2019 - Seniors are best ignored

April 4, 2019. A recent article along with additional media publicity has focused on anti-vaxxers and their success in using public funding to support their spurious claims and misleading campaigns.
Some of my email correspondence with the Medical Director, Communicable Diseases & Immunization Service, last year indicated that if the Ministry of Health approved funding for Shingrix vaccination, it would become available on April 1st this year. Evidently, this has not happened, so my current missive to her is somewhat strident:

"Recent media reports of public funding of the Health Action Network Society have revealed the hypocrisy of our health care system, which provides support to a discredited anti-social charlatan group, while denying economically stressed seniors protection from a readily preventable condition and potentially saving substantially on the treatment of that condition.

While I do not have the resources to gather hard data on the cost of treating shingles, the simple logic of the issue indicates to me that making Shingrix (RZV) freely available to the susceptible segment of the population is a win-win proposition. This is reinforced by my reading of the following statement taken from Management Options Table 10 in the August 27, 2018 report on the issue: 

"Based on Cost Utility Analysis: - RZV is cost-effective compared to no vaccination for adults ≥50 years. Best cost effectiveness found to be among 65-79 year olds."

I can't imagine that the BCCDPAC has not recommended to the Ministry of Health that Shingrix should be covered by our provincial health plan. However, in spite of your statement that a funded program, if approved by the Ministry, would start on April 1 this year, I see no indication this week that it has even been considered.

My conclusion is twofold: 1. Seniors are viewed as a population segment that is not worth their cost; and 2. The Ministry of Health is such a cumbersome bureaucracy that by the time it can implement a cost saving measure, its costs have increased to such an extent that the impact of the measure on the system is so minuscule that the additional administrative burden of implementation eliminates the cost saving.

My whole four year quest is living proof that we, the seniors, are second class citizens, and that the British Columbia Human Rights Tribunal (BCHRT), as well as its national (CHRT) and provincial counterparts, is nothing more than a kangaroo court set up principally to cater to a larger ethnic component of our society, whose votes are critical to the political elite.

The extensive redaction in the voluminous documentation presented by the government lawyers prior to, and during the Human Rights Tribunal hearing sixteen months ago are a clear indication of the secrecy associated with health funding, but at this time I should like to know if there is any chance that the Ministry will fund Shingrix vaccination at any time in the foreseeable future. I am copying this query to Dr. Henry in the hopes that she, as Provincial Health Officer, may also shed some light on this issue."

When, or if, a response is forthcoming from the establishment it may provide an indication of the futility of trying to advocate for a group that lacks sufficient political influence.

May 31, 2019. Earlier this month yet another seniors' organization was contacted for help with advocacy, and the response was the same mealy-mouthed put-off that appears to be standard with such organizations in response to initiatives coming from outsiders. Our somewhat curt response was to suggest that a close and personal encounter with the malady might influence their attitude toward advocacy for the vaccination.
Frustration with six months of stonewalling by both the Minister of Health and the Premier (without so much as an acknowledgement of our communication), led to an appeal to the official opposition, which not only produced an instant auto-response, but a prompt and positive reply (in less than ten minutes) from their health critic, Norm Letnick, that it is something he is considering for their platform, and that he had already brought it up with Minister Dix in the House.
By sheer coincidence around noon today we received a response from the Ministry of Health to our email of December 14, 2018. Our reply indulged in sarcasm.
Some correspondents queried how they might assist our effort: our response to one applies to all.

June 10, 2019. The header of this section appears to apply not only locally but universally: news from the United Kingdom has a cut in seniors' privileges making up for a budget shortfall. It's far easier to impose hardship on the helpless than cut fat where it's protected by unions and other vested interests. That brings to mind that we have a Seniors Advocate in British Columbia. Past attempts at interaction with her office have proved futile. Perhaps it's time to rattle her cage again.

July 3, 2019. A phone call last Friday with Isobel Mackenzie, the BC Seniors Advocate, provided some encouragement that she will bring up shingles vaccination at future meetings with pertinent officals, but no specific commitments. A news article on the election results in Prince Edward Island has the new Conservative government indicating that it will pay for shingles vaccinations next year, but they have not yet considered the issue of which vaccine it is to be, and need to study it - which sounds like they are trying to justify the delay in commitment of funding.

August 9, 2019. The daily press has lately been providing frequent exposure to a pretty disgusting, apparently transgendered, publicity hound, cleary reinforcing the case for dismantling the BCHRT; which managed to survive the demise of Section 13 of the Canadian Human Rights Act and the exposure of the odious Richard Warman and his CHRT sponsor, the late Jennifer Lynch.

