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Doctor outraged over increased X-ray fees

VCH’s new rates a barrier to health care, says Zeglinski
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For Dr. Cathryn Zeglinski, it's the plight of transient workers that's driving her to voice outrage over Vancouver Coastal Health's recent increases in X-ray fees.

There is an assumption that people from outside Canada have travel insurance when they come to play in the mountains around Whistler, the doctor told Pique Newsmagazine this week. But about 50 per cent of her patients either have let their insurance expire or they never bought it in the first place because they are working for $9 to $10 an hour and don't have extra funds.

In August this year, Vancouver Coastal Health increased the rates for X-rays to out-of-province patients across their jurisdiction. The rates went from $99-$122 to $187-$504. Since then, Zeglinski said she is constantly seeing people choose not to get X-rays.

"As far as physicians go, our role is to help people," she said. "This whole idea that a monetary interest is putting a barrier between our ability to help our patients is something that is against the covenant of being a physician."

Unlike many other communities in British Columbia, the Sea to Sky corridor doesn't have a private X-ray clinic and in Whistler the only place where people can get X-rays is at the public facility in the Whistler Health Care Centre.

Zeglinski said she believes VCH's monopoly in the area is causing the X-ray rate inflation.

These new rates are out-of-whack with the rest of the province, she said. For example, out-of-province patients pay between $66 and $140 for X-rays on Vancouver Island, administered by Vancouver Island Health Authority, and roughly $66-$85 in areas of the Lower Mainland governed by Fraser Health Authority.

Moreover, Zeglinski pointed out that private facilities in the Lower Mainland only charge between $75 and $125 for X-rays.

"Why are they trying to gouge us?" she asked.

"I had a patient who fractured his jaw. He was sucker punched at the bar, and he was leaving the next day. All he kept asking was, 'How much is this going to cost me?'"

Dr. Laurin Shaw at the Whistler Medical Clinic echoed Zeglinski's concerns.

"All the physicians are concerned about this," said Shaw. "We are seeing more patients now that are declining X-rays."

"We strongly encourage them to obviously follow good medical advice, and our concern is that people that opt not to have these X-rays may have bad orthopedic outcomes and other serious outcomes down the road."

Shaw said the X-ray fees have been a common topic of discussions at Whistler physicians' monthly medical advisory meetings.

However, Shaw added from her experience the number of people who are affected by the new rates is small. Most people have medical insurance, so only about five per cent of her patients who need X-rays choose not to get them because of cost.

When asked about the new rates, Anna Marie D'Angelo, senior media relations officer, said VCH increased the fees because the B.C. Ministry of Health mandated this year that all provincial health authorities now have to fully recover their costs.

She said she doesn't know if other authorities have adopted this new methodology yet, but if they haven't, they will do so soon.

"We used to have an older methodology," she said. "We found when we looked at it that it was really not the real cost of what it costs to provide the service."

She said the new rates are not designed to bring in a profit for VCH, and all extra money incurred goes back into the health care system.

Moreover, the VCH spokesperson stressed the new rates only apply to non-British Columbia residents without insurance. Australians working in Whistler without insurance, on the other hand, are eligible to pay lower rates for X-rays because they pay taxes to the province through their pay roll deductions, she said.

"Our health care is paid for by the residents of B.C., and we definitely will share our health care with anyone that needs it," said D'Angelo.

"If you are a B.C. resident, and you don't happen to be paying your MSP payment, (your health care fees) are less than if you were a non-resident or foreigner because we provide health care through taxes to residents."

Later, following this week's inquiries by local media, D'Angelo added if foreign workers carry a copy of their work visa or other proof of residency, they will be charged resident rates, not out-of-country rates.

"We are going to try to make that clear," she said. "It needs to be understood that they will be charged this higher rate unless they show us their work visa or proof of residency, and then they will be charged a lower rate."

No one is ever denied treatment because of inability to pay, said D'Angelo. Instead, VCH back-charges for their services over a period of time. And if someone has a problem with the fees they were charged, they can contact the health authority to look into it, she said.

Zeglinski said, from her experience, the front desk staff at the Whistler Health Care Centre have no instructions on what rates to charge foreign workers and she has seen foreign workers charged non-resident rates even though they pay into the B.C. tax system.

However, she was happy to hear on Wednesday morning that VCH now plans to make their policy clearer on how much foreign workers should be charged.

"It is important all these young people now start carrying a copy of their passport with their work visa when they go up the mountain," she said. "If they do get injured, they don't have the hassle of trying to pay up."