Province keeps U.S. spinal surgery price tag under wraps
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Manitoba taxpayers are being asked to sign a blank cheque to cover spinal surgeries performed stateside, after the financial interests of a North Dakota hospital were found to outweigh the public interest in disclosing the price tag.
Some 40 Manitobans have received long-awaited and desperately needed spinal surgery at Sanford Health Fargo under an agreement signed in February between the provincial government and the South Dakota-based, non-profit health system.
However, the cost to perform those operations is being withheld by the province, after the hospital argued it would lose its competitive position if such details were made public.
The Free Press obtained a partially redacted copy of the medical services agreement between Sanford Health and the Manitoba government through a freedom of information request.
Sections of the agreement covering fees and the projected value of the untendered contract were redacted under legislation that allows the province to withhold information that might be harmful to a third party’s business interests.
In an explanation for the deletion, access and privacy officer Tom Ormiston said the department considered whether it was in the public interest to disclose fees charged by Sanford Health to the province. However, it decided financial information did not come within the scope of exceptions included in the Freedom of Information and Protection of Privacy Act.
“We have been advised that the third party does not disclose any of their organizations’ contractual arrangements, as such disclosure might allow other health-care organizations to pursue similar arrangements,” Ormiston wrote in response to the Free Press.
“We are of the view that the possible harm that could come to the third party outweighed any of the reasons for disclosure set forth in (the legislation).”
Manitoba Health Coalition provincial director Thomas Linner said the province has an obligation to taxpayers to be transparent about its spending, particularly when health-care dollars are being sent out of province for services that should be readily available close to home.Manitoba Health Coalition provincial director Thomas Linner said the province has an obligation to taxpayers to be transparent about its spending.
“Quite simply, Manitobans’ responsibility is not to Sanford Health. It is to each other and to our public medicare system,” said Linner, whose organization advocates for universal, public health care.
“The Manitoba government is telling us… that this is a worthwhile investment, that this is in fact a solution to the problems that face us. I can’t see a reason why the Manitoba government would not choose to give us this information.”
The Tory government has finite resources to address multiple shortcomings in the health system, including the staffing crisis and the severe backlog of surgical and diagnostic procedures, and spending on out-of-province care should be scrutinized, he said.
“Every dollar that we are spending on private, out-of-province clinics, particularly clinics in the United States that operate in a for-profit competitive environment, are dollars that we are not spending and investing in Manitoba to increase capacity here.”
To tackle the massive surgical backlog caused in part by disruptions to the health system during the COVID-19 pandemic, the Manitoba government also signed agreements with the Cleveland Clinic in Ohio, Sanford Health in North Dakota, and Big Thunder Orthopedic Associates in northwestern Ontario to perform up to 750 hip and knee surgeries on Manitobans annually over the next two years.
When pressed on the price for the out-of-province hip and knee procedures, David Matear, provincial director of the diagnostic and surgical recovery task force, would not say how much more the surgeries will cost compared to being performed in Manitoba.
“We have a significant discount, I can tell you, from the U.S. providers, so that we’re not paying anywhere near the full cost there and we’ve got fairly favourable arrangements and terms there,” Matear told reporters while announcing the program last month.
“There’s no question it will be at higher cost.”
As a matter of accountability, all Manitobans should be told how much the Progressive Conservative government will spend on a “cornerstone” of its surgical and diagnostic recovery plan, St. Boniface MLA and Liberal Leader Dougald Lamont said.
“We don’t know how these deals were reached. We don’t know if we’re getting the best deal. We don’t know if we’re paying more, or if it’s a great deal. It’s a black hole,” Lamont said.
In keeping with contracts awarded to local, private clinics for surgical services, the out-of-province agreements should have been competitively sourced, he added.
The value of contracts inked with Western Surgery Centre and Maples Surgical Centre — two local, private clinics hired to perform surgeries for the province — are proactively disclosed by the government and routinely updated by the task force.
“There’s no justifying different treatment,” Lamont said. “It doesn’t look good when you’ve got two sets of rules.”
The province did not make anyone available for an interview with the Free Press.
In response to written questions, a government spokesperson said agreements with out-of-province partners are part of a “balanced approach of evaluating solutions from multiple angles to address wait lists.”
“The total cost of our agreement with Sanford, or any other out-of-province partner, for any given period of time could only be reported retrospectively as we are billed for care provided to each patient,” the spokesperson said. “These costs will be summarized within regular financial reporting from Manitoba.”
However, when asked, the province would not say how much it has been billed for the patients who received spinal surgery in Fargo to date.
Sanford Health Fargo vice-president of operations Brittany Sachdeva confirmed the organization does not comment on specific contract terms.
“We remain committed to providing access to affordable, high-quality specialized spinal care for patients in their time of need,” Sachdeva said in an emailed statement. “We are honoured to have the opportunity to work with the government of Manitoba as part of this mission.”
Danielle Da Silva
Danielle Da Silva is a general assignment reporter.
Updated on Monday, September 12, 2022 7:43 PM CDT: typo fixed
Updated on Monday, September 12, 2022 8:45 PM CDT: photo removed
Updated on Monday, September 12, 2022 8:47 PM CDT: photo added
Updated on Tuesday, September 13, 2022 10:21 AM CDT: Fixes formatting