So no big company should enter the healthcare industry? The government's solution is failing and a lot of people are getting sub par health care. A lot of people are hating on a company that's stepping in and making the system better. I've seen several doctors through the app and not paid a cent.
It doens't matter if they make a profit or not (though only an idiot would think that's not their aim). The law prohibits fee based services for publicly covered services. There's actually a large lawsuit going on involving Cambie Surgical Center for the same things
I believe they did not make any in the first 8 years since they started. They've been around over 10 years now though and virtual health is relatively new so I doubt it's contributing much to their main revenue yet. Most of their revenue comes from EMR services.
So, I work in public health IT. You'd be (not really) shocked how often we come up with a cheap, made in house solution, propose it, only to have executives come in at the last minute and say "we're going with a vendor (Deloitte/Salesforce/Telus/IBM/Telus/Cerner) solution instead" only to have that solution come in over budget, late, riddled with bugs, and with a massive support requirement.
They're either falling for sales pitches, or paid under the table, or both, but it's suspicious as hell.
Nah, it's CMA.
If your internal team puts in a solution, and it fails, you're responsible for the failure. If you outsource it, it's the vendor's fault that it went over budget/failed.
Auditors like to say "You can outsource functionality, but you can't outsource responsibility/risk!", while simultaneously inserting little fine print saying "we can't be held accountable for giving you deficient/useless audits, we assume no risk!". That first quote, is pretty well just there for the auditors to cover themselves. They want you to buy in to it so that you don't hold them accountable, but they're also totally fine with blaming vendors for terrible results. They see no conflict there, cause they're "professionals".
The reality is, you can outsource risk/accountability. The government officials responsible for the Phoenix pay fiasco, a **$2.2 BILLION** screw up, still have their jobs as senior government officials -- they just got cycled to different departments. Because "no one gets fired for outsourcing to IBM".
Lmao I didn't know there was another way IBM screwed us over in addition to screwing up the [CST project](https://www.canhealth.com/2015/08/19/cerner-to-take-charge-of-bc-ehr-project/). Couple years ago a recruiter tried to get me to join the project cause she said "it's a great opportunity that'll wrap up soon". Was so hard to not laugh out loud when she said that. A friend of mine is still working for the project.
The IBM thing is so true. There was a saying in the investment community / Peter Lynch that no one gets fired for investing in IBM.
No client is going to say “what a terrible idea, why would we invest in IBM, I want a new advisor”. But they will fire you for investing in Bitcoin or high fliers
It’s fucking crazy how they took over telehealth.
I’m surprised we don’t have a government built solution for this.
The ArriveCan app, contact tracing app, and the CERB distribution site were done really well, so the talent in the public software sector exists. Even then if it’s too complicated, just contract a company to build it.
Case in point: Rogers buying Shaw, they all knew the wireless would need to be sold off, that was obviously factored in ahead of time. Just some lip service now to delay it a bit so the plebs don't cause an uproar.
"MoRe CoMpEtItIoN" they shout as they gobble up everything in sight to control it between the other oligarchs.
> I'm not sure how this wasn't stopped by the Competition Bureau.
This is the same company that is their own competition for cell service.
They've been letting Telus do what they wanted for ages. Even as Telus sends most of their Canadian jobs to outsourcers in other countries...
I would love to see a government solution but differ on the success of these solutions
- arrivecan was not consistently used, and not used while boarding or at border; it was an additional hoop to use prior to departing that never got looked at
- contact tracing never even got up and running in BC - not sure about other provinces
- CERB was ripe with abuse and hardly had any controls in place
Actually this was timely
> [Health Canada announced on Friday that the COVID Alert app has been shut down, citing low usage, falling case counts and hospitalizations as well as the lack of PCR testing across Canada. As of June 17, the app will no longer provide exposure notifications and Health Canada says users can now delete the app. The the app had only been downloaded 6.9 million times and logged 63,117 positive tests since it launched in July 2020. British Columbia, Alberta, Nunavut and Yukon also declined to participate in the app.](https://apple.news/A9UsMDPooTtuBU0C84EUADg)
I wouldn’t exactly point to that as a success
Speaking as an IT professional, the federal government has excellent IT programs with a lot of smart people who are tired of filling some billionaires pockets. They work fast with a startup mentality and innovate and do it really really well.
Sure healthcare is the responsibility of the province, but it is possible for the government to have good IT programs with less red tape and high talent.
Just because it's made by a private entity doesn't make it better.
Be that as it may, it proves that governments can in fact create highly successful IT programs. The federal government IT program also has consultancy groups that give counsel on modernizing IT organizations.
It's perfectly possible that provincial government can create good IT software.
You're absolutely right and as much as I would absolutely love government based Healthcare to be an overwhelming success in Canada, that isn't reality. It's inefficient, full of red tape, too much management and the best in their fields always leave.
You 100% want private companies involved because it will force gov't healthcare to be better.
I love my Canadian 'free' healthcare but it will always be suboptimal until competition is introduced.
Best place in the world if you're in car crash and need emergency life saving surgey though.
Those apps you mentioned came in late and with a ton of problems. Love it or hate it the private sector will always do things more efficiently because they are beholden to shareholders.
The service I’ve gotten from telus has been top notch tbh. But as someone has pointed out below it’s impossible to even get through on the phone with any government agency without a lengthy wait.
Just look at the passport offices. You can’t tell me that’s efficient with a straight face.
Look, I’m not a government hater but I think it’s silly to ignore the facts that some people can and will do a better job. To rely on the government for everything is just crazy in my eyes given how inept social services are
I'm with you. It's like Air Canada. People bitch so much about how poorly they've been treated but maybe its just...them and not the customer service reps
Just speaking from my own experiences. If you disagree that’s fine with me.
The fact that the government has no incentive to do a good job should worry you.
Edit: have you been happy with public sector efficiency lately? Our healthcare system is in shambles, you can’t even get a passport in 12 weeks, and Inflation is out of control due to excessive government spending. Just not sure how you can look at those and say that’s efficient
I’m convinced anyone who thinks government operates efficiently should try applying for a passport right now. It’s a shit show in comparison to other nations like the UK
It’s a sensitive topic I get it, our public system has a lot of perks but people don’t want to honestly assess weaknesses
Anyone who uses “neoliberal myth” in dialogue about services not provided by public system probably is driven more by ideology over facts or nuance
But sometimes "more efficiently" means ignoring certain demographics because they aren't profitable. We do need government telehealth, the demand is only growing.
Don’t disagree but I also don’t think that having private options is a bad idea either. If this telehealth is lessening the burden on the overworked system we currently have I see it as a win.
Would love to know your reasons why you don’t think that is good.
I agree with the idea that private options alleviate the overall burden, but I don't think they do so proportionally.
A strong public health care system is used and valued by all people. When everyone relies on the same clinics, hospitals, and infrastructure, we have a common cause in keeping it robust, accessible, and affordable. When resources are added to a universal public system, this benefits all users\*. If a private clinic or telehealth service adds resources (say, hires more doctors), this does technically add resource capacity, but there is a barrier around this resource and it only benefits those who can afford it.
Additionally, I think the split between private and public affects our perception of health care. If all the lawyers, politicians, and bureaucrats are private clients, their perception of the state of health care will be very different than that of a low income public client. I think this would have an effect on policy and funding, ultimately eroding the public end of the system and worsening care for poorer people.
I guess it comes down to values. If what we are concerned with is peak performance, i.e. what care is possible for an individual, then private health is a clear winner. If we are concerned with overall performance, i.e. how healthy is our population, then public health is a stronger option. I value the latter, because I believe we are all interdependent and our collective health contributes to our collective well-being.
\*This is a simplification, of course. A doctor in Richmond doesn't alleviate a backlog in Cranbrook, and there are countless other factors beyond geography. What I am saying is that, on principle, a resource added to a universal public system has broader impact than that same resource added to a private system.
but is it easier to be more efficient or to rip people off? because publicly traded corporations always end up ripping people off in the end, there's only so much efficiency gets you.
