We can pay for private medical care?

Hello Flatlanders,

I wanted to dedicate this issue to reader feedback about some recent issues of The Flatlander, as there’s been a lot coming in lately.

When it comes to the issue I wrote about family doctors (I need to find a family doctor… again), Carmen wrote in to talk about the challenges her family’s been having with finding a family doctor:

We’re in Regina… and are also struggling to find a family doctor that we really connect with. We had found a good doctor at the Northgate Medical Clinic, but he moved to Ontario a few months after we started with him, and we’ve been “adopted” by another doctor at that clinic but our interactions with her have been short and superficial. We’ve been leaning on the private nurse practitioner … as she can do prescriptions and order tests, but that’s an expensive solution. I wasn’t aware of that $30/patient issue, and it may help explain some of the problems my mom (who has a wide range of health issues) has had in getting attention and support from her family doctor… I wish there was some way that… clinics could pool their administration needs and help one another out.

Apparently, you can pay for private medical care in Saskatchewan and Manitoba

What caught my attention in Carmen’s email was why is a nurse practitioner an expensive solution? Shouldn’t it be covered by Saskatchewan Health?

I looked into it, and there are private clinics, like Nero’s House, in Regina, run by a nurse practitioner, who charges the patient $150 out of pocket for an hour-long consultation. It’s $90 for 30-minute episodic care, if you have something routine, like a bladder infection or a prescription refill.

Apparently, in Saskatchewan, nurse practitioners, who can do a lot of the same work as doctors, cannot directly bill the Ministry of Health for their patient services, so if you go to a nurse practitioner at their clinic, like you would a family doctor, and essentially get the same treatment, it is a non-insured health benefit, similar to seeing a massage therapist or a dentist. Depending on your private insurance, if you have it, this may be covered.

It’s not exactly like that in Alberta or Manitoba

When you go to find a doctor in Alberta, you can get connected with a nurse practitioner, instead of a doctor, through the province’s primary care network and it’s covered by Alberta Health. This is the same in Manitoba if you use the family doctor finder service. When you use the Saskatchewan find a doctor website, it seems to only recommend physicians, however.

That said, there are some Manitoba nurse practitioners seeing patients privately and charging them out of pocket too.

Eroding our health care system

It looks like there is a loophole in federal health care insurance legislation dating back to the 1980s that allows for nurse practitioners to offer a private fee for service. There is no legislation or regulation under the Canada Health Act that prevents nurse practitioners from working privately. 

The Manitoba Nurses Union doesn’t like these private services because the province has a shortage of private nurse practitioners and they’re concerned these private clinics will poach these professionals from an already stretched private clinic.

A medical cooperative?

Now when it comes to Carmen’s point about family doctor offices pooling their resources, I did find an example of this being done at the Saskatoon Community Clinic. It has foundation support and uses a cooperative model, so nurse practitioners are able to see patients, like a doctor would, without having to directly bill the patient or worry about billing the Saskatchewan government. The clinic is not accepting new patients though…

Questions about how doctors are paid

Larry wrote in about the issue of fee per patient:

Who sets this fee structure? Is it a result of the medical associations seeking compensation for the specialists, or is it an attempt by governments (since it is happening across the country) to reduce costs? and does this low remuneration schedule for family practitioners represent an attempt, either by governments or the medical association, to shift towards drop-in, quick fix clinical practices with specialist picking up the primary medical response on a disease or injury focused basis?

Rhea also wanted to know more about how doctors are paid and what the possibilities are for a different pay structure to keep the focus on patient wellness instead of patient volume.  

Great questions and I’ll continue to investigate.

The housing market on the Prairies is evolving

In regard to the May 3 Flatlander issue on housing prices: “Some houses are going $100,000 over the asking price,” one reader wrote the following:

Thanks very much for this most recent piece on the real estate market in the prairies. It very much reflects our experience house shopping here in Saskatoon — we found out that the house we bid on recently, and didn’t get, actually sold for $80,000 over asking… We are also finding that much of what is out there is, indeed, in need of significant updates, as you described. This Epic Alliance fiasco is quite interesting and am hoping these properties will be released on the market soon and level out the playing field a bit for us poor buyers.