August 31, 2019. A pretty strong case can be made for the dismantling of human rights tribunals as an expensive forum and platform for petty and vexatious claims of extortionists and narcissist exhibitionists such as Jessica/Jonathan Yaniv, whom the media are giving the exposure she (he, they, it?) craves. The latest case being pursued by an extortionist "babysitter" in Edmonton is an indication of the ridiculous trivialities the tribunals accommodate while failing those in crises.

September 22, 2019. The writ was dropped on September 11, and the federal election campaign is well under way. While we try to stay apolitical, one issue that should be front and centre is the dismantling of the Human Rights Industry at the federal level at this time. The provincial election in British Columbia in October next year may provide the opportunity to lobby for the abolition of the costly and ineffectual BC Human Rights Tribunal as well as the additional grievance bureaucracy of the BC Human Rights Commission.

October 7, 2019. A review of recent developments on the Shingles vaccination issue has found that the Canadian Association of Retired Persons (CARP) finally started advocating for its inclusion in provincial medical coverage, but only Ontario has responded favorably - unfortunately on a very limited scale and with the wrong vaccine. A recent item from CBC's Dr. Brian Goldman makes a strong pitch for Shingles vaccination, while another report expresses serious concerns with Shingrix and the whole Shingles scenario.

October 24, 2019. It appears that the BCHRT is at least able to take considerably less than three years on the obvious! It has produced a ruling on the Jessica Yaniv complaint, mentioned above, which actually penalizes the plaintiff. Another very minor positive note is that our GP's office has now entered the 21st century by setting up a system for making appointments on line.

December 6, 2019. Having had pretty well no success in enlisting any seniors' advocacy groups or individuals in my shingles quest, I am almost prepared to give up - and indeed, on the fifth anniversary of its start, in just over two months, I shall. Meantime, I missed commenting on the most recent declaration of hypocricy from our Province on October 1st, and no comment is required on the continuing Yaniv saga.

March 2, 2020. The latest bizarre ruling from the nationwide human rights industry comes from Manitoba, and considers convicted pedophiles a victim class needing protection under the human rights umbrella. Meantime, it appears the Ministry of Health has finally come to its senses in denying funding to anti-vaxers, so perhaps there is hope that it may yet acknowledge that seniors have rights.

January 1, 2021. Having almost given up on the issue of the hopelessness of trying to expose the moral bankruptcy and corruption of the Human Rights Industry (it has certainly achieved industrial dimensions) I have one further comment on the conduct of the BCHRT, and that is one that essentially confirms its illegitimacy. In recalling the proceedings, at the actual three day hearing, there was a prohibition on any sort of video, photo, or sound recording. Presumably this was to ensure that there was only one official record of the event, which could be presented as the only truth. Transparency and accountability be damned, no one but the establishment and its minions is capable of producing the absolute truth! In retrospect, I believe I should have ignored this prohibition on the grounds that this was a public hearing and in the interest of accountability and transparency I needed a full record of the proceedings for myself, including photo and video recordings.

November 27, 2021. As an ironic finale, about ten days ago I started to feel an itch on my back, which felt like a mosquito bite. Having an occasional mosquito still show up at home once in a while, I thought nothing of it, until there was another a day or two later, and more coming until I had a bunch of apparent welts on the left centre of my back. I finally showed it to Elaine, and her immediate response was: "it's shingles". Having suspected the same, I believe that I have a mild case - no pain, only a persistent itch, and of course the red welts with some small blisters. In light of the billions currently being spent on COVID, and its economic impact, I believe the cost of vaccinating elders against the ravages of shingles should seem like chump change to the medical community - particularly now - thanks to COVID there are so many fewer of us...

Sequel - 2018

2018 - New Year's update
A late breaking news item from a national news source strongly supports the contention that Zostavax is history, and this was confirmed in a CARP (Canadian Association of Retired People) expert panel discussion held the day my tribunal hearing started: December 4, 2017.

January 8, 2018. An email this morning from GSK Canada announced the immediate availability of Shingrix, with a search engine to find clinics to dispense it in the local vicinity. A check with several pharmacies in our locale provided a touch of disparity in pricing and availability, but the consensus appears that it is available to order, which may take a few hours or a couple of days, and the price should be close to $140 per shot, with two shots at least two months apart required for the advertised efficacy. Two items to bear in mind: you do not need a prescription from a physician: a pharmacist can both sell and administer the injection. The other is that this inoculation may have some minor side effects with discomfort lasting up to a couple of days.