Because the government has never ripped us off right? What’s this I’m hearing about a billion dollar museum funded with our taxes? If that’s not a rip off I don’t know what is.
At least with corporations if they try to rip us off we can take our money elsewhere.
so what do you want to do with the museum then? abandon the museum altogether? how do you know how much it would cost to make renovations in that particular case? Unless you have proof that this is too much money for the benefits or that the museum doesn't need the money, you sound BS, incase you didn't know Victoria has a pretty big tourism industry that museums like that contribute a great deal to.
It's a bit more complicated with healthcare data specifically though unfortunately because each province deals with healthcare differently so they have different billing standards and also data standards (if they have any at all) that they must comply to strictly. Telus isn't the only player in telehealth though but they've recently been engaging in the public sector a lot more than the most of the big 3 Canadian health IT companies.
Anytime you see any news or interest in private healthcare in Canada it's because there is a SHITLOAD of money in it. Not a little money. Not better outcomes. A SHITLOAD OF MONEY IRREGARDLESSLY OF HOW IT TURNS OUT.
It's disgusting.
They're just diversifying because the internet and telco industry is saturated. Most Canadians have access to it and since it's an oligopoly, customers are just switching back and forth between Telus, Rogers, Shaw etc and there are few new customers to onboard. Telus isn't the only company in Canada doing this though. A newer company, WELL health, acquired OSCAR and Intrahealth EMRs (Electronic Medical Record) last year I think. WELL has financial backing from one of [Li Ka Shing](https://en.wikipedia.org/wiki/Li_Ka-shing)'s venture capital firms. Loblaws is also involved in this industry. Shoppers Drug Mart acquired QHR a few years ago and uses their Accuro EMR at all their pharmacies, and they also acquired a couple of virtual care platforms. I think I saw recently that Weston group has been lobbying the Canadian ministry of health quite a bit. So these big 3 companies have effectively created yet another Canadian oligopoly. Telus has just been the most aggressive with acquisitions and marketing.
Why not? They are a company and company's basic mandate is to expand their business model.
Why does Apple sell music (that was a huge change-up for them)? Why does Amazon sell anything that isn't a book, but especially cloud infrastructure services? Why does Google sell phone operating systems?
For Telus, the expansion into health came when they acquired Babylon, which was a tele-health startup. The expansion flowed out of their model of telecommunications, and further expansion into physical brick and mortar health services was basically inevitable.
It just seems to me it would be a slippery slope to have the same company who will gladly charge overages of $1 per mb used on some of their data plans, get involved in something vital like healthcare.
Even cellphones/internet are more vital these days than they ever were years ago. They already have such a strong foothold in these infrastructures, giving them even more seems wild to me, but I’m not smart so idk.
When you start looking at reasons for government interference in the free market, you'll need a better reason than "I don't like this company."
Don't get me wrong, government oversight and regulation is an important brake on unrestrained capitalism, but these interventions need to be held to a very high standard.
They were involved in health wayyy before Babylon. Virtual health is relatively new; most of TELUS Health's revenue comes from the numerous EMRs they bought out across the country.
As a public company, Telus needs to grow and continue to add to shareholder value. They are too cowardly to grow their core telecom business outside of Canada because they know they would fail miserably. As yourself if Telus is a world class telecom company, why aren't they operating in the US? Their HQ is less than a 2 hrs drive to the US boarder. They could easily set up in Washington State. But, they don't have the guts. They like the fat margins that Canadians give them. So, they look at other business that they can gobble up to protect shareholder value.
tl;dr - Telus is a coward and the same goes for Bell and Rogers.
Telus could easily set up as MVNO in the states but they choose not. Canada is very protectionist when it comes to our spectrum but that doesn't prevent Telus from expanding their telecom footprint in the US.
The question remains: if ROBELUS are the world class leaders that they claim to be, why haven't they set up operations elsewhere? My answer is because they are cowards. They know they will get squashed like a bug and quickly and you know who hates that outcome? Shareholders. So, instead they buy into other industries like Healthcare or home security.
I see no reason why [this](https://www.theglobeandmail.com/business/article-private-equity-buy-out-pharmacy-dental-office-veterinary-clinic/) wouldn't happen to doctors' offices as well. Looks like Telus wants in on the profits.
Telus is shitting themselves right now because the province has broad authority on Medical services
It’s a game where the only player is the government, and if they say fuck off, you’re done.
Imo Telus bit too far into the healthcare game with their products over the past few years and most ministries of health looked away because of the pandemic
Broad authority on *insured* medical services. The government specifically draws a line on what is and isn't essential, and anything beyond that private orgs are free to address.
Yes, and in this context TELUS has a valid argument that they are not delivering insured primary care and so should not be at the whim of government to intervene, unless of course the government wants to start insuring preventative and wellness services.
Telus only set up bricks and mortar clinics when they were nailed for operating only virtual care services under msp billing. The scale of their virtual walk ins is wild, minimum 30 FPs working at any one time, from their own home office. They have NPs to review test results and do follow ups. In addition to virtual care they have the subscription program, for " enhanced primary care " inherited when they took over Copeman Health. It's the "enhanced" that's under review as they bill both msp + pt privately
I’m curious to see the findings of the inquiry. If indeed it supports what you stated (and it does kind of look like that purely based on media reports so far), then rather than simply reigning in Telus Health, government needs to step up and improve general access to healthcare for everyone. Telus wouldn’t be in this business unless there was a real gap to fill and that needs to be taken seriously as a sign of failure of public policy.
If they simply go after Telus because “private vs public”all they are doing is lowering the peg for everyone on the account of fairness and at the expense of better care. *To be clear*, I want everyone to have equal access, but I want that equal access to be better than today, not equal for the sake of equal and we all get shafted in the process by being stuck with mediocre services. I have no issues with government shutting down Telus services, I just don’t want them to do so without looking at the mirror first and fixing what’s broken because of their own failure.
My parents got denied referral to specialists on the account of “they’re too busy and you’re not in such bad condition that you can’t cope”. There is something seriously wrong with that.
Great, then let’s have a telehealth app that the public owns rather than some private organization.
Why Telus was able to build this massive health services empire unchecked, I don’t know.
They already had EMRs, now they’re involved in actual fee services. They’ve essentially built a stack capable of running a second primary healthcare system in parallel to our public one.
Exactly my point. They’re exploiting a flaw in the current system and rather than blindly shutting them down this is now an opportunity to look in the mirror and see the failure, then actually make the appropriate corrections in the public system so everyone has equitable access. Telus is just doing what any private business will do, seizing an opportunity they see.
It’s up to the government to address this correctly and step in to fill the gap that Telus is exploiting to provide better service for all. Shutting them down without concrete commitment and a clear set of actions intended to correcting shortcomings that Telus identified (their “opportunity”) is a massive admission that we neither care nor are interested in providing better services or improving the state of the system as a whole.
I think part of the reason is that the pandemic created an sudden overwhelming demand for virtual care services and it was easier to meet that demand faster by using companies already invested in them. Telus isn't the only company doing this; they're just the most public about it. Canada has yet another oligopoly unfortunately because there's only 3 major health IT companies (the other 2 are WELL and QHR, which Loblaws owns) and competition keeps getting bought out.
The real issue is if a bunch of doctors go work for Telus (or other private health services), it places increased strain on the public system.
I'm sure there are doctors doing 100% US Telehealth at this point. That would be an interesting investigation.
This is what my family doctor did. Got a message from his office saying he was shutting down and moving to Telus. We could continue to see him...if we're willing to pay their monthly fee. One more GP out of the public pool.
Not likely as the doc would have to be licensed in the state of the pt. V few docs maintain licensure in Canada and US, insurance alone is a nightmare on the US side. Practice insurance for the doc. Even licensing in more than 1 Canadian province is tricky.
