B.C. Medical Services Commission files court injunction against Telus Health over fee-based program

A commission overseeing B.C.'s public health insurance program has taken court action against Telus Health's fee-based LifePlus program, claiming the service is breaking the law by charging patients for services that should be publicly covered.

The B.C. Medical Services Commission's injunction application, filed Thursday, claimed LifePlus is violating the extra billing provisions of the province's Medicare Protection Act. 

The program leads people to believe they will get preferential treatment if they pay for a membership, alleged the petition filed in B.C. Supreme Court.

"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," said Health Minister Adrian Dix at a news conference on Thursday. 

The province began investigating the program in February. Court documents said a would-be patient and a private investigator said they were told they would have to pay an annual fee to see a family doctor, which isn't allowed under the Medical Protection Act.

The act ensures access to necessary medical care should be based on need, not an individual's ability to pay. 

An estimated one in five — nearly a million — British Columbians do not have a family doctor, with the lack of access to primary care putting pressure on emergency rooms, urgent care centres and specialist's offices. The COVID-19 pandemic exacerbated the problem, leading to staffing shortages, emergency room closures and hours-long ambulance delays with potentially fatal consequences.

Telus Health denied the accusations Thursday, saying its program is only trying to relieve pressure on the public system.

It said its fees — $4,650 in the first year and $3,650 in subsequent years — are not for primary care and "strictly" for uninsured services like dietitians, kinesiologists and other health and wellness needs.

"We're blindsided right now … and I think that's very disrespectful, and it's quite a shame. We are disappointed with the route that the Medical Services Commission has chosen," vice-president Juggy Sihota told a teleconference after the injunction application was filed.

"The services that we have them providing through the life program are for preventative care. If a preventative care patient is coming to use the service and has an insured service request, that physician is free to provide that care to that patient of their own accord."

The commission is asking the courts to declare that Telus Health is violating the Medicare Protection Act. It's also seeking interim, interlocutory and permanent court orders to stop Telus Health's physicians from providing MSP-covered services.

Sihota didn't say whether Telus will be fighting the injunction but said it "welcomes the legal proceeding." The company has 21 days to respond.

Patient says he lost his family doctor to Telus Health 

In an affidavit filed as part of the proceedings, Vancouver resident Mark Winston, 72, said his family doctor informed him last December that he would be shutting down his family practice and moving over to Telus Health.

The sworn statement said patients were told to find a new physician or speak with Telus Health about its fee-based membership.

Winston said he was told he could only continue seeing his doctor if he paid.

"I was devastated because he was, I'm sure still is, a fantastic physician, and I've been with him for probably 14 or 15 years and really had a great relationship with him," said Winston, a retired Simon Fraser University professor.

An analysis found fewer than seven per cent of the family doctor's patients followed him to Telus Health, according to the court filing.

"At my age and with the relationship I built with my family doctor, I really did think about doing it because I didn't want to lose that care, but I just don't believe in private health care," Winston said, speaking in an interview Thursday.

"I don't believe any Canadian should have to spend $4,000 a year to see a primary care provider."

Winston said he managed to find another family doctor, but she's leaving her practice soon for other reasons. He's now waiting to be taken in by another doctor at the same clinic.

"That just highlighted for me how precarious our primary care system was — it left me without any primary care, which turned out to be quite a journey," he said.

Under the Medical Protection Act, health insurance premiums are permitted as long as residents are not denied coverage for medically necessary hospital and physician services.

Dix noted the province's concern is only regarding fees charged by the LifePlus program, not other aspects of Telus Health.  

"We do significant work on a number of files [and] health issues with Telus, and they're an outstanding corporation in B.C.," he said. "[The injunction application] only reflects aspects of that program." 

The Medical Services Commission is a statutory body made up of three government representatives, three from Doctors of B.C. and three from the general public. The group manages the MSP program on behalf of the provincial government.

Dix said the commission will argue its case in the coming weeks.