January 28, 2018. While I can't say I have had any negative feedback about this narrative, all the comments so far have been quite complimentary.

February 22, 2018. A commentary in yesterday's Calgary Herald appears to concur with my contention that shingles vaccination - particularly with the newly available Shingrix vaccine - is a cost effective win-win for our medical system nationwide.

March 9, 2018. The ninety days for the Tribunal Member (TM) to submit a ruling and report expired on Tuesday (March 6), and yesterday I received a letter from the TM, Ms. Korenkiewitz, stating that she has been unable to fulfill the commitment to render a decision within the 90 day prescribed period, citing excessive workload and under staffing as the reasons for the delay. This appears to be indicative of the vested interest of the legal profession in delay. Why confront an issue when it can be deferred?
Meantime, I posed the question to the Medical Director for BC's immunization programs (who turned out to be aware of the TM's response, in spite of not being listed as a recipient or shown as copied in the letter itself) as to how long it might be before the Shingrix vaccine could be found cost effective and therefore provided free on demand by our medical system. Her quick response was that it may (all other issues aligning as they should) come up for consideration at her committee's June meeting. My thinking here is that it would be interesting if we were provided with free shingles vaccination before the BCHRT renders a decision. That would really expose this three year plus process for the travesty and waste of public resources that it truly has been!

April 20, 2018. A recent query from a reader who was considering being vaccinated against shingles, but was uncertain as to whether he should bite the bullet and pay for it, or wait in the expectation that it will be covered by MSP (the Provincial Medical Services Plan) sometime soon, provided food for thought and elicited the following response, which I consider a reasonable compromise. If you have had no prior shingles vaccination, it's prudent to pay for Shingrix and get vaccinated now. Since I had a Zostavax injection only three years ago, I'm going to wait and see if Shingrix vaccination is going to be covered by MSP by the end of this year. I might do a bit more prodding if it's still in limbo at that time.
A local acquaintance, whose means are somewhat strained, indicated her preference was to wait. I believe that an individual's overall state of health is also key. Anyone who seems susceptible to colds and 'flu, or any variety of infections, should probably not wait.

June 13, 2018. The original 90 day commitment for a ruling was deferred by the Tribunal ostensibly because of excessive workload and under staffing. Meantime according to their news page as of April 24th, 2018, they have appointed a new Tribunal Member, hired three new staff, and are advertising an opening for a part time lawyer. However, another hundred days beyond the original ruling commitment have passed, and there is still not a peep from them. I infer from this that their strategy in this unusual age discrimination case is to defer a decision until the complainant dies. If I were a true cynic, I would suggest that as a supposedly independent body, the BC Human Rights Tribunal is unwilling to produce a ruling that would run counter to the position of the Ministry of Health and its monstrous bureaucracy. That would effectively be biting the hand that feeds it, and endanger future funding and growth.

July 22, 2018. Last week, along with the ususal MSP invoice, the mail brought an enclosed leaflet announcing a new online service, enabling invoice delivery via email, and payment of MSP directly to Revenue Services of British Columbia by direct bank transfer or by credit card. Having been paying this on line from my bank in any event, it's no big deal, but it's an indication that MSP billing has finally caught up with the rest of the world and entered the 21st century. However, if they really do provide for credit card payment with no additional charge to the client, they are giving up several percentage points to the card issuer bank, which will have to be made up through other means.

July 30, 2018. Eight months since the BCHRT hearing, and still no ruling, and further excuses are not even being offered. Obviously the Tribunal has priorities, and ruling on an issue which may put them at odds with another provincial bureaucracy is not one of them.
My one reliable contact with the Ministry of Health, being the Medical Director, Immunization Programs and Vaccine Preventable Diseases Service at BC Centre for Disease Control, indicated some time ago that the Communicable Diseases Advisory Committee, which makes recommendations on issues such as funding of vaccinations, was meeting in June, and might at that time make a recommendation on including Shingrix among the vaccinations that are publicly funded. While she would not indicate whether that issue had been discussed at the recent meeting, I had an instant response to my query as to how long it would take to implement a positive recommendation. The earliest that Shingrix could possibly be made available free of charge to a selection of susceptible subjects would be April 1, 2019. That is not to say it will be; and since at this time I have no idea whether the matter even came up at the current meeting, the likelihood of having free shingles vaccination within my lifetime is looking pretty slim at the moment.

