Back in April, with some puffery, Health Minister Randy Delorey heralded the government’s compassion in providing travel and related funding for Nova Scotians who have to go out-of-province to receive medical care that’s not available in Nova Scotia.
“I can appreciate the toll it must take to be away from home for medical care,” Delorey sympathized, adding people should be able to focus on their recovery without the added worry of travel expenses. He said the province would cover those costs, up to certain limits.
Not three months later, and a Pictou County man, who’s been waiting more than two years — partly because of bureaucratic foot-dragging — for a surgical procedure that’s insured in Nova Scotia but not performed in the province, has been told that, while the operation is covered, his travel expenses won’t be.
The decision to disallow his travel costs — which fall well within the province’s allowable limits — may be capricious, arbitrary or simply mean-spirited, but with the stroke of a bureaucratic pen, the province and MSI plunged the 47-year-old man whose deteriorating hips have kept him off work for the past two-plus years, into deeper financial despair.
Robert — his family name is omitted to protect their privacy — had worked his entire adult life to put food on the table for his family of five, and to try to save a little for the kids’ education.
But, more than two years ago, with increasing pain in his hip, he saw an orthopedic surgeon in New Glasgow who determined Robert was a good candidate for hip resurfacing. A referral was made to a surgeon in London, Ont., who is skilled in the operation, and the Ontario surgeon concurred that Robert was an excellent candidate for what’s called metal-on-metal (MOM) hip resurfacing arthroplasty (HRA).
Here’s where the columnist steps out on thin ice. Some Nova Scotian orthopedic surgeons, including some with considerable clout, are not fans of MOM HRA and consider the total hip replacements that are performed daily in Nova Scotia to be the way to go.
However, many jurisdictions — Ontario included — accept hip resurfacing as a preferred treatment in certain, limited cases always involving younger patients. British tennis star Andy Murray had MOM HRA surgery in January and completed his return to his sport by winning the Queen's Club doubles title six months later. That would not have been possible had he undergone a total hip replacement.
Robert hopes the resurfacing operation will allow him to return to work. He does hard, physical labour and, like his doctor, believes MOM HRA offers him a better chance to go back to work than would a total hip replacement.
Robert and his New Glasgow doctor jumped through all the hoops to gain the necessary approvals for out-of-province medical care. He travelled to Ontario in June for an appointment with the surgeon there and his surgery was scheduled for August.
It was only when he submitted the required proof of travel for reimbursement that he discovered his travel costs would not be covered.
The Department of Health had this to say: “Referral requests for procedures that are not insured in Nova Scotia and not recommended as the standard of care by clinicians and the Nova Scotia Health Authority are not eligible for travel assistance.”
Robert was pre-approved for the procedure, which is an insured service in Nova Scotia, so the government is obviously relying on the “recommended ... standard of care by clinicians and the Nova Scotia Heath Authority” as the reason to deny him travel assistance.
They just waited until after he incurred costs that he can ill afford before they bothered to tell him.