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This article was published 19/4/2017 (1525 days ago), so information in it may no longer be current.
People covered by the Workers Compensation Board of Manitoba are receiving preferential MRI access — a benefit that needs to be made abundantly clear to the public, the province's auditor general said.
The WCB is four years into its current, decade-long agreement with the Pan Am Clinic — a division of the Winnipeg Regional Health Authority — whereby workers are guaranteed MRIs at the facility within 20 business days; a stark contrast with the average Manitoban’s 23-week wait. The agreement was highlighted in auditor general Norm Ricard’s 43-page report released two weeks ago exposing the many flaws in Manitoba MRI management.
"We believe that it’s a public asset that all members of the public should be given equitable access to," Ricard told the Free Press in an interview earlier this week.
"If they want to give priority to private insurance patients that are covered by private insurance, then they just need to say that they’re going to give priority to patients with private insurance."
The WCB does "buy preferred access, buy expedited treatment," the WRHA’s chief medical officer Dr. Brock Wright said in an interview shortly after the report’s release, "but what we charge them is considerably more than our cost of providing the exam."
WCB pays roughly $830 per scan. In 2015, Pan Am performed 1,440 scans on WCB clients, amounting to earnings of almost $1.2 million, Ricard's report states.
"It’s a benefit to our Manitoba patients," Wright said. "What we do is then put all that profit back into providing more exams than we otherwise would be able to afford."
It’s unclear how much profit the WRHA makes off the agreement or what impact the WCB scans have on the overall wait time. The WRHA was unable to make anyone available to speak to the Free Press Wednesday.
But is whatever profit the WRHA gleans from the practice worth it? Lorian Hardcastle, associate director of the Centre for Health Law, Policy and Ethics based at the University of Ottawa, isn’t convinced.
"Are the financial benefits that accrue to the public system really worth allowing that kind of disparity to persist?" Hardcastle said. "If it was a week or something… that maybe would be a different story, but when we’re talking months that’s really concerning. That’s a lot of inequity."
WCB spokesman Warren Preece wouldn’t speak to ethical concerns but said because the workers aren’t covered by public insurance, it’s necessary for the WCB to reach agreements with facilities such as Pan Am.
"The diagnostic procedure is part of the road to recovery," Preece said. "The injuries that injured workers have are real injuries and debilitating, so us wanting to speed the return to health is where our major focus is."
It isn’t the WCB’s first such agreement. During its previous one with Pan Am Clinic, the WCB paid not just for the scans but also $1.5 million in "leasing" fees between 2005 and 2013. The clinic blocked off six MRI slots daily — more than 2,000 a year — for possible WCB patients. The current agreement doesn’t include leasing, a decision Preece explained as "just the preference" at the time.
These worker compensation agreements have existed for decades all across the country, said Hardcastle, "a legal anomaly that’s always been carved out for (them)" despite the fact Canada is meant to be a one-tier health-care system.
Originally, the argument was "it's important to get workers back to work," she said. But now that Canada’s population is aging and living longer, she thinks it's time to reevaluate, especially with burgeoning wait times.
"If you happen to be lucky enough to have broken your hip at work then great, you get seen right away," Hardcastle said, "but if you’re an elderly person who fell, then too bad for you."
The auditor general wouldn’t say whether the practice should be allowed to continue.
"They paid for that access which… I don’t know if that makes it right, but it makes it understandable," Ricard said. "Being transparent about it is important."