When Russ Ackland travelled to Vancouver for a medical procedure in September, he didn’t expect to rack up a $600 hotel bill in two nights.
That bill was two months’ rent for Ackland, who pays about $314 a month at the affordable seniors’ residence on Front Street in Whitehorse. His monthly income is less than $1,500.
“It’s just the fact that it’s humiliating,” he said.
Ackland is one of several people who have approached the News with concerns about Yukon’s medical travel system, some arguing that the government needs to take a fresh look at the program.
It wasn’t just the cost that upset Ackland. He felt lost throughout the process and didn’t know where to turn for advice about how to keep the trip affordable. He doesn’t own a computer or a cellphone.
His daughter, Lacey, eventually booked him a room at the Burrard Hotel. She said a number of events in Vancouver that weekend made it hard to find a room at all, let alone anything affordable. Even with the hotel’s hospital rates, the bill for two nights totalled $637.
“My dad’s dignity was a bit taken from him, going on that trip,” Lacey said. “It was very degrading.”
After he got back to Whitehorse, Ackland cancelled a subsequent medical appointment in Vancouver. “I can’t afford that kind of money,” he said.
Ackland said he’d like the Department of Health and Social Services to provide more support to patients to help them navigate stays in Vancouver.
“Why can they not sort of suggest or provide some information in terms of where you could stay that’s reasonable?” he said.
The medical travel program currently provides a $75 a day subsidy to patients and pays for their flights to and from Vancouver, Edmonton or Calgary. An escort, usually a family member, can also be covered if medically necessary.
Spokesperson Pat Living said patients travelling to Alberta can also receive assistance getting to and from the airport and medical appointments.
And she said all patients should receive a booklet with information about medical travel, including suggestions of where to stay.
But Ackland said he was never offered any such information, even when he called the department.
Alison Freeman, president of the Yukon Medical Association, said it’s not unusual for patients, especially the elderly, to find the medical travel process confusing.
“It is challenging,” she said. “There’s people that don’t know how to book things online.”
She said she will sometimes book hotels for her patients, to make things a little easier.
But she doesn’t believe the government has a responsibility to provide more information to patients, though she said “it would be a nice thing to do.”
Freeman said the most common complaint she hears from her patients about medical travel is that the $75 a day doesn’t cover all their costs.
But she said the subsidy isn’t meant to pay for everything.
“I think we know as Yukoners that we live quite a distance from tertiary medical care, and so I think we can’t expect that every single expense is going to be paid for when we go down south,” she said. “We have a limited pool of money, and an unlimited need, essentially.”
However, she did say that some of her patients genuinely can’t afford to go to Vancouver, and the government could consider a needs assessment to look at how best to help those people.
One thing that might help, she said, is if fewer people requested to travel with a family member. She said it’s fair to ask for an escort if the illness is life-threatening, for instance, but she believes many people ask for escorts who don’t really need them.
“I think it’s an abuse of the system, and I think it’s extremely expensive.”
Carla Mangnus also has complaints about the cost of travelling to Vancouver. She says the $75 a day subsidy is barely enough to pay for food. But she has other concerns as well.
In December 2015, Mangnus was diagnosed with mesothelioma, an incurable cancer. She’s travelled to Vancouver 10 times in the last year, but says chemotherapy and radiation are no longer options.
Mangnus recently heard about a new clinical trial in Edmonton that might extend her life, and hoped that the Yukon government would cover her travel. But she was told that the medical travel program doesn’t cover clinical trials, even though she says this is her last option.
Freeman said paying for clinical trials would be a slippery slope.
“You would have people going down to Mexico for really off-label, poorly designed studies,” she explained.
Mangnus recognizes that it might be difficult to know where to draw the line if the government started covering some clinical trials.
“But on the other hand, if it can extend my life, yes, I think the government should help me,” she said. She has now started an online fundraiser to help pay for her travel.
Other patients have concerns about the fairness of the medical travel policy.
Marilyn Hagerman said she was denied coverage when she tried to tie in a recent medical appointment in Vancouver with a vacation to Florida. She wanted to travel on from Vancouver to Florida on her own dime, and have the medical travel program pay for her return from Vancouver to Whitehorse in January. She said she would have covered any difference in the cost of the flight.
The medical travel policy allows the government to “deny the payment of medical travel expenses to any eligible person who arranges to take non-emergency medical treatment at a time when they were already scheduled to travel.”
But Hagerman said it’s common for senior bureaucrats to travel to conferences and then on to a vacation, with the government covering the work-related portion of the travel. She said she booked many such flights when she worked in government, and this should be no different.
“If a person can tie in two things together, it’s not costing the government any more money,” she said. “It’s so stupid. It’s just stupid.”
She believes the decision in her case was made arbitrarily, and she’d like to see the policy revised to make it clearer when the government should refuse coverage.
The Yukon government spent $12.7 million on medical travel in 2015-16.
Living didn’t say if there have been any discussions about reviewing the medical travel program. But the Yukon Party’s election platform did include commitments to create a pilot project to help Yukoners better navigate the program, and to review the medical travel policy.
The Liberal platform does not mention the medical travel program.
Contact Maura Forrest at firstname.lastname@example.org