August 7, 2018. BCHRT has Service Standards which it "aims to meet at least 80% of the time". Unfortunately, this complaint falls into the other 20%. In light of the recent establishment of a BC Human Rights Commission (with no apparent input from any seniors' advocacy group), we can now expect turf wars to commence between the Tribunal and the Commission, which apparently is principally concerned with issues such as gender identity and aboriginal grievances. In any event, a letter of encouragement to the Tribunal Member to get on with a ruling was sent today.

August 10, 2018. FINALLY - a ruling. I don't believe my letter sent three days ago had any influence on the timing of the release of this decision, but it felt good to let them know that the delay was unacceptable. As expected, the result of the extended proceedings was an unqualified victory for the establishment, and corresponding defeat for me and all BC seniors, which is summarized in the last - 110th - paragraph of the 28 page document: "The complaint is dismissed in its entirety".

December 14, 2018. Last month a close friend and retired teacher emailed us the following note: "I am on Day 15 of my shingles experience and it ain’t pretty- it chose to make itself known on my face and in my scalp, so not only is it painful, but darn hideous, too. I must admit it is better than the first few days when I looked like some meth addict who had come in second in a fist fight. The big worry is any effect on the vision. My Dr. got me into an ophthalmologist PDQ - first examination was clear, but I have a return visit on the 28th, so keeping fingers crossed.

I’ll have to make a decision about whether or not to get the vaccine when I’m eligible- no guarantees that it will prevent a return though." 

 My response: "Ouch! That could make us re-think our decision to wait 'til spring (reminds me of the "why wait for spring" work promotion campaign - from 50 years ago), when there's a chance the Communicable Diseases Advisory Committee might have recommended inclusion of the vaccination at their last meeting back in June this year (see the July 30 entry in my blog - above). If you feel like strangling the two overpaid, arrogant, supercilious females from the Attorney General ministry who conducted the establishment's rebuttal of my complaint, I can point you in their direction and maybe assist you in the endeavour - then we could go after the Tribunal member who made the ruling. Otherwise we can just hope that they all come down with shingles themselves in due course. 
A principal justification Elaine and I are using for the delaying our own Shingrix shots is that we have already spent $400+ on Zostavax (which I couldn't even get today because I'm too old), but I believe that Shingrix is way more effective, and of course, the effectiveness of Zostavax diminishes with both time and age."

 A more recent note from this victim indicates that she is over the worst, and the symptoms are slowly diminishing. However, a good six weeks of agony might readily have been avoided if she had been vaccinated. Meanwhile, our "progressive" government and its Ministry of Health appear to have plenty of excess funding available for sex changes! A statement about their questionable priorities can be made here, and meantime I would encourage everyone to contact their MLA to denounce this travesty. My letter to the Minister of Health can be accessed here, with a similar missive to the Premier.

BC Human Rights Tribunal Hearing

Prior to the hearing, a case conference held on November 22nd turned out to be just a procedural discussion, at which the Tribunal Member (TM), Barbara Korenkiewitz, who was to preside and eventually render a decision, laid some ground rules, such as how the witnesses were to be scheduled and how the meeting would be structured in terms of timing and procedure. She also requested that a joint book of documents be prepared for her, including all submissions that had been made and were to be included in the hearing. The Respondent's lawyers agreed to do that, and I was to submit any new documentation from my side to them for inclusion.

The Tribunal Hearing, which was booked for a week, actually lasted barely two full days, although the second day was spread over two mornings - Tuesday the 5th, and Wednesday the 6th of December. The five days were blocked off at the request of the respondent team - and I use that term advisedly, as there were five of them on the Ministry's side of the five metre long board table.

The physical set up was straightforward: at one end of the table was the TM, who was essentially the adjudicator, the other end was the witness seat, and I had one long side to myself as the complainant, facing on the other side, the two lawyers with their two paralegals/clerk-secretaries who took copious notes, and a gentleman whom I only managed to identify at the end of the proceedings by asking him who he was. He turned out to be Brian Sagar, the new Executive Director for Public Health Services, who was too new in the position to testify at the hearing, so he was there as an observer. The retiring Executive Director, Warren O'Briain, is moving on to an equivalent position in Mental Health and Substance Use, but provided testimony as a witness in his former position. This individual was the only other male in the room. So the whole of the respondent team plus two out of the three expert witnesses were all ladies. I was surprise that the case manager, who had handled all the correspondence and effectively controlled the documentation, was not present. I should note that the second lawyer assigned to the case, Rochelle Pauls, did most of the talking during the hearing, and she was much more animated than Ms. Pritchard, who at this point was obviously sick and very subdued.