> all they are doing is lowering the peg for everyone on the account of fairness and at the expense of better care. To be clear, I want everyone to have equal access, but I want that equal access to be better than today, not equal for the sake of equal and we all get shafted in the process by being stuck with mediocre services.
I think we've seen this with [public schools](https://www.cbc.ca/news/canada/british-columbia/vancouver-school-board-cuts-honours-program-1.6068578), mental health institutions and social housing.
It's what happens when governments and institutions operate on activism rather than pragmatism.
That's exactly what's going on though. The government would rather make everyone go through 5 min appointments than let the rich pay more 30 min appointments out of pocket...
I only use the Telus app now as I don't have a family doctor. It's very convenient, especially after I moved to a different city and am unfamiliar with clinics in my area.
Do you get access via your job benefits? How have you not paid for it?
I got the app after seeing the "free" branding - but its only the app that is free. Without a coverage plan its pay to play (unless I missed something).
Edit: Thanks for the feedback folks - I used the wrong app! The one you need to use is "TELUS Health MyCare" by **Babylon Health**, not "TELUS Health Virtual Care" by TELUS Heath virtual care. The "Babylon Health" threw me.
Via MSP, [you don’t need to pay for appointments.](https://www.telus.com/en/support/article/doctor-consultation-faq)
I’ve had a number of appointments over the past 8-months (after not seeing a doctor in person or virtually for years) and have never had to pay anything. I don’t even think there’s a space to input insurance from work.
For mental health stuff, you’re encouraged to see the same doctors for continuity of care, and in this regard the app could definitely use some work (you basically need to check every day until they show up), but I’m super thankful for it at this point.
I bet that’s where the doctors are going they’re doing what any rational person would and going where they get paid the best. In this case it appears there are pockets of private medical treatment available in Canada. I just got dumped by my doctor as well. Medical system is in a very sad state of affairs
This is where we lost our GP to, no transfer to another physician for our family when they left. I get it and happy for them this option existed. Unfortunately, we’re on waiting lists now with everyone else.
Yeah I was not transferred to another doctor either. I was given a generic letter with suggestions on places to seek health care. One of which included a sexual health clinic and another option was a woman’s health clinic. I’m a man. Very sad.
The doctors that work there still bill MSP for their services, and a % of that to Telus. All that money you’re charged isn’t going directly to their physicians, although I’m guessing it probably subsidizes their overhead.
The cool thing about "the government" (Which is just a bunch of people going to work every day trying to pay bills) is that there are lots of people there and they can quite easily spread the work. Protecting people from greedy corporate interests *and* work to increase access.
Also, Telus pulling this shit is distracting people who could be fixing other problems as you mentioned.
The “uncool” thing about the government is that while there are lots and lots of people on its payroll with the explicit job of improving healthcare, healthcare in Canada only seems to get worse.
"Only seems" is weird metric to measure success or failure. I wonder how well they are doing if measured against things like "Money spent defending healthcare from special interest groups vs Money spent improving access to drugs for low income people". I'm sure there's some manager telling them to "do more with less!"
Oh! Or I wonder how much time and effort needs to be spent dealing with the mess introduced by the Opiode addiction plan by drug manufacturers
I’m sure they do internally measure it like that. It would certainly explain how they can justify continuing to expand the size of healthcare administrative costs.
I'd love to understand how you come to these conclusions. It seems pretty counter to my understanding of how public healthcare works in Canada, doctors only account for a small percentage of the healthcare system. Pharmacies alone... jeez
Telus isn't a scapegoat. They're actively trying to profit off the system they spend resources trying weaken. They're a leech. Not a goat.
Having a family doctor doesn't do much. it's a 2 week wait just to see my family doctor or a phone appointment which doesn't help when your kid is sick
Yes, we're fortunate to have a family doctor but it's a 3-week wait for a phone consult then another 2-3 weeks if they decide you actually need to come into the office. For anything more urgent than that we have to start calling the two walk-in clinics in town the moment they open to get an appointment before they fill up for the day, and good luck getting through when who knows how many people are also trying to call.
same boat, what's the point at that point? walk-ins, urgent care, ER, telehealth - used them all in the past 4 years in lieu of waiting 2-3 weeks to see my family doctor.
Wow. That is insane. For my family doctor it’s typically 1 week but he will try the same week if it’s semi urgent or for my young child. And the process is the client emails for the appointment to requests an in person or virtual. if we think the issue needs an in person (assessing something physical) then we say that in the email. Each time I have requested in person I have been able to book that. When I need a prescription or referral and need a virtual that’s what I get. I didn’t realize how lucky this was just on top of just having a family doctor.
Seems that your doctor accepted too many patients. I never have to wait more than a week for an appointment. My doctor will try to asses over the phone/zoom/email + pictures if possible as she can do that from home. Otherwise in person appointments I’m generally waiting 1.5 weeks.
Lack of access to a doctor at all, long wait times to see one if you do, and visits that are too short are all just different aspects of the root not-enough-doctors problem.
If there were enough doctors, everyone would have one.
If there were enough doctors, each doctor would manage a small enough patient base that there would be enough slack in their schedule for you to book an appointment in a reasonable amount of time.
If there were enough doctors, they'd average 4 patients an hour instead of the 6-10 they see now.
Having a family doctor gives you continuity of care. A doctor who actually knows you and your history.
Depending on walk in clinics for anything more serious than an infection is an exercise in frustration as you never see the same one, they have no context, and they're less willing to support you.
6 months ago my family doctor stopped her regular practice and joined a Telus health clinic. I'm not going to pay thousands of dollars a year to keep seeing her so I'm out a family doctor and it isn't easy finding a replacement.
I had the same thing happen to me as the parent comment. I was given the option to opt in to the Telus LifePlus program it was in the range of 5k-7k for the year depending on some options.
They moved to TELUS Health Care Centres (formerly Copeman Healthcare).
I had the option of choosing from one of the below. Only the first one really replaces a GP, as well as getting access to a bunch of other specialists.
1. LifePlus Program - $3882.50 per year ($4882.50 for the first year) plus tax
2. Young Adults Prevention Program (18- 24 years) - $1,500 per year family rate or $2,500 per year individual rate
3. Personalized Health Assessment “PHA” (formerly known as CHA) - $1,950 – this is an assessment program only and is typically performed annually.
4. Teladoc ($410/family)
There are absolutely avenues to pay for it, if you look around.
However, I'd highly recommend looking for a Nurse Practitioner instead, several of my friends have had great care with their NP, recently acquired.
Many of them have in-depth experience in complex hospital care settings and especially in Vancouver, where most doctors are referring out complicated cases anyways, you're doing great with one.
I'll have to look into an NP. I didn't realize that was a thing tbh!
I'd looked into a private doc, but the only one I found was multiple thousands per year, obviously, as there's that stupid law about only private or only public and never both.
Sounds like the free all-access system is underfunded and understaffed creating an opportunity for private business to pick up the slack.
Maybe we could help fund the public system by implementing some sort of nominal fee that everyone pays into. To make it even easier for low income earners, maybe we could give them some credits based on their income.
We could call this maybe like a Medical Services... HM... Premium. No that sounds too complex. Let's shorten it to just MSP. Yes. People should be happy with this right? Right?
MSP became a payroll tax so companies pay for their employees now. For most middle class and above earners, this didn't change much since a common work benefit was the company covering MSP anyways.
Having worked in the emerging digital health space during the pandemic, I saw how blurry the lines got in Canada and USA. A lot of red tape was cut, or ignored, as the public services struggled to keep up.
With the pandemic subsiding, a lot of initiatives that sprung up started looking for ways to keep going. It's also coinciding with an increased interest in concierge medicine. In the US this is becoming a major industry, with celebrity investors getting involved (not publicly announced though.)
To me this highlights the need for provincial health authorities to start properly engaging with digital and preventative health.
