Man falls through Canada’s northern health care loophole

Bust an ankle while scaling the Saint Elias Mountains and a search-and-rescue helicopter will whisk you to safety.

Bust an ankle while scaling the Saint Elias Mountains and a search-and-rescue helicopter will whisk you to safety.

Crash-land a small aircraft, and the military will launch Buffalo aircraft from CFB Comox on Vancouver Island to sweep Yukon’s boreal forests in search of you.

Try to canoe across Lake Laberge unprepared, as a man did last week, and if waves swamp your vessel and leave you wet and shivering onshore, help from the RCMP is just one satellite-beacon call away.

All these services are free, regardless of whether you’re a Yukoner or a visitor.

But if you appear to be about to suffer a heart attack in Whitehorse and you lack Yukon residency or private insurance, you could end up owing $20,000.

Such is the predicament of Sheldon Miller—who had recently moved from the Northwest Territories in June of 2005—when he was evacuated from Whitehorse to Victoria.

He was assured by Whitehorse General Hospital staff he would not have to pay for the evacuation. The two territories would work it out, he was told.

He believed them. That proved a costly mistake.

Miller, 53, is a highway cook. Work has been tight lately. His wife works as a hostess at the Yukon Suspension Bridge.

They’re raising three young children, aged two, eight and nine.

Twenty thousand dollars is an enormous amount of money to them. They can’t afford to pay.

Nor should they be expected to, concluded Yukon’s ombudsman, Tracy-Anne McPhee, after a lengthy investigation. She found that the Health Department and hospital committed “administrative negligence.” That means they screwed up.

Health staff told Miller he wouldn’t have to pay. So he shouldn’t have to. Straight forward enough?

Apparently not. The Health Department won’t budge, even after McPhee raised the matter several times and eventually tabled a report in the legislature.

If the Yukon government has a coherent defence for sticking Miller with a $20,000 bill, they aren’t sharing it.

When Liberal Leader Arthur Mitchell asked Premier Dennis Fentie to adopt the ombudsman’s advice and drop Miller’s bill, Fentie replied with a whole lot of spin and made it sound like the real victims are Yukon’s civil servants.

The News has requested interviews with Fentie and Health Minister Glenn Hart about the matter for the past 18 consecutive business days. They’ve yet to reply.

When this reporter cornered the two at a recent public event, they offered a wide range of explanations, some of them patently false.

Fentie claimed he didn’t have any information on the matter. That’s not true. The ombudsman wrote directly to him, after she had no luck with Hart. Besides, Fentie had publicly spoken to the matter in the House.

Hart first tried to hide behind doctor-patient confidentiality. Then he said he couldn’t understand why Miller wouldn’t pay his bill. After all, he said, others have paid theirs.

Then Hart admitted his department is now investigating the matter.

Miller was evacuated nearly four years ago. The ombudsman has repeatedly asked the territory to drop his bill. Hart has always said no.

Now, after receiving angry phone calls from constituents who have read about Miller’s plight, Hart’s looking into it.

But, setting aside the bumbling and bluster of our territory’s elected leaders, an important question remains unaddressed. How did Miller end up in this situation in the first place?

Canada claims to offer universal, free, portable health care to its residents. But that’s simply not the case for people caught in the predicament that Miller finds himself in.

Miller’s treatment by the territories appears to violate the Canada Health Act’s key principles, said Dr. Jeff Blackmer, director of medical ethics with the Canadian Medical Association.

“You’d expect that if you’re in a different province, and they can’t provide that kind of care in your locale, you’ll still be able to, in the public health system, get help to go somewhere else, particularly in an emergency-type situation,” he said.

“If you’re sick in Canada, you should have access to medical care … not differential access depending where you live.”

Medevacs help determine whether a patient lives or dies, but they aren’t considered “medically necessary” under the law. They aren’t covered under the Canada Health Act.

That’s why health insurance offered by the NWT to its residents does not extend to medevacs outside of their jurisdiction. Yukon has similar restrictions.

As far as the NWT is concerned, Miller should have known better than to leave their territory without first buying private insurance. They have pamphlets in health centres that recommend their travelling residents to do so.

Yukon, meanwhile, won’t pay Miller’s transportation costs because he was just one day short of becoming a resident here. It doesn’t matter that he’s continued to make Whitehorse his home for four years.

The law may not consider medevacs to be a necessary service, but Whitehorse General Hospital staff clearly do.

After Miller’s evacuation, he was told by staff that, had he refused treatment, he would have been forcibly evacuated. Doctors believed a heart attack was imminent, and they don’t have a cardiologist on staff.

Federal officials, asked if Miller’s treatment violates federal law, said it wasn’t their problem. It’s the jurisdiction of the territories.

It appears Miller’s medevac bill isn’t anybody’s problem in government. That must come as a relief to pencil-pushers in Whitehorse, Yellowknife and Ottawa.

But it’s a big worry for him.

Contact John Thompson at johnt@yukon-news.com.