest the services would be available to members who pay fees.
“Alberta’s government would be extremely concerned if this clinic was charging fees for services that are insured and offering accelerated access to a family physician at the expense of other patients needing to wait longer,” the statement reads. “We have directed Alberta Health to investigate this specific clinic to ensure compliance with all legislation. If any non-compliance with relevant legislation is found, we will take appropriate action.”
The College of Physicians and Surgeons of Alberta said in a statement Tuesday it was not asked to review the clinic’s proposal before implementing the fee system.
“As we currently do not have a full understanding of what’s being offered, CPSA isn’t in a position to comment on whether or not the model is in alignment with our standards, but will follow our normal processes to better understand the concerns brought forward.”
Fiona Clement, a professor who specializes in health policy at the University of Calgary, said there have been membership-type clinics since 2008.
“It’s not a new idea, it’s not only in Alberta. There are clinics like this across the country,” she said.
Clement said the province’s response will be key.
“(The fee plan) really isn’t in the spirit of the Canada Health Act, but technically it’s not illegal,” she said.
“It’s technically not a violation of the Canada Health Act, which is the federal government’s responsibility to enforce. It’s not a breach of ethics or professional practice, which is the College of Physicians and Surgeons’ responsibility to enforce on an individual physician level.”
Smith has faced concerns over comments she made before she become premier last fall, such as advocating in multiple interviews and in an academic policy paper that Albertans should pay out of pocket for some medically necessary services — such as seeing a family doctor — to ensure the system can remain sustainable over the long term.
Smith, however, has since promised her UCP government is committed to medicare.
Her mandate letter to LaGrange last week urged her to improve the system “within the pillars of the Canada Health Act and, importantly, in alignment with our government’s Public Health Care Guarantee that no Albertan will ever have to pay out of pocket to see their doctor or receive a needed medical treatment.”
Alberta, like other jurisdictions, is trying to recruit more doctors and related health workers to fill vacancies, particularly in rural and remote areas, to alleviate strain on emergency wards.