BC doctor seeks class-action suit over payment for uninsured patients

An emergency physician who used to practise in British Columbia is suing the provincial government for nonpayment of services he provided to uninsured patients. Dr. James Halvorson has also applied to have his case certified as a class-action suit, which has the potential to involve many more of the province's doctors. A decision is expected soon.

Halvorson's lawyer, Sandy Kovacs, says the lawsuit requests that the case date to 1984, when the Canada Health Act was enacted. Kovacs estimates BC physicians have lost $140 million since then because they weren't paid for providing care to uninsured patients. Before 1996, medical insurance for BC residents was cancelled if premiums were in arrears for more than 3 months; physicians lost about $10 million a year because of nonpaid treatment provided to these deinsured patients. After 1996, changes were made to cover people for up to a year after they fell into arrears. Kovacs estimates that about $5 million a year is owing to physicians for uninsured services provided since then. BC and Alberta are the only provinces charging medical insurance premiums. In BC, premiums cost $64 monthly for families with 2 children.

About 40 000 of BC's 4 million residents are currently unregistered. Nonpayment of premiums doesn't limit a person's health coverage “in any way,” says Jeff Gaulin, a government spokesperson. The government tries to trace unregistered people; if there is no contact for a year, they are assumed to have left the province.

Emergency physicians are affected most. At St. Paul's Hospital in downtown Vancouver, which serves many homeless people who have no insurance, emergency doctors opted for a service contract 10 years ago to cover uninsured patients' billings.

Dr. Jane Goundrey, head anesthetist at the Peace Arch Hospital in White Rock, says the problem of uncompensated, on-call work is “infrequent but annoying.” These patients often arrive with nonemergency complaints during evenings or weekends, she said. Recently, surgery was delayed for a patient with a fractured ankle after doctors discovered that his medical insurance had lapsed. Goundrey defends the action: “There was at least a 3-day period in which the surgery could be performed safely, so there was plenty of time for the patient to apply for benefits.” — Heather Kent, Vancouver