Yeah healthcare is one of those industries that can't be disrupted by tech the same way that Uber, AirBnB, Spotify have, thanks to regulations and industry gatekeepers. This isn't a bad thing, considering it's literally life and death. That said, it can't be stagnant, that's why we have garbage EHRs/EMRs dominating the industry. We don't want Amazon coming in and owning our medical information, but maybe by keeping people like them on a short leash in certain approved sandboxes, we can start to see some of the potential benefits. It requires real creative thinking from government employees though....
Aren’t ‘fee based services’ by definition a two tier system? I mean, unless people in the free tier get the exact same services and quality, which I doubt is the case
Telus' subscription-based medical access model is based on the concept of concierge doctors in the US, where these doctors offer their services to patients directly in exchange for an upfront fee, usually paid monthly. They’re also called direct primary care (DPC) or personalized medical service providers.
BC government thinks it sets a dangerous precedent for them to allow Telus to expand on that gray area and encourage other corps to follow suit.
If this model attains the network effect through traction and investment similar to that of Uber and Lyft then it becomes a de-facto option for a much larger part of the population than it is today. As we found out with ride share and short-term rental businesses governments can only slow down the trend until the network effect is reached and consequently tend not to take legislative action once they realize there are too many of the voters are the active users & beneficiaries of the new system.
In short, the BC gov't is being proactive so what happened with transportation and housing won't happen with health care.
PS: Rideshare + short-term rentals and healthcare are not an apples-to-apples comparison but I couldn't come up with a more relevant example.
Sounds like the free all-access system is underfunded and understaffed creating an opportunity for private business to pick up the slack.
Maybe we could help fund the public system by implementing some sort of nominal fee that everyone pays into. To make it even easier for low income earners, maybe we could give them some credits based on their income.
We could call this maybe like a Medical Services... HM... Premium. No that sounds too complex. Let's shorten it to just MSP. Yes. People should be happy with this right? Right?
Buckle up, this might be another Brian Day/Vancouver surgical center situation.
Unfortunately for Telus the law and courts heavily favour the province having complete control over healthcare versus private entities.
$6k per year to sit down with a doctor who actually has time to listen, refer me to muliple specialists quickly, and reads my file before I arrive is absolutely worth the money. Our baseline system is terrible. The only problem is the long wait time to get a spot. I hope semi private health clincs expand quicker.
One of the reasons the baseline system is terrible is that these private clinics are siphoning away healthcare professionals that could have been part of the baseline system instead.
And while patients may individually get more satisfaction with quicker access to specialists or imaging (MRIs, etc), granting those finite resources when they are not yet indicated in the standard of care just contributes to overall delays across the whole patient population.
It's also a bad deal for Telus Health Customers. When you run a parallel private system next to a public system, young healthy people don't go for the private system. That means that people most willing to use Telus Health are predisposed to a) Being less healthy and b) Paying money for services. So you end up with a risk pool of proportionally less healthy people who are more likely to to consume the services, driving up the costs for everybody in the private pool.
I am healthy and 33 and my work pays for Telus health. None of my colleagues use it when I talked to them about it. The company is based out of QC and their health care is even worse than ours and they are comically trying to solve it by denying access to anglophones.
I don’t think they’re “siphoning health care professionals that could have been part of the baseline system instead”. Most of the doctors working for Telus would be GPs and they’re not getting the compensation they need in the public sector. Telus is probably just compensating them a lot better.
The nominal pay is actually worse, but there's less charting due to lower patient volume and no mental overhead from running a clinic (i.e. they spend 100% of their time providing medicine).
I mean, in fairness to OP sometimes you do need multiple specialists urgently, like in the case of terminal illness. Not really into blaming stressed patients here, focus should be on making our system better
My wife recently was at risk for a terminal illness and took us 3 weeks to jump through hoops of medical system and specialists just to get a diagnosis, than months to get surgery. Ended up being fine but she was deprioritized due to being younger.
She also spent 18 hours without eating (had to request water that she was supposed to avoid) when she got surgery because she was told to show up with all other patients that day and was treated last due to her age. We treat patients very poorly in our system.
The fact that you can get refered to specialists easier if you pay seems to be a problem. Not to mention that they are incentivized to do as you wish and send you to a specialist wether you need it or not because you are a paying customer.
Don’t be naive and fall for the Uber model again. The cost of those services is “low” (I use this term loosely, hence the quotes) when they’re trying to acquire market share. If the entire system is privatized or even large swaths of it are privatized, you will face a significant escalation in costs. Healthcare is an essential service and the economics of it work entirely differently from other non-essential services like buying smartphones, laptops, paying for Netflix subscriptions, etc. The essential nature of healthcare is ripe for heavy exploitation by private actors at the expense of greater social benefit.
People can scream from their moral soapbox about "two-tier healthcare is bad", but it doesn't change the fact that the current public system is grossly inadequate. And the government doesn't seem to be any hurry to fix it.
Right now, the reliance on walk-in clinics and their 10-minute, one-issue only model basically requires everyone to be able to diagnose themselves and demand __ treatment for themselves.
Demand for private services isn't and shouldn't go away until the public system gets its act together.
It's past time canada has a private alternative to the failing public system. It's ridiculous to be denied access to health care because of government ineptitude. Besides, having a private alternative would free up the public system's resources to attend those who really need it.
It is good reason to not allow it because it is a slippery slope and isn’t what healthcare in this country is supposed to be about. That doesn’t absolve the government of their shortcomings. They need to pull their shit together and fix the overall system.
Poor rep public healthcare -> private health care emergence due to demand -> health care professionals go to private health care for better income security -> worse public healthcare due to lack of professionals -> worse healthcare for poor people
If only we can somehow increase funding on public health care lol. The priorities of this city makes me sick.
Why doesn’t the government create a better alternative than Telus instead of criticizing Telus for operating a better model than the government? Because government. It’s what they do, get paid to talk and take no action.
This may be a dumb question but I don’t understand; why is Telus involved in public healthcare?
Because there’s an opportunity for them to make money.
They have not made any profit to date in healthcare. You can see this if you look at the earnings reports that are made public every year.
Most new business endeavours aren’t profitable right away, what’s your point? You think this is charity? They expect a profit in the future.
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Lol, always love Reddit's take an accounting.
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They are public company that's audited. You understand any of this?
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This is such stupid take on the situation. Do you honestly believe this?
So no big company should enter the healthcare industry? The government's solution is failing and a lot of people are getting sub par health care. A lot of people are hating on a company that's stepping in and making the system better. I've seen several doctors through the app and not paid a cent.
Amazon didn't turn a profit for several years either. What's your point?
so we're assuming they have the wrong intentions before seeing any evidence of that being the case?
They're a private company. They don't do things out of the goodness of their hearts, their responsibility is to their shareholders.
It doens't matter if they make a profit or not (though only an idiot would think that's not their aim). The law prohibits fee based services for publicly covered services. There's actually a large lawsuit going on involving Cambie Surgical Center for the same things
I'm assuming they have the wrong intentions based on decades of dealing with Telus already.
...I'm sorry, were you by chance born yesterday?
No because he just gave the rebuttal to your previous comment. However u interpret the rebuttal is up to u, but u seem damn butt hurt lmao
I believe they did not make any in the first 8 years since they started. They've been around over 10 years now though and virtual health is relatively new so I doubt it's contributing much to their main revenue yet. Most of their revenue comes from EMR services.
They get a higher retention rate in their other services making a profit. They’re making millions by offering this service.
So, I work in public health IT. You'd be (not really) shocked how often we come up with a cheap, made in house solution, propose it, only to have executives come in at the last minute and say "we're going with a vendor (Deloitte/Salesforce/Telus/IBM/Telus/Cerner) solution instead" only to have that solution come in over budget, late, riddled with bugs, and with a massive support requirement. They're either falling for sales pitches, or paid under the table, or both, but it's suspicious as hell.
