Researchers are calling on the province to create a stable source of travel and housing funding for rural British Columbians needing medical treatments such as organ transplants in Vancouver.
The appeal came during the Union of British Columbia Municipalities 2024 Convention underway in Vancouver. A clinic titled Bridging the Gap: Innovative Solutions for Rural Healthcare included presentations from Jude Kornelsen, co-director for the Centre for Rural Health Research and Jacqueline Podewils, co-chair of the Lung Transplant Support.
Kornelsen, who co-authored a 2021 study into out-of-pocket costs paid by rural British Columbians travelling for medical care, presented new research that pegged the average cost of patients undergoing solid organ transplants in Vancouver at $44,624.23 (including costs for their care-givers). This figure includes costs incurred during the period before, during and after the transplant.
"So obviously, this is a substantial amount of money," Kornelsen said. She added that finding affordable and appropriate housing was the biggest challenge. "Many people also had to maintain a house in their home community," she added.
Building on Kornelsen's research, Podewils said patients undergoing transplants in Vancouver can draw on a system of supports.
"But there is a giant gap," she said. Patients undergoing lung transplants need to have an annual household income of under $50,000 to qualify for assistance for the three-month-or-longer relocation period.
"So if you are above this line, you are asked by the transplant team, quite frankly, if you can afford it," Podewils said. "(So) out of desperation, most people say yes...but that is not fair. That is not how we offer health care."
This predicament gained a face in Princeton resident Christina Derksen-Unrau. Needing a double-lung transplant, she removed herself from the transplant registry because of the financial demands of having to stay in Vancouver for up to six months.
Her story eventually earned the attention of political leaders including Premier David Eby and Penticton entrepreneur Gary Johal, who helped to cover whatever costs left uncovered by the province.
Derksen-Unrau recently underwent the procedure and shared her story, as well as a message of thanks to Johal, by video. She was due to attend the panel, but doctors advised against spending time with a large group of people at this stage in her recovery process.
Podewils also pointed to another gap — the existence of "silos" of support systems with different rules for eligibility. She called for an "umbrella" of dedicated funding that would give patients, their caregivers and their families certainty.
"Working in silos is a downfall to the patient and the system," she said.
She also pointed to other inefficiencies. For example, the ongoing practice of using "moderately priced hotels" for accommodations. A better approach would be dedicated housing for patients and caregivers close to medical facilities, she said.
"We need a better answer than expecting patients and their caregivers to spend, on average, if they are lucky, $400 a night for a hotel room," she said.
Podewils' recommendation also included calls for a provincial task force and an emergency fund for people having to travel immediately to Vancouver for transplants. She later pegged a "baseline" figure of $50 million per year in dedicated funding, subject to assessment.
"We need the task force," Kornelsen added. "There is no provincial coordination. So we have an estimate, but we don't know all the disease categories that would actually benefit from being able to stay at a place in Vancouver. We need a long-term strategy and as (Podewils) said in the recommendations, it needs dedicated patient funding."
Kornelsen also pegged the size of the emergency fund at around $8 million.
Tuesday's panel also included presentations from: Lynette Luca, director of Helicopters without Borders, which delivers health care to remote and rural communities in British Columbia; Mark Rubinstein, Chief Hope Officer of Hope Air, a national charity offering free travel and accommodations for Canadians in financial need accessing medical care far from home; and Paul Adams, executive director of B.C. Rural Health Network, a network of healthcare advocacy organizations working with healthcare policymakers.
Premier David Eby, who met with Adams as part of the UBCM convention, said during an unrelated event Wednesday (Sept. 18) that he had a commitment to the Rural Health Network to address travel and housing expenses connected to medical travel.
"There is more to do, we will have more to roll out in our platform," Eby said.
Speaking with Black Press Media Wednesday, Health Minister Adrian Dix said he has met with advocates to discuss this issue.
"Of course, we can do more," he said. He said existing medical travel programs represent an improvement upon the centralization policies of past governments, which "left a lot of patients holding the bag for greater travel." Dix pointed specifically to government's cancer travel program, "on which some of this discussion is based, including those numbers."
Government last month announced an additional $20 million over two years to the Canadian Cancer Society to support travel and lodging for cancer patients, building on $10 million announced in 2023. Dix also pointed to government plans to improve cancer care (which would reduce the need for travel) as well as ambulatory services across B.C.
Dix added that British Columbians also have to travel for other kinds of care with all transplant patients required to travel to Vancouver.
"There are a number of programs to support that," Dix said. "(The) question is how do you build that up? What's the mechanism? (We) are working on those issues as well."
