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Curbing the High Cost of Highway Medicine in Manitoba

April 12, 2015 10:09 AM | Columns

By Kate Jackman-Atkinson, myWestman

STARS Air Ambulance - Belmont

STARS Air Ambulance lands on a gravel road near Belmont, Manitoba on Saturday, August 24, 2013 during one of its busiest days in the province. (STARS / HANDOUT)

Across southwestern Manitoba, rural medicine is changing. Most communities are desperately short of family physicians and many people have to travel out of town to see a doctor. Some communities are seeing temporary or permanent closures of their emergency rooms because there aren’t enough staff to operate them. Rural medicine in changing and for many Manitobans, one thing is clear, we will be travelling further for health services.

The good news is that emergency medical services have been evolving and changing along with the changes in rural health care. In Neepawa, like in other communities, the ambulance used to be run by the local funeral home. Today, an ambulance, whether on the ground or in the air, looks a lot like a hospital. The EMS staff are trained to deal with all manner of medical emergency and have the tools at their finger tips treat trauma or keep a patient alive until until they can reach a medical facility.

It’s a good thing. While the NDP vowed to end hallway medicine, increasingly, Manitobans are subjected to highway medicine.

Emergency medical services have stepped in to fill the void left by staffing shortages at hospitals and we are in good hands. But there is a problem, unlike walking into your local hospital’s emergency room, an ambulance ride isn’t free.

Manitoba Health will only cover ambulance trips if they are medically-necessary inter-facility transports. This means that the ride is only covered if the patient is being transported between designated healthcare facilities for diagnostic tests or treatment, or from a more specialized level of care to another facility closer to home for rehabilitation or recovery. The province does cover air ambulance transfers, but the patient is still responsible for ground transportation.

According to the CBC, Manitobans pay the highest ambulance rates in the country. Their investigation showed that the most expensive flat rate fee, $530 a trip, was charged in the Prairie Mountain Health region. Winnipeg wasn’t far behind with a flat rate of $512 a trip.

In most other Canadian provinces, it costs less than $200 a trip, unless it’s especially long or the trip is deemed medically unnecessary. In Ontario, all medically necessary ambulance trips cost just $45. In Alberta, it costs $385 to be taken to hospital and $250 to be treated at the scene.

The high cost of ambulance trips has a direct impact on the treatment decisions made by Manitobans. People weigh the costs of that ambulance ride and many opt to find their own transportation. There are cases of parents receiving bills totalling more than $5,000 for ambulance trips for their sick child and in one case, an elderly Manitoba woman walked to the hospital in -40°C weather because the cost of an ambulance was too high.

While many Manitobans have private insurance plans that cover the cost of ambulance rides, the unemployed and the elderly don’t generally have this safety net. The cost burden falls most heavily on those whose who can least afford it.

The Manitoba government can’t fund all areas of health and even at a cost of $530 per trip, Manitobans aren’t shouldering the whole cost of their ambulance rides. But when rural Manitobans are being told that their emergency medical needs will increasingly be met by emergency medical services, this high cost is unacceptable. Medically necessary ambulance rides are an integral part of rural medicine and keeping Manitobans healthy. We all pay for health care in the province and when it comes to preventative medicine and positive outcomes in emergency situations, increased funding of ambulance trips is crucial.

The first few minutes of medical treatment or the ability to treat a worsening condition can mean the difference between life and death. In Canada, we shouldn’t be making these decisions for our loved ones or ourselves based solely on cost.