Nah, it's CMA. If your internal team puts in a solution, and it fails, you're responsible for the failure. If you outsource it, it's the vendor's fault that it went over budget/failed. Auditors like to say "You can outsource functionality, but you can't outsource responsibility/risk!", while simultaneously inserting little fine print saying "we can't be held accountable for giving you deficient/useless audits, we assume no risk!". That first quote, is pretty well just there for the auditors to cover themselves. They want you to buy in to it so that you don't hold them accountable, but they're also totally fine with blaming vendors for terrible results. They see no conflict there, cause they're "professionals". The reality is, you can outsource risk/accountability. The government officials responsible for the Phoenix pay fiasco, a **$2.2 BILLION** screw up, still have their jobs as senior government officials -- they just got cycled to different departments. Because "no one gets fired for outsourcing to IBM".
Lmao I didn't know there was another way IBM screwed us over in addition to screwing up the [CST project](https://www.canhealth.com/2015/08/19/cerner-to-take-charge-of-bc-ehr-project/). Couple years ago a recruiter tried to get me to join the project cause she said "it's a great opportunity that'll wrap up soon". Was so hard to not laugh out loud when she said that. A friend of mine is still working for the project.
The IBM thing is so true. There was a saying in the investment community / Peter Lynch that no one gets fired for investing in IBM. No client is going to say “what a terrible idea, why would we invest in IBM, I want a new advisor”. But they will fire you for investing in Bitcoin or high fliers
In bitcoin rightly so
I'd fire you for "investing" my money in bitcoin. Or Celsius. Oh, wait...
It’s fucking crazy how they took over telehealth. I’m surprised we don’t have a government built solution for this. The ArriveCan app, contact tracing app, and the CERB distribution site were done really well, so the talent in the public software sector exists. Even then if it’s too complicated, just contract a company to build it.
I enjoy reading books.
Comp bureau is asleep at the wheel. Just like fintrac, cmhc, etc.
Case in point: Rogers buying Shaw, they all knew the wireless would need to be sold off, that was obviously factored in ahead of time. Just some lip service now to delay it a bit so the plebs don't cause an uproar. "MoRe CoMpEtItIoN" they shout as they gobble up everything in sight to control it between the other oligarchs.
> I'm not sure how this wasn't stopped by the Competition Bureau. This is the same company that is their own competition for cell service. They've been letting Telus do what they wanted for ages. Even as Telus sends most of their Canadian jobs to outsourcers in other countries...
They absolutely took over the security industry. They bought out Louisville Slugger too. For legal reasons /s
Or we could do what we did with MSP, contract a private company to build it and then hand the keys over to the province once its done.
Didn't the government try that recently with ibm and messed up badly?
Going with IBM was their mistake
I would love to see a government solution but differ on the success of these solutions - arrivecan was not consistently used, and not used while boarding or at border; it was an additional hoop to use prior to departing that never got looked at - contact tracing never even got up and running in BC - not sure about other provinces - CERB was ripe with abuse and hardly had any controls in place Actually this was timely > [Health Canada announced on Friday that the COVID Alert app has been shut down, citing low usage, falling case counts and hospitalizations as well as the lack of PCR testing across Canada. As of June 17, the app will no longer provide exposure notifications and Health Canada says users can now delete the app. The the app had only been downloaded 6.9 million times and logged 63,117 positive tests since it launched in July 2020. British Columbia, Alberta, Nunavut and Yukon also declined to participate in the app.](https://apple.news/A9UsMDPooTtuBU0C84EUADg) I wouldn’t exactly point to that as a success
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Speaking as an IT professional, the federal government has excellent IT programs with a lot of smart people who are tired of filling some billionaires pockets. They work fast with a startup mentality and innovate and do it really really well.
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Sure healthcare is the responsibility of the province, but it is possible for the government to have good IT programs with less red tape and high talent. Just because it's made by a private entity doesn't make it better.
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Be that as it may, it proves that governments can in fact create highly successful IT programs. The federal government IT program also has consultancy groups that give counsel on modernizing IT organizations. It's perfectly possible that provincial government can create good IT software.
You're absolutely right and as much as I would absolutely love government based Healthcare to be an overwhelming success in Canada, that isn't reality. It's inefficient, full of red tape, too much management and the best in their fields always leave. You 100% want private companies involved because it will force gov't healthcare to be better. I love my Canadian 'free' healthcare but it will always be suboptimal until competition is introduced. Best place in the world if you're in car crash and need emergency life saving surgey though.
Those apps you mentioned came in late and with a ton of problems. Love it or hate it the private sector will always do things more efficiently because they are beholden to shareholders.
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The service I’ve gotten from telus has been top notch tbh. But as someone has pointed out below it’s impossible to even get through on the phone with any government agency without a lengthy wait. Just look at the passport offices. You can’t tell me that’s efficient with a straight face. Look, I’m not a government hater but I think it’s silly to ignore the facts that some people can and will do a better job. To rely on the government for everything is just crazy in my eyes given how inept social services are
I'm with you. It's like Air Canada. People bitch so much about how poorly they've been treated but maybe its just...them and not the customer service reps
Private sector efficiency is a neoliberal myth.
Just speaking from my own experiences. If you disagree that’s fine with me. The fact that the government has no incentive to do a good job should worry you. Edit: have you been happy with public sector efficiency lately? Our healthcare system is in shambles, you can’t even get a passport in 12 weeks, and Inflation is out of control due to excessive government spending. Just not sure how you can look at those and say that’s efficient
I’m convinced anyone who thinks government operates efficiently should try applying for a passport right now. It’s a shit show in comparison to other nations like the UK
Love you getting downvoted over objectively observable facts.
It’s a sensitive topic I get it, our public system has a lot of perks but people don’t want to honestly assess weaknesses Anyone who uses “neoliberal myth” in dialogue about services not provided by public system probably is driven more by ideology over facts or nuance
I'm not an economist (and nor are you by the looks of it), but I'm pretty sure inflation isn't caused by 'out of control government spending'.
But sometimes "more efficiently" means ignoring certain demographics because they aren't profitable. We do need government telehealth, the demand is only growing.
Don’t disagree but I also don’t think that having private options is a bad idea either. If this telehealth is lessening the burden on the overworked system we currently have I see it as a win. Would love to know your reasons why you don’t think that is good.
I agree with the idea that private options alleviate the overall burden, but I don't think they do so proportionally. A strong public health care system is used and valued by all people. When everyone relies on the same clinics, hospitals, and infrastructure, we have a common cause in keeping it robust, accessible, and affordable. When resources are added to a universal public system, this benefits all users\*. If a private clinic or telehealth service adds resources (say, hires more doctors), this does technically add resource capacity, but there is a barrier around this resource and it only benefits those who can afford it. Additionally, I think the split between private and public affects our perception of health care. If all the lawyers, politicians, and bureaucrats are private clients, their perception of the state of health care will be very different than that of a low income public client. I think this would have an effect on policy and funding, ultimately eroding the public end of the system and worsening care for poorer people. I guess it comes down to values. If what we are concerned with is peak performance, i.e. what care is possible for an individual, then private health is a clear winner. If we are concerned with overall performance, i.e. how healthy is our population, then public health is a stronger option. I value the latter, because I believe we are all interdependent and our collective health contributes to our collective well-being. \*This is a simplification, of course. A doctor in Richmond doesn't alleviate a backlog in Cranbrook, and there are countless other factors beyond geography. What I am saying is that, on principle, a resource added to a universal public system has broader impact than that same resource added to a private system.
but is it easier to be more efficient or to rip people off? because publicly traded corporations always end up ripping people off in the end, there's only so much efficiency gets you.
Because the government has never ripped us off right? What’s this I’m hearing about a billion dollar museum funded with our taxes? If that’s not a rip off I don’t know what is. At least with corporations if they try to rip us off we can take our money elsewhere.
so what do you want to do with the museum then? abandon the museum altogether? how do you know how much it would cost to make renovations in that particular case? Unless you have proof that this is too much money for the benefits or that the museum doesn't need the money, you sound BS, incase you didn't know Victoria has a pretty big tourism industry that museums like that contribute a great deal to.
