{"id":14775,"date":"2019-04-24T11:00:21","date_gmt":"2019-04-24T15:00:21","guid":{"rendered":"http:\/\/lifeinsurance-orleans.ca\/Life-Insurance-Blog\/the-military-provides-health-care-to-its-members-but-not-their-families\/"},"modified":"2019-04-30T21:32:36","modified_gmt":"2019-05-01T01:32:36","slug":"the-military-provides-health-care-to-its-members-but-not-their-families","status":"publish","type":"post","link":"https:\/\/blog.lifeinsurance-orleans.ca\/index.php\/2019\/04\/24\/the-military-provides-health-care-to-its-members-but-not-their-families\/","title":{"rendered":"The military provides health care to its members, but not their families"},"content":{"rendered":"
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Many health care providers are unaware that military families are divided in the way they access health care\u2014that is to say, each family is divided. Members of the Canadian Armed Forces (CAF) receive federally funded health care directly from the military, often right on the bases they are posted to, while their spouses and children typically receive care through the provincial and territorial systems where they live, the same way most other Canadians do.<\/p>\n

But because military families move up to four times more frequently than other families\u2014it\u2019s estimated that 10,000 relocate annually, and about 8,000 move provinces\u2014they face unique and substantial barriers in their access to care. They can wait years to secure a family doctor, only to receive notice that the family is relocating. They can wait months to see a specialist in one province or territory and then have to go to the back of the line in another; they may even have to be re-diagnosed before being allowed to get in line at all.<\/p>\n

Neither the military health care system nor the provincial\/territorial ones were set up with an eye to how spouses and children of members might get caught in the gap between them. But with increasing attention being paid to this gap\u2014both within the military and by health care providers\u2014some potential solutions are beginning to be explored.<\/p>\n

What we know about military families\u2019 access to health care<\/strong><\/h2>\n

In 2013, the military\u2019s Ombudsman reported<\/a> on the \u201cwell-being of the military family in the new millennium.\u201d One key finding was that \u201caccessing health care and maintaining a reasonable level of continuity during mandatory moves remains a persistent challenge for military families,\u201d making particular note of \u201cthe reality that many [military family members] take leave and travel to their previous postings to consult their former physicians because they have not secured doctors in their current locations.\u201d The report recommended that the military encourage medical practitioners to take military family members on as patients, and also to explore \u201cwith provincial and professional partners the possibility of transferring the family member\u2019s position on a wait list intra- and inter-provincially.\u201d<\/p>\n

In 2018, Military Family Services (MFS), a CAF organization that works to ensure the military family community is well supported, similarly reviewed<\/a> the state of the military family in Canada, pointing to a 2013 Quality of Life study (conducted by the Department of National Defence) which found that 44 percent of spouses said it was \u201cextremely difficult to re-establish medical services after relocation.\u201d In fact, spouses identified primary health care as the \u201csecond highest challenge overall for military families.\u201d In the 2013 study, 24 percent of military spouses reported not having a family doctor, and 17 percent reported that their children did not have a family doctor. (This was compared with an average of 15.5 percent of civilians who did not have family doctors at the time.)<\/p>\n

Also in 2018, Alyson Mahar, epidemiologist and assistant professor at the University of Manitoba, led a retrospective cohort study<\/a> comparing 7,508 military families\u2019 access to health care in Ontario with that of 30,032 matched civilians over a period of roughly two-and-a-half years. The study found that the military families had a significantly longer interval than civilians did to their first contact with any health care provider (including family doctor, emergency department, and specialist)\u2014118 versus 83 days. This is in spite of the fact that military families are likely to seek out providers soon after they move. \u201cBecause this is a group that\u2019s trying to reintegrate into the health care system, they\u2019re more likely to be initiating contact,\u201d says Mahar. For 18 percent of military families, the ED was their first contact with the health care system; for civilians, this number was 14.7.<\/p>\n

Other key findings from Mahar\u2019s study included the fact that children in military families were less likely to see a pediatrician than their civilian counterparts (17.7 percent vs. 26 percent) and were less likely to receive non-influenza vaccinations (23.2 percent vs. 32.3 percent).<\/p>\n

What this means for military families<\/strong><\/h2>\n

Retired Colonel Russell Mann spent five years working with MFS, travelling around Canada, and hearing about families\u2019 experiences. Here is one of them: A young couple living in Quebec, expecting a baby, received notice of posting to Alberta. The baby was born soon after they moved and before their Alberta health insurance was available, as per the \u201cthree-month rule\u201d<\/a> in which people are covered by their previous province\u2019s insurance for the first three months of residency in a new province. But in this case, the bilateral agreement between the provinces did not allow Quebec to cover the delivery. \u201cThe rationale is, \u2018You knew were pregnant, you shouldn\u2019t have moved,\u2019\u201d says Mann, who now works as a senior adviser at the Vanier Institute of the Family. But this family didn\u2019t have a choice, and they found themselves with a $22,000 bill.<\/p>\n

This situation was one of the cases used to persuade the provinces to waive the three-month wait period for military families, which happened between 2013 and 2014. This change is \u201cmostly built on goodwill,\u201d says Mann. \u201cI don\u2019t know that there\u2019s any legislation or amendments to health care acts.\u201d<\/p>\n

Mann\u2019s own family experienced health-care barriers following a relocation. After being posted to Quebec, his wife tried to find a family doctor and discovered a queue of 10,000 people ahead of her. \u201cIf we had stayed in the military, we would most likely have relocated before she ever got through that wait list,\u201d says Mann.<\/p>\n

The problem of access to primary care is, of course, not limited to military families. In 2016, Statistics Canada reported that nearly 16 percent<\/a> of Canadians did not have a family doctor (nearly 29 percent of them had not tried to find one). Several provinces have centralized waitlists<\/a> for family physicians; in Nova Scotia, that list recently topped 50,000<\/a>. At the Military Family Resource Centre in Halifax (MFRCs are not-for-profits stewarded by MFS), executive director Shelley Hopkins says this is \u201cprobably the number one frustration\u201d for military families, who are using walk-in clinics and the ED for prescription renewal, and who travel back to the provinces where they were previously posted to see specialists for mental health conditions, diabetes, and even cancer.<\/p>\n

Travelling back to their previous province is not a realistic option for Melissa Harrison\u2019s family. Last fall, she posted a video<\/a> on Facebook in which she explained that her son, who has autism, would have to be re-diagnosed in B.C., where the family was moving, in order to go on a wait list for therapy (which he\u2019d started in Ontario). Harrison had been told that the wait to see a pediatrician was a year, and the wait for therapy another 16 months. Despairing that her son would lose the gains he\u2019d made, Harrison was contemplating paying privately for therapy, at $175 a session.<\/p>\n

\u201cThe present health care system doesn\u2019t account for families like that,\u201d says Michelle Szkwarek, who co-founded the Canadian Armed Forces Family Advocacy Group, an online community of 500 people, including CAF members, family members, veterans and allies. \u201cAnd it means those family members go under-served or face financial hardship.\u201d<\/p>\n

From 2012 to 2018, Szkwarek\u2019s husband was based in the U.S., where her family received health care through the American military (as per an agreement between the two countries). While in the States, Szkwarek worked for MFS and heard from families with children with special needs about \u201chow glad they were, being in the U.S. at the time of the diagnosis, because it was earlier access, quicker response, earlier intervention and continuity, and it set them up for success,\u201d she says. \u201cWhereas they felt if that process had been happening in Canada, there would not only have been delays but setbacks every time they had to move.\u201d<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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Military families face unique and significant barriers in their access to health care, in large part because they relocate so often<\/p>\n

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