I was asked for an opening statement, and I simply alleged age discrimination on the grounds that all childhood, and most other vaccinations, such as 'flu shots, were by and large provided at no direct cost to the patient, while shingles vaccination was not. The respondent's opening statement, copies of which were provided to everyone, ran to twenty-nine individual points on seven pages, ending with: "The Province's position is that the Complainant will not be able to establish prima facie discrimination".

I was the only witness on my side, so I effectively wore two hats, and took the witness stand to be cross examined - very briefly, since there was virtually no evidence to process. As I neglected to include all the preliminaries and formalities in the original estimate of hearing time my complaint would require, I wound up actually taking up close to half an hour by the time I had responded to a few questions from the TM, which included stating my age.  I returned to my spot on the empty complainant side of the table while the counsel for the respondent, who initially took turns asking questions and making presentations, summoned their first witness: Dr. Bonnie Henry, Deputy Provincial Health Officer for BC. For the sake of brevity, I shall just say that the two or so hours of questioning covered details of the Public Health Act, the functioning and structure of the Ministry of Health with respect to the Provincial Immunization Program and a host of factors involved in the functioning of the various branches and agencies such as the BC Centre for Disease Control. The next witness was the ex-Executive Director of Public Health Services, and his testimony, which covered much of the same ground in more detail, took up pretty well the rest of the day, so that the second day, which only lasted about three hours, was taken up with the third witness, Dr. Monika Naus, who was the only witness who is not resident in Victoria. She is an Associate Professor at UBC as well as being a Medical Director of the BC Centre for Disease Control, and her 71 page resume (abbreviated to 36 pages for the hearing) speaks volumes to her expertise and dedication to her field. She provided further detail for the functioning and choice of vaccines that are provided by the Ministry, as well as a historical perspective on the development of policies. Her testimony was completed shortly after noon of the second day, at which point we retired to prepare closing statements for the following day.

The closings statements on Wednesday morning were in much the same proportions as the rest of the hearing. I prepared a one page statement which took about ten minutes to present, and then there were maybe another ten minutes of questions. I quoted four principles of the Canada Health Act which are being breached, and pointed out the lack of data on the cost of treatment of shingles. I also stated that while I was pleased that my complaint elicited a serious response, the disproportionate magnitude of the resources deployed by the Ministry of Health in this action is a clear denial of transparency and accountability.

The respondent's closing statement, copies of which were provided to all, together with a four inch thick binder labelled "Book of Authorities of the Respondent", took close to three hours to present, and covered 108 points on 23 pages. Needless to say, it summarized everything that had been discussed and then some, including all the points I had made, as well as references to witness testimony and background documentation. Of course all this was to deny my cause any shred of credibility or chance of consideration. It ended on an untruthful note, stating that I had brought the complaint up only on my own behalf, and not on anyone else's. This is clearly a fabrication by Ms. Pauls, and flatly contradicts what I stated on page 6 of the complaint form filed at the outset of this process, where I indicated I was acting in the interest of all the seniors of the province. The very last item dealt with my claim for compensation in the amount that had been spent on this whole process by the respondent, which I had thrown in as a red herring, that was swallowed by the respondent's lawyers - hook, line, and sinker.

The hearing ended with the TM telling us that her report would be submitted within ninety days, so it will be next March before the whole process winds up - well over three years from the start. Has it accomplished anything? Well, that's debatable, but it has shown me quite clearly that there is definitely a lot wrong with our healthcare system, and other branches of our provincial government require a good deal of scrutiny and economic evaluation. I may at some stage try and tabulate all the issues that this process has revealed, but the one overwhelming impression that I am left with is the excessive, and obviously expensive, response to what started as a few well founded gripes about publicly funded health care. While I may not have been totally serious about my compensation claim, what I am deadly serious about is the sheer cost of this exercise, and how my hard earned tax dollars are being misspent. I believe if an auditor were charged with determining the costs, she would find that many of them are very difficult to quantify. I am left with the impression that many of the resources that were deployed against me were so directed simply because they exist, and do not have a clear mandate or definition of purpose. I don't believe there was any consideration as to whether the process was justified or reasonable.

I should also add that the future of the current vaccine, Zostavax, is essentially over. Being a live adjuvant vaccine, its effectiveness and efficacy declines with time as well as the age of the recipient, so that for a 70 year old vaccinated at age 65 it is down to about 14%. A comparable decline does not apply to Shingrix, a new vaccine approved in Canada in October, which is over 90% efficacious and apparently stays that way, so it will totally displace Zostavax. Some of the statistics quoted in the preceding linked article seem to indicate that the Ministry's contention that the cost of shingles vaccination does not justify the benefits is now completely at odds with the facts. With 130,000 cases of shingles each year in Canada, leading to more than 250,000 doctors visits, and about 2,000 requiring hospitalization, the $2 million estimated annual cost for British Columbia, assuming we represent around a quarter of the national numbers, could be paid back in less than six months, without any value placed on pain and suffering.

