Patrick Belanger, 23, said his experience is a warning to Quebecers and all Canadians who pride themselves on a universal health care system, because doctors in other provinces could deny treatment to Quebecers claiming they don’t they will be compensated. Belanger’s ordeal began when he and his girlfriend were walking along a trail in southern B.C.’s Sun Peaks Resort. on the evening of June 10. He tripped and stumbled backwards into the darkness and hit his face on a boulder. He was taken by ambulance to Royal Inland Hospital in nearby Kamloops shortly before midnight and was told he needed surgery for a “broken face.” But a surgeon wasn’t available Saturday, so he was discharged with a prescription for the opioid drug Percocet to manage his pain, Belanger said. The next morning, he returned to the hospital with his girlfriend, Beth Cooper. But Belanger said as he prepared for surgery, the surgeon called off the procedure. “He said the hospital wouldn’t let him do the surgery because I was from Quebec,” Belanger said, adding that he had presented his provincial health card when he arrived in Royal Inland. “I was kind of shocked. The more I thought about it, the more I thought it didn’t make sense. Normally, you’d do the surgery and figure out the charge afterwards, or at least I thought that would be the case. “I was pretty scared. I was still freaking out because I was in a lot of pain and I was on painkillers. And I was calling my parents trying to figure out what to do.” Belanger said he offered to pay for the surgery through his family’s private insurance, but the surgeon declined that option, saying he first needed to speak with a hospital administrator who was unavailable over the weekend. “When he told me that the operation could not be done [that day]he suggested I fly back to Quebec City to go have the surgery,” Belanger said. He was given a 10-day window before the bones in his face began to fuse. “We thought it was completely absurd that I, with a broken face, was going to take a commercial airline to go and have surgery in my own country.” Royal Inland Hospital in Kamloops, BC, pictured on June 5, 2021. (Ben Nelms/CBC) Belanger’s father and mother arrived in Kamloops later that week and tried unsuccessfully to speak with an administrator at the Internal Health Authority about the best options for their son. “We were confused about his basic rights as a Canadian,” said Richard Belanger, calling his son’s experience a “nightmare.” He said he went to the surgeon’s private clinic to provide information about the family’s insurance plan as well as his credit card in case the surgery could be performed there, but the staff told him that the severe facial fractures his son suffered they meant that the operation had to be done in a hospital.
The 2nd doctor completes the operation
An agonizing four days since the surgery was canceled had Belanger managing “severe pain” with prescription opioids and morphine before his case was switched to another surgeon, Belanger said. “I would wake up in the middle of the night crying and screaming in pain,” she added. The second doctor said he needed quick surgery, and the surgery was finally performed seven days after he fell, said Belanger, an economics student at Bishop University in Sherbrooke, Que. His family said they are still puzzled as to why the original surgeon did not perform the operation. “It’s gross incompetence on the part of the hospital and a failure on the part of the Canadian health care system,” said Belanger’s mother, Martha Ferris. Both Patrick and Richard Belanger say the end result was “discrimination” against a patient from Quebec, who pays hospital costs but does not participate in a reciprocal billing agreement for doctors’ fees that applies to all other provinces and territories .
BC doctors can’t charge MSP for Quebec patients: union
Doctors of BC, an association representing doctors, said an agreement allows its members to bill their own provincial medical plan for out-of-province patients and then the plan is reimbursed by the patients’ home jurisdiction. “Physicians are paid as if the patient were a BC resident,” it said in a written statement. But that doesn’t apply to Quebecers who need medical care in BC, he added. In these cases, doctors can either bill that province or bill the patient, who would seek reimbursement from the Quebec government. The Ministry of Health in Quebec said doctors elsewhere are paid the same rates as if the patient had received the same treatment in his home province. Patients must pay any difference in costs and could apply for reimbursement through private insurance if they have it, the department said in a written response. The department recommended that Quebecers obtain private insurance before traveling outside the province. Richard Belanger said the family’s private insurance company refused to pay any costs after the first surgeon wrote in his son’s medical chart that he could return to Quebec and have the surgery there within 10 days. The insurer had also initially refused to pay expenses when an emergency room doctor noticed possible intoxication in his son’s chart, Belanger said. But that was later ruled out when the family asked why no tests were done to determine the presence of any substances, including alcohol, he added. Dr. Peter Stefanuto, the original surgeon, declined interview requests. He said in an email that he could not talk about any specific incident, but that “care is provided to all patients regardless of their province or country of origin on an urgent basis.” Issues surrounding reimbursement for services could best be handled through the BC and Quebec governments, Stefanuto added. Dr. Bob Rishiraj, who ended up performing the surgery, said he wasn’t concerned about any “politics” surrounding the charge, especially after learning the patient had been on opioids and methadone for days and that a longer wait for surgery posed a risk contamination. “It became very concerning to me that he was using a lot of morphine and his pain was not well controlled. If we don’t do that, we’re going to have a problem possibly having someone with potential drug abuse on the street,” he said. . “I think a patient is a patient and it doesn’t matter if they’re from Quebec or Ontario or wherever. I think they just need to be treated,” Rishiraj said. The risk of a billed patient not paying a doctor is low, and cost doesn’t appear to be an issue for Belanger’s family, he said. Interior Health did not respond to a request for an interview, but said in an email that the doctors are not employees of the health authority. Ferris said the family paid Rishiraj $2,563 and will apply for compensation from Quebec. The irony is that the family used their private health insurance while traveling out of the country, but didn’t expect to have to rely on it in Canada, she said. “It’s shocking to me, kind of shocking,” he said. The BC Ministry of Health did not respond to questions about patients from Quebec who were refused surgery. Dr. Catherine Smart, president of the Canadian Medical Association, said the country’s universal health care system is meant to provide care to all Canadian citizens and permanent residents. “We strongly encourage provincial and territorial governments to work together to ensure Canadians get the care they need, when and where they need it, and the federal government to enforce the principles of the Canada Health Act evenly across the country,” he said. in a written statement. Health Canada said the reciprocal billing agreements are administrative arrangements between provinces and territories to facilitate the portability criterion of the law while people are temporarily away in another part of the country and need care. “These agreements are voluntary and are not a requirement of the Canada Health Act,” it said in a written response.
The week-long wait was ‘crazy’: health teacher
Belanger, who still struggled to speak because his jaw was wired shut after surgery, said the emotional toll he suffered is “immeasurable,” in addition to the physical pain, which still includes migraines. Damien Kontandriopoulos, a professor of nursing and health policy researcher at the University of Victoria, said regardless of Quebec’s pricing scheme, the province pays, on average, higher doctors’ fees than other jurisdictions for the same care, which is reversed by practice her years ago. It’s common for thousands of Quebec patients to receive care from family doctors in Ontario’s border towns and their province reimburses the cost, he said, adding that he’s “shocked” that services would be denied to a patient because of billing issues. But doctors in B.C., where relatively few Quebecers receive care, may be deterred from seeking out information on the prices the province pays because it runs to about 3,000 pages in some complex categories and in French, he said. Kontandriopoulos, a former resident of Quebec. In Belanger’s case, the surgeon could have called his insurance company’s 24-7 hotline to get information from a representative, instead of saying that administrators were unavailable over the weekend, Kontandriopoulos said. He called Belanger’s week-long wait for surgery “crazy.”