This isn’t Toronto…

From my own recent experience, while my husband and I were buying a house in Moose Jaw, the real estate agent tried to pull us into a bidding war, as houses in our price range are selling within a few days of being listed. Sometimes they sell the same day.

We were like this isn’t Toronto and walked away from the bidding war before it started. According to our real estate agent, the house only sold for $5,000 over asking and we weren’t the only buyers not interested in getting in a multiple-offer situation, as we were told other buyers also passed.

In the end, we bought another house we liked better for $10,000 off the asking price. It had been on the market for a whole six days, so maybe the sellers were starting to get nervous and were more willing to negotiate.

Even in my remote(ish) community, houses can sell fast

Weirdly enough, our house that we just sold near the border of Saskatchewan and Alberta, about 20 minutes away from Pierceland, SK, sold within 24 hours of listing. We got our asking price too.

We listed higher, expecting we would have to come down in price, because who wants to live four hours north of Saskatoon? And the market is supposedly depressed in my current area by five per cent. Now I’m wondering if we should have listed higher…

Saskatchewan needs 142,000 houses to meet demand

Scrolling through the news tonight, I came across this story about how Saskatchewan needs to build about 142,000 new houses over the next eight years to keep up with demand, and the growing population. Otherwise, housing will become completely unaffordable, according to the both the Saskatchewan Realtors Association and the Saskatoon & Region Home Builders’ Association.

There are no immediate plans to build these new houses, however, as the political will is lacking.

A housing market slowdown in Manitoba?  

Meanwhile trends have changed slightly in Manitoba since I wrote the issue on housing two weeks ago… well sort of…

In the May 3 issue of The Flatlander, I noted that high demand in Winnipeg for houses and low supply were driving prices up, but it seems like since then the supply is starting to catch up with demand. More houses are coming onto the market this month while sales are slowing.

Prices haven’t adjusted to reflect this yet though. The average home in Winnipeg is going for $435,262 on average this year, instead of the $331,841 average from last year.

Looking at the Winnipeg market the other day, I noticed many real estate agents are encouraging bidding wars by adding a statement in the listing about how offers will be presented to the seller on such and such a date.

Although there is no bidding war being set up for this $8.5 million home.

Curiously, although Winnipeg has been experiencing low supply for the average family home; there are a lot of new builds way outside that price point in Tuxedo. You can have a home built there for $1.5 million.  

On gun violence

There were a lot of great reader comments and questions about last week’s issue on gun violence on the Prairies, and how strict gun legislation should or shouldn’t be legislated.

If you didn’t get a chance to read it, I’d encourage you to go back and check it out.

It’s an issue that some Flatlander readers are passionate about, and I will share that feedback on this issue later, as it can take a few weeks for people to write in, and I want to make sure I don’t miss any comments as I learn so much from readers.

Five stories from Manitoba you may have missed

1. Industry in peril: Manitoba bee farmers suffer big losses due to bad weather
2. ‘It’s a number we’re not proud of’: Winnipeg hits 20 homicides by mid-May
3. Need for sandbaggers in Minnedosa grows during ‘absolutely terrifying’ flood, business owner says
4. Red River College Polytech makes changes after trans student’s human rights complaint
5. Some Winnipeg patients sick enough for hospital admission waiting days for in-patient bed

Five stories from Saskatchewan you may have missed

1. Photos, videos show apparent tornado touch down in southern Sask.
2. Sask. ICU doctor leaving province partly due to Premier Moe’s ‘failed leadership’ during pandemic
3. Humboldt applies for government help to fund $35M Broncos tribute centre
4. Trends show fewer farms, aging population of farmers in Sask.: StatsCan
5. Sask. government rejects new committee to address suicide

Photo of the week

Until next week…

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Thanks for reading, and kind regards,

Kelly-Anne Riess