Although I tried to attract media attention to the hearing by emailing every media contact I could find, they had no representatives at any of the sessions. However, I received some favourable coverage in the Vancouver Sun the following weekend.

Two Weeks until the BCHRT Hearing

Two weeks to go until the hearing, as listed in the schedule, which has been updated today, and is finally showing that there is a venue for the hearing, as opposed to the locale TBD (to be determined), to which I formally objected in a letter to the Tribunal Registrar on November 11. The principal complaint in that letter, however, was that the tribunal is routinely dismissing requests for information about its proceedings with the lame excuse that if you are not a party to a complaint you have no right to know anything. So far, the Tribunal has sent me an automated response that my email was received, and my case manager, Sandy Tse, phoned me on Thursday, November 16, in spite of my stated preference for written communication. The objective of the phone call was principally to make lame excuses, which she obviously was not prepared to commit in writing, and assure me that my concerns were being addressed. At the same time, she requested that I commit to a number of possible dates before the hearing in order to set up a "case conference" requested by the Ministry's lawyers, to which I had earlier objected and had my objection arbitrarily overruled. The dates originally proposed have all passed, so the time left for a case conference is getting very limited.

Meantime, since the June update, I have received two weighty packages from the Ministry's lawyers (there are now two) amending and supplementing earlier submissions, and updating their witness list, which includes an expert with a 71 page resume. Unfortunately a good 75% of the paper stacks comprise redacted data, and of the rest, most are irrelevant, with less than 5% actually containing material that appears to relate to the issue of my complaint.

A couple of interesting developments that have caught our attention are:
1. Shingles vaccination is now covered by public health systems in Australia and Ontario, as well as Britain, France, and a number of other jurisdistions.
2. A new vaccine from GSK is proving to be even more effective than the current standard, and may provide some healthy competition for Zostavax.

A small, but significant, victory

June 1, 2017. today I received hard copy confirmation of the hearing set for December 4 - 8, which lays out a series of deadlines starting June 16 for submission of "complete disclosure regarding witnesses and remedy", with a bunch of links and references to forms that must be completed, and it goes through another five deadlines for all sorts of process which have all been covered off in the past - on my side by my submission that I shall be taking up five minutes as opposed to the five days required by the Ministry of Health. Did I mention the image of a nuclear device to kill a fly before? In any event, although I have presented my case on more than one occasion in the past, I shall have to re-submit some of the documentation that I have already provided, and adhere very closely to the rules of the tribunal, which are designed as a make work project for civil servants as near as I can determine.

The mediation session on March 28, 2017, turned out to be a non event. I brought Elaine, my wife, along for moral support, and across from us were two lawyers and a paralegal from BC Legal Services, plus Warren O'Briain, Executive Director of Public Health Services with responsibility for immunization policy, and of course Diane McLean, a Tribunal lawyer, as mediator. The principal message that the mediator opened with was that the proceedings are strictly confidential, so I can provide no detail except to state that I felt that nothing was accomplished beyond knowing what my adversaries looked like. We spent around two hours hashing over mostly what is detailed in documentation: the objective being an amicable resolution which would have mostly required me backing off my demands, which I outlined as:

1. Immediate termination of the discriminatory practice of making seniors pay for shingles vaccination.

2. Retroactive application of this measure to the first availability of the refrigerated form of the vaccine, approximately three years ago.

3. Refund of my $400 personal outlay for shingles vaccination for myself and my wife.

4. For my time and trouble in bringing this blatant discriminatory practice to light, I should be compensated the same amount as the Ministry of Health has spent on their lawyer and her support over the course of the past 18 months, including all Ministry personnel involved.

The next stage will apparently be a full Tribunal session, and that will hopefully be scheduled before people start taking off for summer holidays, but I'm not holding my breath. An email from the Tribunal on April 4, 2017, suggested a commitment to a conference call between April 18 and 25 to "hear the complaint's application for an expedited or alternate process". I indicated I am available on any of those dates, and today, April 6, I received an email from the Tribunal fixing the time for the call as 1500 on April 25, 2017.

