How Judges Could Cut Travel Insurance Costs

Two determined Alberta men have gone to court to fight for speedier access to health care. If they succeed in reducing wait times, the result could also be cheaper travel insurance.

All will depend on whether the recent court challenge prods provinces to respond with new strategies to reduce wait times and meet demands for hospital beds and medical care.

“Long wait times and a shortage of hospital beds in Canada often force travel insurers to pay for surgeries and post-operative care in the United States, where costs are much higher,” notes Robin Ingle, Chairman of Ingle International.

“Travel insurers’ costs would be lower if injured or sick travellers who are stable and able to fly could be treated sooner at home in Canada. Beds in Canada are hard to get for these Canadian travellers. Insurers cannot air evacuate them without a hospital bed in place.”

Alberta residents Darcy Allen and Richard Cross became upset when they could not get care in their province, and were denied any reimbursement for surgery in the United States to relieve their nagging back pain.

But their lawyer John Carpay is aiming to do far more than recover $24,236 for Cross and $77,503 for Allen, who had to give up work as a dentist.

When he appeared for them in Alberta’s Court of Queen’s Bench on October 17, he argued that Canadian residents deserve access to private clinics and private health insurance if provinces can only offer access to a waiting list.

Life, Liberty, and Security

A medical system fraught with unreasonable delays deprives Canadians of their right to “life, liberty and security of the person” as set out in section 7 of the Canadian Charter of Rights and Freedoms, argued Carpay, president of the Justice Centre for Constitutional Freedoms.

A win in court would extend the legal principle upheld eight years ago in Quebec. A majority of the Supreme Court of Canada ruled then that delayed treatment and provincial bans on the sale of private health insurance could result in physical and psychological suffering, even death in some cases.

At that time, three judges agreed that the federal Charter gave physician Jacques Chaoulli the right to operate a private clinic to meet public demand for care outside of Quebec’s public health care system.

They also agreed, in effect, that  patient George Zeliotis had a right to speedier care in a private clinic, and that private insurers should be free to sell him insurance to cover the cost of care.

But, while three judges said the federal Charter should protect impatient patients, the fourth judge, whose ruling the others supported, referred only to Quebec’s Charter of Human Rights and Freedoms. A modest impact stopped at the Quebec border.

An Early Decision is Unlikely

Carpay does not expect an early win. When asked, he estimated that it will be two to eight months before Allen and Cross get a ruling in Alberta, and many months or years before the outcome of appeals is known.

“I would expect this decision will very likely be appealed to the Alberta Court of Appeal and the Supreme Court of Canada,” Carpay replied to questions by email.

And while it has been legal in Quebec for private insurers to compete with the province to pay for speedier health care, major insurers have yet to step forward, Toronto political science professor Daniel Cohn noted in a 2010 paper (requires Adobe Reader).

Private insurance to pay for health care covered by provincial heath insurance would not be cheap, and unless there were laws similar to the “Obamacare” rules adopted recently in the United States, it would not even be available to everyone who could afford it.

One Skeptic’s View

“There are some ‘niche’ players that do offer Canadians insurance products that allow them to get non-emergency care outside of the country,” Cohn replied to questions in an email.

“[But] the major Canadian health and life insurers (Sun Life, Manulife, Great-West and the big bank-owned insurers) do not want any part of this market. Their lack of interest is probably based on a belief that this sort of insurance would not generate large enough profits to warrant their involvement,” he added.

“I don’t think the [Alberta] court case you mention will change much, because it is already possible for insurers to offer such coverage and niche players do so,” Cohn added in his email. “However, I don’t think the big players will ever get into this or any other form of ‘competing’ with provincial public plans.”

But Carpay insists his objective is to open the field for insurance that would pay for better and faster health care in Canada, not abroad.

“I’ve heard that 50,000 or more Canadians travel abroad for health care each year, spending tens of millions of dollars that could be spent at home. So success with this court action would likely hurt the ‘medical tourism’ business.”

Cross Your Fingers, Don’t Hold Your Breath

As for travel insurance for emergency medical care, a win for Darcy Allen and Richard Cross could be years away. Then provinces would have to respond in such a way that wait times in Canada are reduced. Not even Carpay was willing to speculate on how provinces might respond. So cross your fingers, but don’t hold your breath.

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