21, 1952 B.C. LUMBER WORKER From inereased benefits demanded, and recommended. No justification could be found the co-insurance charges, which the Board proposes should now be eliminated. Evidence indicated clearly that such charges “hit a man when he was down”. The hospitals were prac- tically unanimous in opposing co- insurance as it led to gross in- equities, multiplied outstanding accounts receivable, and did not curtail hospitalization abuses. If the report is implemented by the Legislature, persons in the low-income groups will be ex- empted if in the case of a single erson the income is less than 0 per annum, and for married Persons less than $1200 a year. The responsibility for payment of premiums for those so exempt- ed personally should now be as- sumed by the appropriate Gov- ernment departments, it is recom- mended. The categories referred to are se such as dependents of ex- Service men, not otherwise pro- tected by the Federal Govern- ment regulations, persons on slim retirement or investment income, and those with limited earnings. It is contended that the prin- ciple of such exemptions has al- ready been established ~for cer- tain categories, and in all justice should now be extended to all those in the lowest income bracket, especially as costs of living are increasing. 5s Chronic Cases The plight of hospital pa- tients declared to be suffering from chronic ailments is dealt with at length, with full em- phasis upon the inhumane con- sequences of existing regula- tions. It is proposed that treat- ment should continue for such patients until they are other- wise placed, provided that this ‘shall not extend more than 60 days after the case has been ruled to be chronic. Advance notice should be given of the discontinuance of benefits, it is stipulated, and in no case should rulings be made retro- active. Provision is made for the ap- pointment of a Medical Board of Review to deal with differences of opinion regarding the correct- ness. of diagnostic decisions in such cases. The Board of Review will be formed of two representa- tives of BCHIS and three to be named by the College of Physi- cians and Surgeons, it is sug- gested. 2 If in any hospitaj a surplus of beds should exist, and agreement may be reached regarding the rate between the hospital and the Social Welfare Agency, consent may be given to a special rate for cl ic cases, Inhumane Treatment ‘The intention of the authors of the report is that a stop should be put to the practice of dis- shorging chronic patients from under conditions which would cause immediate and dan- gerous deterioration. In future, as recommended, DETAILS OF . BCHIS REPORT | BCHIS patients compelled to oc- cupy private or semi-private wards through no choice of their own, will not be charged extr: for such accommodation. + Expansion of out-patient ser- vices of the hospitals is favored by the Board as likely’ to provide necessary diagnosis under condi- tions which would act as a deter- rent to bed-occupancy. 4 Board of Review The Board also proposes that the Medical Board of Review, to be established, should have _ power to authorize the use of special drugs, when vitally necessary. ‘his recommenda- tion was based on evidence . which indicated that new and expensive drugs had been with- held by BCHIS from patients in a critical condition, who were thus denied the life-say- ing advantage of new and proven scientific discoveries. Married veterans, who are themselves proteeted for hospi- talization by the Department of Veterans’ Affairs, will now, as proposed, be required to pay premiums for wives at the rate set for a single person. More adequate provision is pro- posed for those compelled to seek hospital treatment outside the province. The recommendation stipulates payment of $6.50 per day up to 30 days, and 50% of all extras ordinarily provided in the province, Student nurses under the age of 21 years should be recognized as dependents with regard to the payment of premiums, it is pro- posed. An end to any changes in premium rates or benefits during the course of a premium year is sternly frowned on by the Board as inequitable and unbusiness- like. The opinion is expressed that such changes should only start after due notice at the be- ginning of the next premium year if considered necessary. The manner in which the last two increases were enforced was shown to have caused deeply- rooted public resentment. Public Subsidy That the Provincial Govern- ment should accept greater re- sponsibility for the stability of the scheme was emphasized in the report. A long-range pro- gram should be developed, it is urged, with a definite policy and formula for Government financial support. Any deficit in the scheme beyond the con- trol of the BCHIS and the hos- pitals should be met out of Consolidated Revenue, it is recommended. This recommendation, which constitutes a major departure from former policy, is based on a citation of evidence to show that Norman M. Liles OPTOMETRIST 320 COLUMBIA ST. Phone N.W. 3521 ha IRE SPECIALISTS hospital costs have reached a point where the individual is no longer able to meet these costs in full. By the same token, it is said, no group can be expected to meet hospital costs without a subsidy. Alt thought of making the scheme self-sustaining was aban- doned by the Board as a result of the enquiry. The emphasis was Placed on iull coverage as a mat- cer of public responsibility. Another $2 Million Although the proposals