On February 16, 2017, after several emails between myself and both the BCHRT and Ms. Pritchard, and phone calls from the tribunal, a date was set by Nikki Mann, Mediation Scheduling Coordinator for the Tribunal, for mediation at the Tribunal office on March 28, 2017, at 0930. This was followed up with hard copy in the mail, and a phone call on Friday, March 24, 2017 from Diane McLean, a lawyer with the Tribunal, who will be mediating the meeting. She simply wanted to talk to both parties to confirm the schedule and stressed that it will be very informal. I indicated I would probably bring my wife to witness the proceedings, and expected that the process would be quite simple.

On Friday, February 10, 2017, I received in the mail copies of letters to me and the Tribunal that the Ministry's counsel, Ms. Pritchard had emailed to the Tribunal, but neglected to email to me. The same afternoon Sandy Tse called to cancel the conference call set for February 24, 2017, and propose that she schedule a settlement conference at the earliest opportunity by simply calling me and the Ms. Pritchard separately. I indicated that I was available any time within the next three week preferably, or six weeks if necessary, and I sent out an email confirming this conversation to both Ms. Tse and Ms. Pritchard.

On Wednesday, February 8, 2017, I received a notice from the Tribunal to participate in a conference call to set a date for a hearing or a settlement meeting. The same afternoon I received a call from Sandy Tse, Case Manager for the Tribunal, inquiring if I had received an email from the Ministry counsel, and I indicated that I had not. The following day, I sent an email to the Tribunal proposing to invoke Rule 17 to expedite the process of Tribunal deliberations.

On Tuesday, January 24, 2017, The B.C. Human Rights Tribunal released a decision which runs to 20 pages, the full text of which is a touch tedious, but the conclusion, shown below, is interesting.

Basically, all this means is that my general complaint about the MSP's lack of transparency and accountability will now have to be pursued through some other avenue, and I shall have to pay more attention to legal details such as Rules of Practice and Procedure, and provision of specific instances of wrongdoing. However, the fifth item above, in denying the Ministry's application to dismiss my specific complaint of age discrimination with respect to the shingles vaccine means that the issue will be brought to a ruling by the Tribunal unless the Ministry pre-empts it by making the vaccine available free of charge (i.e. paid through MSP) before we come to a hearing. I am fairly confident that upon hearing the case the Tribunal would rule against the Ministry, so that the only uncertainty is timing. So my advise to anyone thinking about shingles vaccination is wait a few weeks, because it will be free of direct cost soon - it is already in Ontario.

MSP Accounting - Simplicity - ICBC Example

MSP Accounting - Simplicity - ICBC Example Here's how a reasonable, efficient, and transparent accounting system works. The example is another provincial crown corporation - ICBC - the Insurance Corporation of British Columbia.

Last week I had the windshield on my vehicle replaced. I paid the deductible and the glass shop is collecting the rest of the cost from my insurance provider. ICBC sends me a summary of the invoice, and requests that I contact them if I have any concerns. They want to be sure I am happy with the work that was done, but most of all, they want to be sure the billing is legitimate! They don't ask for an acknowledgement from me, but assume that if I do not respond that everything is above board and they can go ahead and pay the vendor.

Granted that this is an extra procedure, and there is a cost attached, but for most people these days the whole process could be managed electronically and the cost effectively minimized as a programming function rather than mailed documentation. Even with the mailed hard copy, there is likely no human interface in the ICBC process, and the impact of the transparency achieved is obvious.

Moving through the BCHRT process is excruciatingly slow, and the next stage, with partial victory for the system brought a small measure of encouragement.

British Columbia Human Rights Tribunal Complaint

It is now fully two months since I first tried to contact the Medical Services Plan (MSP) on the issue of Accountability and Transparency, and specifically about the blatant age discrimination in not providing for coverage of shingles vaccination under MSP. Consequently, I have laid a complaint with the B.C. Human Rights Tribunal against the Minister of Health and MSP. It's a fairly long form with a lot of pigeonholes to make it flexible, but I think it covers the issue fairly well. Stay tuned for what it may bring...

The form runs to seven pages, and the rest of it, including the first page seen here, is linked here.
When I filed it with the Tribunal on April 9, 2015, I decided to attend the help clinic offered by the Tribunal the following Monday, and the young lawyer who reviewed my complaint documentation had nothing to add or change, and simply commented that it was an unusual type of complaint.