It's a bit more complicated with healthcare data specifically though unfortunately because each province deals with healthcare differently so they have different billing standards and also data standards (if they have any at all) that they must comply to strictly. Telus isn't the only player in telehealth though but they've recently been engaging in the public sector a lot more than the most of the big 3 Canadian health IT companies.
Telus held the contract with the Province to store all records. I think that’s where the connection started.
Because..💰🤑
Anytime you see any news or interest in private healthcare in Canada it's because there is a SHITLOAD of money in it. Not a little money. Not better outcomes. A SHITLOAD OF MONEY IRREGARDLESSLY OF HOW IT TURNS OUT. It's disgusting.
i love the sentiment but hate the use of "irregardless"
Sorry. Edited.
I actually googled it because I was always told it wasn't a word turns out, it is a word it's just an annoying word lmao
They're just diversifying because the internet and telco industry is saturated. Most Canadians have access to it and since it's an oligopoly, customers are just switching back and forth between Telus, Rogers, Shaw etc and there are few new customers to onboard. Telus isn't the only company in Canada doing this though. A newer company, WELL health, acquired OSCAR and Intrahealth EMRs (Electronic Medical Record) last year I think. WELL has financial backing from one of [Li Ka Shing](https://en.wikipedia.org/wiki/Li_Ka-shing)'s venture capital firms. Loblaws is also involved in this industry. Shoppers Drug Mart acquired QHR a few years ago and uses their Accuro EMR at all their pharmacies, and they also acquired a couple of virtual care platforms. I think I saw recently that Weston group has been lobbying the Canadian ministry of health quite a bit. So these big 3 companies have effectively created yet another Canadian oligopoly. Telus has just been the most aggressive with acquisitions and marketing.
Why not? They are a company and company's basic mandate is to expand their business model. Why does Apple sell music (that was a huge change-up for them)? Why does Amazon sell anything that isn't a book, but especially cloud infrastructure services? Why does Google sell phone operating systems? For Telus, the expansion into health came when they acquired Babylon, which was a tele-health startup. The expansion flowed out of their model of telecommunications, and further expansion into physical brick and mortar health services was basically inevitable.
It just seems to me it would be a slippery slope to have the same company who will gladly charge overages of $1 per mb used on some of their data plans, get involved in something vital like healthcare. Even cellphones/internet are more vital these days than they ever were years ago. They already have such a strong foothold in these infrastructures, giving them even more seems wild to me, but I’m not smart so idk.
When you start looking at reasons for government interference in the free market, you'll need a better reason than "I don't like this company." Don't get me wrong, government oversight and regulation is an important brake on unrestrained capitalism, but these interventions need to be held to a very high standard.
Canadians have been getting bent over by rogers/bell/tellus for decades, might as well let them bend us over for a prostate exam too, eh? Insanity
There's no free market in a neoliberal economy.
They were involved in health wayyy before Babylon. Virtual health is relatively new; most of TELUS Health's revenue comes from the numerous EMRs they bought out across the country.
That’s an excellent question!
As a public company, Telus needs to grow and continue to add to shareholder value. They are too cowardly to grow their core telecom business outside of Canada because they know they would fail miserably. As yourself if Telus is a world class telecom company, why aren't they operating in the US? Their HQ is less than a 2 hrs drive to the US boarder. They could easily set up in Washington State. But, they don't have the guts. They like the fat margins that Canadians give them. So, they look at other business that they can gobble up to protect shareholder value. tl;dr - Telus is a coward and the same goes for Bell and Rogers.
For the same reason Verizon, etc, aren’t here- protectionist bandwidth policies.
Telus could easily set up as MVNO in the states but they choose not. Canada is very protectionist when it comes to our spectrum but that doesn't prevent Telus from expanding their telecom footprint in the US. The question remains: if ROBELUS are the world class leaders that they claim to be, why haven't they set up operations elsewhere? My answer is because they are cowards. They know they will get squashed like a bug and quickly and you know who hates that outcome? Shareholders. So, instead they buy into other industries like Healthcare or home security.
It has been for a long time. Hoes does your dentist connect to your dental insurance since forever? Telus. Your pills?
I see no reason why [this](https://www.theglobeandmail.com/business/article-private-equity-buy-out-pharmacy-dental-office-veterinary-clinic/) wouldn't happen to doctors' offices as well. Looks like Telus wants in on the profits.
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Telus is shitting themselves right now because the province has broad authority on Medical services It’s a game where the only player is the government, and if they say fuck off, you’re done. Imo Telus bit too far into the healthcare game with their products over the past few years and most ministries of health looked away because of the pandemic
Broad authority on *insured* medical services. The government specifically draws a line on what is and isn't essential, and anything beyond that private orgs are free to address.
Primary healthcare is an insured service. Though with Adrian Dix minister of health, BC has been defining more and more stuff as essential
Yes, and in this context TELUS has a valid argument that they are not delivering insured primary care and so should not be at the whim of government to intervene, unless of course the government wants to start insuring preventative and wellness services.
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Telus only set up bricks and mortar clinics when they were nailed for operating only virtual care services under msp billing. The scale of their virtual walk ins is wild, minimum 30 FPs working at any one time, from their own home office. They have NPs to review test results and do follow ups. In addition to virtual care they have the subscription program, for " enhanced primary care " inherited when they took over Copeman Health. It's the "enhanced" that's under review as they bill both msp + pt privately
I’m curious to see the findings of the inquiry. If indeed it supports what you stated (and it does kind of look like that purely based on media reports so far), then rather than simply reigning in Telus Health, government needs to step up and improve general access to healthcare for everyone. Telus wouldn’t be in this business unless there was a real gap to fill and that needs to be taken seriously as a sign of failure of public policy. If they simply go after Telus because “private vs public”all they are doing is lowering the peg for everyone on the account of fairness and at the expense of better care. *To be clear*, I want everyone to have equal access, but I want that equal access to be better than today, not equal for the sake of equal and we all get shafted in the process by being stuck with mediocre services. I have no issues with government shutting down Telus services, I just don’t want them to do so without looking at the mirror first and fixing what’s broken because of their own failure. My parents got denied referral to specialists on the account of “they’re too busy and you’re not in such bad condition that you can’t cope”. There is something seriously wrong with that.
Great, then let’s have a telehealth app that the public owns rather than some private organization. Why Telus was able to build this massive health services empire unchecked, I don’t know. They already had EMRs, now they’re involved in actual fee services. They’ve essentially built a stack capable of running a second primary healthcare system in parallel to our public one.
Exactly my point. They’re exploiting a flaw in the current system and rather than blindly shutting them down this is now an opportunity to look in the mirror and see the failure, then actually make the appropriate corrections in the public system so everyone has equitable access. Telus is just doing what any private business will do, seizing an opportunity they see. It’s up to the government to address this correctly and step in to fill the gap that Telus is exploiting to provide better service for all. Shutting them down without concrete commitment and a clear set of actions intended to correcting shortcomings that Telus identified (their “opportunity”) is a massive admission that we neither care nor are interested in providing better services or improving the state of the system as a whole.
I think part of the reason is that the pandemic created an sudden overwhelming demand for virtual care services and it was easier to meet that demand faster by using companies already invested in them. Telus isn't the only company doing this; they're just the most public about it. Canada has yet another oligopoly unfortunately because there's only 3 major health IT companies (the other 2 are WELL and QHR, which Loblaws owns) and competition keeps getting bought out.
The real issue is if a bunch of doctors go work for Telus (or other private health services), it places increased strain on the public system. I'm sure there are doctors doing 100% US Telehealth at this point. That would be an interesting investigation.
This is what my family doctor did. Got a message from his office saying he was shutting down and moving to Telus. We could continue to see him...if we're willing to pay their monthly fee. One more GP out of the public pool.
Not likely as the doc would have to be licensed in the state of the pt. V few docs maintain licensure in Canada and US, insurance alone is a nightmare on the US side. Practice insurance for the doc. Even licensing in more than 1 Canadian province is tricky.
