DAWSON CITY
If Premier Dennis Fentie and Health Minister Glenn Hart have a good reason for billing a man $20,000 for a medevac he was assured he would not have to pay, they aren’t sharing it.
And they aren’t eager to talk about the case.
For 11 consecutive business days, the Newsrequested to speak with both men about the matter. They never replied.
So this reporter sidled up to Fentie as he was making his way down the stairs of Dawson City’s old administrative building on Friday afternoon, after a ceremonial sitting of the legislature, and put a few questions to him.
Yukon’s ombudsman found the territory was “administratively negligent” in its handling of 53-year-old Sheldon Miller.
Miller, a highway camp cook, was evacuated from Whitehorse to Victoria in July of 2005 when a doctor warned that he may have been about to suffer a heart attack.
Miller explained he was not yet a Yukon resident and had no money to pay for the trip.
Doctors, nurses and administrators told him not to worry: the governments of the Yukon and the Northwest Territories, from which he had recently moved, would take care of it.
Miller took their advice. It proved an expensive mistake.
Bills began to arrive in the mail shortly afterwards. With interest, they now total more than $20,000.
Miller insists he would never have boarded the plane had he known he’d be stuck with this debt. But it’s too late now.
Work has been scarce lately for Miller. His wife is a hostess at the Yukon Suspension Bridge. They’re raising three young children, aged two, eight and nine.
They can’t afford to pay. Nor should they have to, ombudsman Tracy-Anne McPhee concluded after a lengthy review.
The territory screwed up. It ought to waive the bill, she recommended.
Why has this recommendation been ignored?
Rules are rules: Fentie
“We’re just following that policy and all the regulatory mechanisms that go with it,” said Fentie.
Policy states uninsured patients must pay for medevacs, without exception.
But there’s a difference between following the rules and doing the right thing, the ombudsman has objected.
If anyone made a mistake, it was hospital staff, not Miller. It’s not fair to expect him to pay.
The hospital has introduced new rules since Miller’s case. It now requires health staff to disclose to uninsured patients that they must pay for medevacs.
These changes suggest the territory knows it’s treated Miller wrongly, McPhee notes.
To this criticism, Fentie offers a familiar rebuttal. It’s the same one he used when auditor general Sheila Fraser found Yukon’s Finance Department broke its own rules when it invested in asset-backed commercial paper.
It’s only an opinion.
“I don’t have any comment to make on what the ombudsman’s opinion is, or the ombudsman’s work,” said Fentie.
“The ombudsman is here to serve a purpose; the government is here to serve a purpose.
“One of those purposes is to ensure we follow policy, and at this point, the policy is pretty clear.”
But what about McPhee’s finding that Miller had been treated unfairly?
“I don’t have any information on that at all,” he said.
It’s a curious claim. The ombudsman tabled her report on the matter in the legislature only last month. Hart responded, on Fentie’s behalf, with a letter to McPhee, disagreeing with her findings, without saying why.
In the legislature, Fentie responded to opposition questions about the case with a whole lot of spin and made it sound like the real victims are Yukon’s civil servants.
How could Fentie have no information? Hadn’t he made a decision on the matter after McPhee, having no luck with Hart and his staff, took up the case with cabinet?
“Cabinet hasn’t taken any position on it at all,” Fentie said. “We’re just following policy.”
If cabinet didn’t make a decision, who did?
Who’s running the territory, government MLAs or their lawyers?
“I think you’re a little wiser than that, aren’t you?” Fentie asked. “You know how democracy works.”
By now, Fentie had reached the front entrance of the old administration building and took his place for a group photo.
“You’re going to have to remove yourself. We’re having a photo taken and you’re not in it,” he said.
“I think this conversation is over.”
It’s confidential: Hart
Later, Hart was buttonholed.
He couldn’t say much, he said.
“We have issues to deal with, with doctor-patient confidentiality,” he said.
Perhaps. But most of the facts of the case have already been made public by the ombudsman’s report.
During her review, McPhee pored over Miller’s medical file and interviewed hospital staff.
Whatever documentation does exist in health files corroborates Miller’s story, she found.
No doctors or nurses recall the details of their conversation with Miller. None of their notes indicate he had been told he would have to pay for his flight, although a doctor and nurse insist that disclosing this is common practice.
Contradicting this is testimony from another nurse, who believed that patients such as Miller would be covered by their health plans.
That’s false. But it’s that mistaken belief that put Miller into the situation he’s now in.
Miller was eventually warned he would have to pay for the evacuation by one ambulance attendant.
But that was after he received othe r assurances otherwise, and he was by then en route to the plane.
It was “too little, too late,” the ombudsman concluded.
Nobody indicated the magnitude of a medevac’s cost to Miller.
Potentially pricey precedent
But back to Hart. When
pressed, he said he’s worried that waiving Miller’s bill may set an expensive precedent.
“Well, obviously the precedent is a big issue,” Hart said. “We still have lots of people who are repaying their loans.
“I think that’s the other thing that’s been missed in all this. A substantial number of people have been repaying their loans, even on very nominal payments on a monthly basis. So that’s an issue.”
But hadn’t the ombudsman found his department screwed up?
Hart passed the buck.
If any problem occurred, it was with Whitehorse General Hospital, not the Health Department, he said.
But it’s the Yukon government that won’t waive Miller’s bill, not the hospital corporation.
“The issue is still being investigated and we’re talking it over with the hospital corporation and the doctors,” said Hart.
“We’re looking into it.”
Miller was evacuated from the territory nearly four years ago.
The ombudsman has repeatedly flagged his case and asked Hart to drop the bill.
He won’t.
But now he’s looking into it.
A sensible person would want to know why.
It may have to do with irate Yukoners who have phoned Hart’s staff after reading about Miller’s plight in recent weeks.
But in Dawson, there’s no time to ask.
“Minister Hart, we need you for a minute,” interrupted cabinet spokesperson Roxanne Vallevand.
She led Hart away to other, more pressing business.
He walked onto a nearby lawn and posed for a photo with Education Minister Patrick Rouble.
After all this, simple questions remain unanswered.
Above all, why won’t the territory drop Miller’s bill? Hart and Fentie have yet to offer a compelling answer.
Rules are rules, Fentie repeats. But there’s a difference between following the rules and treating someone fairly, McPhee notes.
Money and legal precedents are concerns, says Hart.
That explains why Miller’s case is an inconvenience to the territory. But it says nothing about whether Miller is being treated unfairly or not.
If the ombudsman erred in her conclusions, how is she wrong? Neither Fentie nor Hart would say.
But, in fairness, they were busy posing for photographs.
The News put in an additional two interview requests with Hart and Fentie this week, so they could properly explain themselves.
They’ve yet to reply.
Contact John Thompson at
johnt@yukon-news.com.