North Colchester, Wednesday, June 9, 2004

Support growing for patient co-ops

Harry Sullivan

TRURO – Patient co-operatives, such as is being proposed by a Pictou County doctor, would provide improved health-care services for its members at a nominal cost, say proponents of the plan.

And both Dr. David Zitner of Dalhousie University, and Diane Kelderman, CEO of the Nova Scotia Co-operative Council, believe the concept of community run, medical co-operatives are the wave of the future.

Kelderman, who is based in Truro, said her office has already received a number of inquiries from local doctors who want to more closely study the plan recently proposed by Dr. Cathy Felderhoff of New Glasgow.

“I would say that there will be some rural doctors who will see this as a positive thing,” Kelderman said. “I do see that happening in other rural areas.”

Zitner, who is both the director of Medical Informatics at Dalhousie University and the Health Policy Fellow at the Atlantic Institute for Market Studies (a public policy think tank in Halifax), agrees.

“I think that this is going to be a very popular model,” he said.

“Once the co-op is working to the benefit of all, Nova Scotians will be celebrating and saying we are a leader.”

Zitner views patient co-ops “as a way to inject more money into the health-care system without raising taxes,” thereby improving “the quality, speed, efficiency and convenience of contacts with medical professionals via technology” and to encourage more specialization among various levels of professionals like primary care nurses working under a physician’s supervision.

Kelderman said under the model being proposed in Pictou County patients would be charged a small fee to buy into the co-op membership. They would then choose from a list of services not covered under MSI which they would like to have and would be billed accordingly at proposed rates ranging from between $10 and $25 per month.

Currently in Nova Scotia, doctors are only reimbursed by the government for insured services if they have a face-to-face encounter with a patient, so attempting to obtain a physician’s advice by telephone or e-mail is generally an uninsured service.

Under a member-driven and operated co-op system, however, Zitner and Kelderman said patients would benefit through the additional services of a primary care nurse or other specialist, who could provide treatment that does not require a doctor’s personal attention.

And that can lead to reduced patient lineups and better, more personal care without placing additional burden on the publicly funded health-care system.

“We’re seeing it as a community owned health-care facility,” said Kelderman, who added that, combined with education and information provided by the co-operative, should lead also lead to overall better health.

“People just start to take more responsibility of their own health care,” she said.

And Kelderman said if a patient only goes in for an annual check up their only cost would be the “nominal” membership fee.

“If you don’t use uninsured services, you don’t pay,” she said.

“You only pay if you use.”

Patient co-ops are currently operating successfully in areas of Quebec, Saskatchewan and Ontario, Kelderman said.