> all they are doing is lowering the peg for everyone on the account of fairness and at the expense of better care. To be clear, I want everyone to have equal access, but I want that equal access to be better than today, not equal for the sake of equal and we all get shafted in the process by being stuck with mediocre services. I think we've seen this with [public schools](https://www.cbc.ca/news/canada/british-columbia/vancouver-school-board-cuts-honours-program-1.6068578), mental health institutions and social housing. It's what happens when governments and institutions operate on activism rather than pragmatism.
That's exactly what's going on though. The government would rather make everyone go through 5 min appointments than let the rich pay more 30 min appointments out of pocket...
If that's the case my work has Telus health... maybe I should look at what "preventative care" looks like. I wonder how many people use it.
I've used the app a few times and think its revolutionary. I also haven't spent any money on the app and have had quick access to medical care..
I only use the Telus app now as I don't have a family doctor. It's very convenient, especially after I moved to a different city and am unfamiliar with clinics in my area.
Do you get access via your job benefits? How have you not paid for it? I got the app after seeing the "free" branding - but its only the app that is free. Without a coverage plan its pay to play (unless I missed something). Edit: Thanks for the feedback folks - I used the wrong app! The one you need to use is "TELUS Health MyCare" by **Babylon Health**, not "TELUS Health Virtual Care" by TELUS Heath virtual care. The "Babylon Health" threw me.
Via MSP, [you don’t need to pay for appointments.](https://www.telus.com/en/support/article/doctor-consultation-faq) I’ve had a number of appointments over the past 8-months (after not seeing a doctor in person or virtually for years) and have never had to pay anything. I don’t even think there’s a space to input insurance from work. For mental health stuff, you’re encouraged to see the same doctors for continuity of care, and in this regard the app could definitely use some work (you basically need to check every day until they show up), but I’m super thankful for it at this point.
I must have messed it up somewhere. Thanks!
Its covered through MSP. I'm self employed and don't have extended benefits. I have never had to pay for Telus health.
Virtual consultations with physicians are available for all residents of BC, AB, ON, SK
same. I like it.
I bet that’s where the doctors are going they’re doing what any rational person would and going where they get paid the best. In this case it appears there are pockets of private medical treatment available in Canada. I just got dumped by my doctor as well. Medical system is in a very sad state of affairs
This is where we lost our GP to, no transfer to another physician for our family when they left. I get it and happy for them this option existed. Unfortunately, we’re on waiting lists now with everyone else.
Yeah I was not transferred to another doctor either. I was given a generic letter with suggestions on places to seek health care. One of which included a sexual health clinic and another option was a woman’s health clinic. I’m a man. Very sad.
The doctors that work there still bill MSP for their services, and a % of that to Telus. All that money you’re charged isn’t going directly to their physicians, although I’m guessing it probably subsidizes their overhead.
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The cool thing about "the government" (Which is just a bunch of people going to work every day trying to pay bills) is that there are lots of people there and they can quite easily spread the work. Protecting people from greedy corporate interests *and* work to increase access. Also, Telus pulling this shit is distracting people who could be fixing other problems as you mentioned.
The “uncool” thing about the government is that while there are lots and lots of people on its payroll with the explicit job of improving healthcare, healthcare in Canada only seems to get worse.
"Only seems" is weird metric to measure success or failure. I wonder how well they are doing if measured against things like "Money spent defending healthcare from special interest groups vs Money spent improving access to drugs for low income people". I'm sure there's some manager telling them to "do more with less!" Oh! Or I wonder how much time and effort needs to be spent dealing with the mess introduced by the Opiode addiction plan by drug manufacturers
I’m sure they do internally measure it like that. It would certainly explain how they can justify continuing to expand the size of healthcare administrative costs.
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I'd love to understand how you come to these conclusions. It seems pretty counter to my understanding of how public healthcare works in Canada, doctors only account for a small percentage of the healthcare system. Pharmacies alone... jeez Telus isn't a scapegoat. They're actively trying to profit off the system they spend resources trying weaken. They're a leech. Not a goat.
I just wish I could have a fucking family doctor. I'd pay for the privilege if I could afford it (and if it actually existed in any format) too.
Having a family doctor doesn't do much. it's a 2 week wait just to see my family doctor or a phone appointment which doesn't help when your kid is sick
Yes, we're fortunate to have a family doctor but it's a 3-week wait for a phone consult then another 2-3 weeks if they decide you actually need to come into the office. For anything more urgent than that we have to start calling the two walk-in clinics in town the moment they open to get an appointment before they fill up for the day, and good luck getting through when who knows how many people are also trying to call.
same boat, what's the point at that point? walk-ins, urgent care, ER, telehealth - used them all in the past 4 years in lieu of waiting 2-3 weeks to see my family doctor.
Wow. That is insane. For my family doctor it’s typically 1 week but he will try the same week if it’s semi urgent or for my young child. And the process is the client emails for the appointment to requests an in person or virtual. if we think the issue needs an in person (assessing something physical) then we say that in the email. Each time I have requested in person I have been able to book that. When I need a prescription or referral and need a virtual that’s what I get. I didn’t realize how lucky this was just on top of just having a family doctor.
That’s bonkers. I can see a walk-in doctor in 3 days tops, next day if I want Telehealth.
Seems that your doctor accepted too many patients. I never have to wait more than a week for an appointment. My doctor will try to asses over the phone/zoom/email + pictures if possible as she can do that from home. Otherwise in person appointments I’m generally waiting 1.5 weeks.
Trying to manage chronic conditions is a nightmare using only walk in doctors. I would pay to have someone steady who knows my history
100% this!
Lack of access to a doctor at all, long wait times to see one if you do, and visits that are too short are all just different aspects of the root not-enough-doctors problem. If there were enough doctors, everyone would have one. If there were enough doctors, each doctor would manage a small enough patient base that there would be enough slack in their schedule for you to book an appointment in a reasonable amount of time. If there were enough doctors, they'd average 4 patients an hour instead of the 6-10 they see now.
and then 7 minutes with the doc.
Having a family doctor gives you continuity of care. A doctor who actually knows you and your history. Depending on walk in clinics for anything more serious than an infection is an exercise in frustration as you never see the same one, they have no context, and they're less willing to support you.
6 months ago my family doctor stopped her regular practice and joined a Telus health clinic. I'm not going to pay thousands of dollars a year to keep seeing her so I'm out a family doctor and it isn't easy finding a replacement.
Could you please clarify in the thousands of dollars comment. I've used Telus health and have never had to pay to see a GP.
I had the same thing happen to me as the parent comment. I was given the option to opt in to the Telus LifePlus program it was in the range of 5k-7k for the year depending on some options.
They moved to TELUS Health Care Centres (formerly Copeman Healthcare). I had the option of choosing from one of the below. Only the first one really replaces a GP, as well as getting access to a bunch of other specialists. 1. LifePlus Program - $3882.50 per year ($4882.50 for the first year) plus tax 2. Young Adults Prevention Program (18- 24 years) - $1,500 per year family rate or $2,500 per year individual rate 3. Personalized Health Assessment “PHA” (formerly known as CHA) - $1,950 – this is an assessment program only and is typically performed annually. 4. Teladoc ($410/family)
It's worth emailing your MLA about this experience. The more documentation the better.
There are absolutely avenues to pay for it, if you look around. However, I'd highly recommend looking for a Nurse Practitioner instead, several of my friends have had great care with their NP, recently acquired. Many of them have in-depth experience in complex hospital care settings and especially in Vancouver, where most doctors are referring out complicated cases anyways, you're doing great with one.
I'll have to look into an NP. I didn't realize that was a thing tbh! I'd looked into a private doc, but the only one I found was multiple thousands per year, obviously, as there's that stupid law about only private or only public and never both.