of the Board will add another $2 million to the costs of the scheme, and place additional burdens on other departments of the Government, numerous recommendations were advanced to reduce expenses and increase revenue. Under the plan proposed, muni- cipalities will in future be re- quired to increase per-diem con- tributions from 70 cents per pa- tient day to $1.00 per patient day. it is pointed out that in the last 10 years no increase has been made, although hospital costs have risen sharply. Of all muni- cipal services, hospitals alone have received no increased share from local taxes, The 70 cents paid today is held to be no more than 35 cents 10 years ago, No Religions Exempted The exemption of religious groups from premium payments will be discontinued, if the re- port is accepted. The present ex- emption for Christian Scientists has led to difficulties, along with other religious groups, it is stat- ed. The opinion of the Board is that a Hospital Service is a pub- lic service on the same footing as education or highways. Similarly, steps are urged to end the exemptions for employ- ees’ medical service associations such_as those for the CPR and the B.C, Telephone, when their schemes may be incorporated into the BCHIS. ‘The Board asks that BCHIS be relieved of the cost of treatment for treaty Indians, and that ar- rangements be made for their care by the appropriate Federal Department. Full premiums should be paid to BCHIS by the Provincial Gov- ernment for all social welfare pa- tients, it is found. The costs of training schools for nurses should not be a charge against the scheme, but these should be treated as educational institutions, eligible for “grants- in aid”, from the Education De- partment, New Administration Radical changes in the ad- ministration should be directed by a Board of three members, without legislative or judicial Powers. Closer relationship be- tween the work of this Board and the Legislature is urged in the appointment of a Select Standing Committee of the Legislature to conduct an an- nual review of the affairs of BCHIS, and report to the Le: gislature. - The strengthenine of the Hos- pital Insurance Advisory Council is urged, that its purposes may be fully realized. The addition of two members of the Legislature to the Council is proposed. Other administrative changes proposed provide for the appoint- ment of a Director of Public Re- lations, an increased field staff, and the distribution of informa- tive literature regarding the regulations, ~ Stern Treatment Revenue for the scheme can be substantially increased, in the opinion of the Board, if a dete: mined effort is made to penalize registration evaders and prem- ium delinquents. It is estimated that approximately 20 percent of the population are in these two ways delinquent, This situation, it is pointed out, places an unfair burden on the law-abiding con- tributors. Magistrates are asked to ob- serve the provisions of the Act and order delinquents to pay ar- rears in addition to fines imposed. Steps are proposed to v ordinary garnishee proceedings against delinquents. The report indicates that the Board abandoned a severity to deal wit from July 1 to December 31. Half-yearly payments will be permissible, payment of no small- er portion of the annual premium is allowable. Agreement for pay- roll deductions may be made, with the employer making semi- annual remittances. It is proposed that in future all employers will be required to examine the eligibility cards, and interim receipts of persons apply- ing for employment, and report all delinquents. Employers are also required to make a semi-annual check of em- ployees’ premium payment rec- ords and report those not in good standing. This plan was adopted in pref- erence to one which would have denied employment to any per- son not registered or in arrears, A period will be allowed for delinquents to place themselves in good.standing with the scheme. Licence Conditions As a device to enforce pay- ment from self-employed per- sons, the proposal is advanced that upon.issuance of any pro- yincial Government license, proof must be given of prem- ium payments. Failure to do so will be reported to the BCHIS by the issuing authorities. A similar plan is proposed for the issuance of municipal licerises through the co-operation of the municipal authorities. Effective not later than July 1, 1952, a person seeking to place himself in good standing will be required to pay a sum equal to the premium of the current year, and arrears for which he may be liable. Individuals will be entitled to {of the Enquiry Board on: Hospi- H, E. WINCH, M.L.A., member tal Insurance, urges immediate action to amend Act. hospitalization if payment for the current half-yearly benefit has been made. Among a number of recom- mendations dealing with hospi- tal administratign is one which Proposes a conference between the hospitals and the bargain- ing agencies of the employees. It is explicitly stated that it is not the function of the BCHIS to interfere in wage agreements, either directly or indirectly. Cases where hospi- tals were virtually forbidden to increase wages as bargained for were cited to show the in- justice caused the organized employees. be A recommendation favors the reduction in the hours of work for nurses in training from 48 hours a week to 44 hours a week. 819 EDMONDS ST. ALLARD’S FURNITURE LTD. RADIOS . . . 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