BC and Drug Coverage

Fair Pharmacare
I recently did some analysis of the BC health care coverage for prescription medications for treating HIV. To my surprise, it would appear that none of them are covered under the provincial prescription drug plan.

Why did I find this surprising?  Because this is the very basis of the decision by CIC to refuse my original application.  But the teensy detail they failed to mention (and I hadn’t fully grasped) is that in order to obtain “free” medications in British Columbia you must enroll in the grand medical/social experiment.  In doing so your detailed medical information is provided to the Centre for Excellence for whatever use they deem.

Further, as it turns out, the Centre for Excellence maintains a strict policy with respect to treatment options.  So if your doctor thinks you would be better served by a different treatment option than the ones permitted she probably won’t even mention it to you because she knows it won’t be permitted by this group.

Thus, gaining access to this “free treatment” isn’t part of the health care policy, but rather it is in exchange for agreeing to be a guinea pig in this large medical experiment.  It seems to be a harsh basis for a refusal simply because there is a research group that will permit you to trade your medical privacy (so they can obtain something of value from it) in exchange for “free medication”.   That sure looks more like the normal arrangement for medical experiments.

Thus, it would seem that CIC’s position is that if there’s someone out there that obtains governmental funding for doing research and you might be willing to exchange something of value (your right to the best treatment option for you specifically and your medical privacy rights) for something that might also be helpful to you, then you’re just ineligible to come to Canada in an economic class – well, at least for British Columbia.

I wish I had known about the nuances of how the system worked several years ago, because this would have been a rather interesting conversation: anyone who doesn’t want to participate in the experimental study group has no coverage.  None of the drugs I checked were covered by Fair Pharmacare, which means they don’t count against the cost limit ($10k maximum, lower amounts based on income).  Thus, they cannot create excessive demand.

And if someone does wish to participate in the experimental study group they can do so – but it’s a standard commercial exchange.  The study group does receive governmental funding, but those funds are used as a quid-pro-quo for something else of value.


The Never Ending Story

While my own journey through the quagmire of Medical Inadmissibility has come to an end (at least for now) I am glad to be hearing from those who are going through the process.

I have been surprised when I read the posts of people who are in a similar situation to mine and the vitriolic comments in public forums about them – either that or often a complete lack of response.  It is clear to me that this is a poorly understood area, with a dearth of empathy or understanding from those not impacted by it.

One recent positive step has been that CIC has published new information about the medical examination process.  This includes new forms, new processes and links to a sample from the “Panel Physician Handbook” – apparently the final handbook is not yet complete.  The information there is useful, especially for people trying to understand the initial part of the Canadian Immigration medical examination process.

Revisionist History


Yesterday was the deadline for the government to file any remaining affidavits in the case and they availed themselves of the opportunity by filing one.  Today I had an opportunity to read the actual affidavit, although I am waiting for copies of the exhibits attached to the affidavit.

In this case, it was the medical officer.  On first reading, I must admit, it was actually somewhat convincing that she had actually done some real thinking before reaching her decision.  Admittedly, there are some flaws in that rationale, but after mulling it over for some time, I realized that there’s one thing missing from all of this: what she’s saying isn’t supported by the written record.  Thus, she is now supplementing her original written decision.  That’s not supposed to happen.  I have read numerous legal decisions and I’ve never read one in which it was the government adding new material to the record.  I have read decisions in which the judge pointedly ignores new material submitted by the applicant, precisely because it is not material that was part of the original decision under review – and hence irrelevant.  Thus, I would think the government cannot correct the record “after the fact” any more than I could do so.  This is especially galling since they refused to consider information I actually submitted before they made their decision – “oh, sorry, we didn’t get that.”

So, she provides a nice rationale about how she thought insurance companies wouldn’t pay for medication when they found out that the provincial government had a program for doing so.  She doesn’t offer any evidence of this, merely just her theory.  While that sounds great, I realized that even if you accepted that rationale, it doesn’t explain her rejection of the private health care reimbursement program – known as a PHSP – which (at $20,000 per year) would still have been more than sufficient to pay the anticipated drug costs and which isn’t an insurance company – it’s an employer sponsored expense reimbursement plan.

Had she come back and expressed these concerns, we could have provided her with further evidence.  I could have offered to opt out of the provincial health care plan, which in turn would then have made me ineligible for the very coverage she used to ban me.

Then I can see the clear influence of the government’s attorney – the medical officer claims she signed off on the new medical opinion, and that – voila – i am no longer medically inadmissible.  Of course, she fails to mention that the medical opinion upon which she bases her decision is not even valid for my original case and cannot be used to make the decision in my case.

However, the fact the government is playing this game does tell me one thing: that for whatever reason, the government is actually worried they will lose on the merits.  This nonsense about alternatives and what-not have no bearing on the original decision, they are red herrings intent upon distracting the Court.

My expectation is that the Court will see through this ruse, step back and say “this is all interesting, but it doesn’t repair the original decision, which is defective.”  Even if you accept the affidavit from the medical officer, it says there were hidden concerns that were never expressed.   That would mean the fairness letter wasn’t detailed enough for us to successfully address the concerns.  That would violate the natural fairness required by the process.

That’s giving her the benefit of the doubt.  What seems more likely is that the medical officer is trying to cover her tracks after the fact.  I suspect she just looked at the material and said “none of this changes the medical diagnosis, so I don’t really care.”

We’re now just 1.5 months away from the hearing date.  We will find out after that.