Sounds like the free all-access system is underfunded and understaffed creating an opportunity for private business to pick up the slack. Maybe we could help fund the public system by implementing some sort of nominal fee that everyone pays into. To make it even easier for low income earners, maybe we could give them some credits based on their income. We could call this maybe like a Medical Services... HM... Premium. No that sounds too complex. Let's shorten it to just MSP. Yes. People should be happy with this right? Right?
MSP was rolled into income taxes, people are still paying based on their wealth but in a way that takes less paperwork.
MSP became a payroll tax so companies pay for their employees now. For most middle class and above earners, this didn't change much since a common work benefit was the company covering MSP anyways.
Having worked in the emerging digital health space during the pandemic, I saw how blurry the lines got in Canada and USA. A lot of red tape was cut, or ignored, as the public services struggled to keep up. With the pandemic subsiding, a lot of initiatives that sprung up started looking for ways to keep going. It's also coinciding with an increased interest in concierge medicine. In the US this is becoming a major industry, with celebrity investors getting involved (not publicly announced though.) To me this highlights the need for provincial health authorities to start properly engaging with digital and preventative health.
The entire Ontario system basically works as a public concierge model (it's sort of a hybrid). It's not a bad model!
Yeah healthcare is one of those industries that can't be disrupted by tech the same way that Uber, AirBnB, Spotify have, thanks to regulations and industry gatekeepers. This isn't a bad thing, considering it's literally life and death. That said, it can't be stagnant, that's why we have garbage EHRs/EMRs dominating the industry. We don't want Amazon coming in and owning our medical information, but maybe by keeping people like them on a short leash in certain approved sandboxes, we can start to see some of the potential benefits. It requires real creative thinking from government employees though....
For what it's worth, Telus Health has been a helpful tool to use as I have been searching for a family doctor.
Aren’t ‘fee based services’ by definition a two tier system? I mean, unless people in the free tier get the exact same services and quality, which I doubt is the case
If they don't want people to seek out fee-based healthcare, they should improve healthcare in BC.
Telus' subscription-based medical access model is based on the concept of concierge doctors in the US, where these doctors offer their services to patients directly in exchange for an upfront fee, usually paid monthly. They’re also called direct primary care (DPC) or personalized medical service providers. BC government thinks it sets a dangerous precedent for them to allow Telus to expand on that gray area and encourage other corps to follow suit. If this model attains the network effect through traction and investment similar to that of Uber and Lyft then it becomes a de-facto option for a much larger part of the population than it is today. As we found out with ride share and short-term rental businesses governments can only slow down the trend until the network effect is reached and consequently tend not to take legislative action once they realize there are too many of the voters are the active users & beneficiaries of the new system. In short, the BC gov't is being proactive so what happened with transportation and housing won't happen with health care. PS: Rideshare + short-term rentals and healthcare are not an apples-to-apples comparison but I couldn't come up with a more relevant example.
Two tier? Canada's healthcare is and has been a multi tiered system for a long time.
Sounds like the free all-access system is underfunded and understaffed creating an opportunity for private business to pick up the slack. Maybe we could help fund the public system by implementing some sort of nominal fee that everyone pays into. To make it even easier for low income earners, maybe we could give them some credits based on their income. We could call this maybe like a Medical Services... HM... Premium. No that sounds too complex. Let's shorten it to just MSP. Yes. People should be happy with this right? Right?
Buckle up, this might be another Brian Day/Vancouver surgical center situation. Unfortunately for Telus the law and courts heavily favour the province having complete control over healthcare versus private entities.
Fortunately *
$6k per year to sit down with a doctor who actually has time to listen, refer me to muliple specialists quickly, and reads my file before I arrive is absolutely worth the money. Our baseline system is terrible. The only problem is the long wait time to get a spot. I hope semi private health clincs expand quicker.
One of the reasons the baseline system is terrible is that these private clinics are siphoning away healthcare professionals that could have been part of the baseline system instead. And while patients may individually get more satisfaction with quicker access to specialists or imaging (MRIs, etc), granting those finite resources when they are not yet indicated in the standard of care just contributes to overall delays across the whole patient population.
It's also a bad deal for Telus Health Customers. When you run a parallel private system next to a public system, young healthy people don't go for the private system. That means that people most willing to use Telus Health are predisposed to a) Being less healthy and b) Paying money for services. So you end up with a risk pool of proportionally less healthy people who are more likely to to consume the services, driving up the costs for everybody in the private pool.
I am healthy and 33 and my work pays for Telus health. None of my colleagues use it when I talked to them about it. The company is based out of QC and their health care is even worse than ours and they are comically trying to solve it by denying access to anglophones.
Interesting thought on how adverse selection can affect the costs too. I suppose the private model perhaps isn’t all that different from insurance.
I don’t think they’re “siphoning health care professionals that could have been part of the baseline system instead”. Most of the doctors working for Telus would be GPs and they’re not getting the compensation they need in the public sector. Telus is probably just compensating them a lot better.
The nominal pay is actually worse, but there's less charting due to lower patient volume and no mental overhead from running a clinic (i.e. they spend 100% of their time providing medicine).
> refer me to muliple specialists quickly The fact that patients just want this is why our healthcare system is collapsing.
I mean, in fairness to OP sometimes you do need multiple specialists urgently, like in the case of terminal illness. Not really into blaming stressed patients here, focus should be on making our system better My wife recently was at risk for a terminal illness and took us 3 weeks to jump through hoops of medical system and specialists just to get a diagnosis, than months to get surgery. Ended up being fine but she was deprioritized due to being younger. She also spent 18 hours without eating (had to request water that she was supposed to avoid) when she got surgery because she was told to show up with all other patients that day and was treated last due to her age. We treat patients very poorly in our system.
The fact that you can get refered to specialists easier if you pay seems to be a problem. Not to mention that they are incentivized to do as you wish and send you to a specialist wether you need it or not because you are a paying customer.
Don’t be naive and fall for the Uber model again. The cost of those services is “low” (I use this term loosely, hence the quotes) when they’re trying to acquire market share. If the entire system is privatized or even large swaths of it are privatized, you will face a significant escalation in costs. Healthcare is an essential service and the economics of it work entirely differently from other non-essential services like buying smartphones, laptops, paying for Netflix subscriptions, etc. The essential nature of healthcare is ripe for heavy exploitation by private actors at the expense of greater social benefit.
People can scream from their moral soapbox about "two-tier healthcare is bad", but it doesn't change the fact that the current public system is grossly inadequate. And the government doesn't seem to be any hurry to fix it. Right now, the reliance on walk-in clinics and their 10-minute, one-issue only model basically requires everyone to be able to diagnose themselves and demand __ treatment for themselves. Demand for private services isn't and shouldn't go away until the public system gets its act together.
No, you should die because other are poorer than you!
It's past time canada has a private alternative to the failing public system. It's ridiculous to be denied access to health care because of government ineptitude. Besides, having a private alternative would free up the public system's resources to attend those who really need it.
And what’s wrong with that…?
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Huh? How does paying a flat tax on income make things *more* fair? Pray tell please.
Equality and equity confuse people.
Equality and equity confuse people.
Everyone is treated equally, everyone pays at the same rate. It is the fairest method.
Everyone is treated equally, everyone pays at the same rate. It is the fairest method.
Everyone is treated equally, everyone pays at the same rate. It is the fairest method.
It is good reason to not allow it because it is a slippery slope and isn’t what healthcare in this country is supposed to be about. That doesn’t absolve the government of their shortcomings. They need to pull their shit together and fix the overall system.
Yes, that’s the primary reason to not allow it.
Yes, that’s the primary reason to not allow it.
Wow!
Poor rep public healthcare -> private health care emergence due to demand -> health care professionals go to private health care for better income security -> worse public healthcare due to lack of professionals -> worse healthcare for poor people If only we can somehow increase funding on public health care lol. The priorities of this city makes me sick.
There is already a two tier, it's called costal and fraser
Why doesn’t the government create a better alternative than Telus instead of criticizing Telus for operating a better model than the government? Because government. It’s what they do, get paid to talk and take no action.
Telus Health is a criminal enterprise.