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Medical transport is an essential service, and properly so -- it's time to start treating it like one

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Savills

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So now we need to buy medical-travel insurance when we travel inside Canada?

Who knew?

Certainly not Amy Savill of High Prairie, 360 kilometres northwest of Edmonton, when she took off in July for a family reunion in Northern Ontario with, she believed, a couple months to go in her pregnancy, which was not the way things turned out for her or her baby.

Not most of the rest of us either, I'd wager.

The executives of private medical insurance companies must be rubbing their hands with glee at the marketing potential in the scary publicity surrounding the story of Savill, who found herself stuck in Ontario in late July with neither that province nor Alberta anxious to take responsibility for the medical flight necessary to get her, along with her toddler, to a hospital in another community where her premature baby could be born safely and survive, and from there safely home to Alberta.

And now, because she's a single mom from small-town Alberta without a high-paying job with all the benefits, Savill is having to fund-raise from strangers to pay for a $30,000-plus air ambulance ride to get to a hospital that could treat her baby? What's wrong with this picture?

This happened because the health systems in Alberta and Ontario -- not to mention all the other provinces and Ottawa -- apparently don't recognize that an ambulance ride when a patient's life is in imminent danger is an essential medical service!

It's certainly an essential service if the ambulance crews propose to go on strike, of course. Why, we're all reminded in such circumstances, someone could die! But that apparently is another matter entirely to the Canadian bureaucratic mind which views ambulance services, on the ground or in the air, properly to be uninsured services and conveniently outside the scope of the Canada Health Act.

When Savill went into early labour unexpectedly in Timmins, the local hospital decided it wasn't equipped to treat a baby so premature, so they said mother and still-unborn daughter would have to be flown to Sudbury. However, we've been told -- as if this were an excuse -- that the air ambulance crew told her at the airport there might be a bill of $30,000 or so. What else was she suppose to do, hitchhike? What else would any of us have done in similar circumstances?

She opted to worry about the cost later, and the baby was born by C-section in Sudbury.

Obviously, on the face of it, it's preposterous that an ambulance ride is an uninsured service. But since that's the reality of Canada today as a variety of forces work hard to dismantle our public health care system piece by piece, this is an issue for a lot of Canadians, and not just pregnant moms. Seniors on vacation, healthy unemployed young people on the road looking for work, and anyone without a good medical insurance plan tied to present or past employment should be seriously concerned about this situation. 

"This situation is not related to the patient's condition or location,' explained Timothy Wilson, press secretary to Alberta Health Minister Sarah Hoffman.

"The Alberta government provides health coverage for services such as hospital stays and doctors’ visits for Albertans who are travelling in other provinces," Wilson said in an email. "For example, the services this patient received in the hospital would be covered by the Alberta Health Care Insurance Plan."

However, he stated, "Albertans are responsible for the cost of emergency ambulance services and inter-facility transfers when travelling outside the province."

In other words, you could as easily be stuck with a huge bill just like Savill's if you had a stroke or a car accident, instead of a baby, far from home in a remote part of Canada.

So do we now need to buy private insurance if we don’t have it by other means to deal with situations like this. The answer would appear to be ... "Yes," said Wilson, "we recommend that anyone traveling outside of Alberta, within Canada or abroad, should make sure they have adequate health insurance."

Wilson noted that Alberta has some agreements with British Columbia and Saskatchewan to transfer patients close to the borders of their home provinces, and "we want to see whether there is a way to prevent this scenario from happening through reciprocal agreements with other provinces."

But with most other Canadian provinces in the hands of market-fundamentalist ideologues, and a federal government that apparently doesn't see much of a role for itself at all in such matters as health care, this doesn't sound like a very hopeful prospect.

The Alberta government has indicated it will look for ways to ease the financial burden on Savill -- who has been an effective advocate for her own family. But this is not enough.

I have believed for years that even a $300 bill for a local ambulance ride can cost vulnerable people their lives, when a relative hesitates to call 9-1-1 because of a fear of the financial impact. With the prospect of a $30,000 or even a $55,000 bill, that possibility becomes much less remote.

What would the Ontario ambulance crew have done if Savill had said she just couldn't afford the ride? Left her at the airport?

This is a great opportunity for Alberta's NDP government to lead by example and do what needs to be done in Canada now, and work out the interprovincial agreements later. No Albertan should ever have to worry about the financial impact of calling an ambulance. Nor should any other Canadian.

That's especially true of a mother with a new baby. Here’s what the 1989 United Nations Convention on the Rights of the Child has to say: "In all actions concerning children, whether undertaken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interest of the child shall be a primary consideration."

I have added the italics. Obviously this includes all essential medical services, including medical transport, not just the ones well-off men in Ottawa and the provinces have decided are worthy of coming under the Canada Health Act or public health insurance coverage at home.

Medical transport is rightly viewed as an essential service everywhere in Canada, not as an excuse to enrich profitable insurance companies. It's time to treat it like a real essential service -- starting here in Alberta.

This post also appears on David Climenhaga's blog, AlbertaPolitics.ca.

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