On July 17, 2015, I received in the mail a copy of the Notice of Complaint served on the Ministry of Health. It provides fairly generous time allowances for the process, but a response or an application to dismiss the complaint must be filed by August 17, with a provision for attending an early settlement meeting in October or November. So obviously nothing will come of this process this year, and perhaps we will see progress in 2016. On July 24, I received a copy of a letter to the Case Manager of the BCHRT from the BC Ministry of Justice advising that the Respondent to the Complaint would be represented by Denise Pritchard, Legal Counsel. On August 5, I received a copy of another letter to the Case Manager, this time requesting a month's delay in the proceedings. My response was sent off the following day. That didn't sit well with Ms. Pritchard, who dashed off a note to justify her request for the delay. The registrar at the Tribunal decided on the spot to grant her only half of what she had requested, and the deadline for the response was moved to August 30, 2015.

On August 31, 2015, the response from the Legal Counsel, which had a deadline of August 30, was delivered by courier. It is dated with date of its arrival, so it was a day late to meet the deadline that the Registrar had imposed. That, combined with its principal demand that my complaint be dismissed on a variety of technical and legal grounds, makes it somewhat ridiculous. The technical grounds are that the respondent is incorrectly identified - an issue that had been brought up by a Tribunal official and corrected verbally - and that MSP is not responsible for funding any of the related services - an interesting point, since MSP is the principal funding agency for the Ministry of Health. A further item with which she takes issue is that the complaint refers to this blog, which is "subject to editing" and should therefore be ruled off limits: the material of the complaint should be restricted to what is included in the Tribunal form 1.1 and nothing more. Considering that she completes the main items of the form as "see attached", and specifically responds "no" to the requirement that form 7.2 - Dismissal Application be used to demand dismissal of the complaint, and then demands dismissal in her attachment, it would appear that her submission is not to be subject to the same treatment she demands for mine. The bulk of her argument comprises a bunch of legalese bafflegab about the structure of the Ministry of Health without ever touching on the issue of discrimination. However, she does concede that the Ministry has determined that it is justified in not funding shingles vaccination. Her repeated use of the term "prima facie" pretty well sets the tone for the whole document, and is virtually meaningless in this instance. In any event, her arrogance is breathtaking. The same day, the Tribunal responded with a Respondent's Dismissal Application Deadline, which includes a deadline of October 5, 2015, for me to file a disclosure listing and documentation, which includes details of the remedy I am seeking. Then the Respondent will have until November 9, 2015 to file a response to my disclosure and remedy sought. At this point there is still no date set for an actual hearing, and my list of documents and the remedies have been submitted to the tribunal.

Application to Dismiss
On the afternoon of November 9 a parcel arrived by courier, and it was not until I opened it that I remembered that this was the deadline for the respondent to apply to the Tribunal to dismiss my complaint. It was so impressive that I had to weigh it (2.7 kg or 6 lb) and take a picture.

The contents, comprising 16 items as listed in the "list of documents" are "governed by the rules of confidentiality such that disclosure is given only for the purpose of this hearing": which I take to mean that I may not disclose them here or anywhere: they are for the eyes of tribunal participants only. This is something of a relief, since I certainly am not about to scan and digitize several hundred pages of reference material along with covering legal qualifications and other bullshit. What I can do, without, I hope, the risk of litigation and further intimidation, is summarize what this package contains - and possibly speculate on what it cost. The basic message is : "the complaint should be dismissed in its entirety". That's a lot of paper and documentation for a pretty simple message. It does not say - let's see if this has any merit, or let's see if there are points to discuss, or let's consider if we have all the answers. It states very clearly: let's blow this issue to kingdom come, regardless of the cost of doing so!

There are three witnesses on the list submitted: all high powered and drawn from the top echelons of the Ministry of Health hierarchy - one executive director, and two directors. The second largest item in the above picture is a sworn affidavit by the Executive Director of Public Health Services covering everything you ever wanted to know (and a whole lot you didn't) about immunization in British Columbia.

The largest item in the package is titled "Book of Authorities" and incorporates eleven cases that have been heard by the BCHRT, two that went to the Supreme Court of Canada, as well as the British Columbia Public Health Act (SBC 2008 Chapter 28). Needless to say, they all support the contention that my complaint should be dismissed out of hand. Without attempting to go through them all, I found a measure of encouragement in one of them that touched on a personal note with me. This was titled "Armstrong vs. British Columbia (Ministry of Health)", and concerned having to pay for PSA (prostate specific antigen) testing.  The case, which was heard in December 2006 and January 2007, and decided in January 2008, resulted in the complaint being rejected and the case dismissed: a clear victory for the Ministry of Health. Curiously, by coincidence, in the fall of 2006 I was subjected to testing for prostate cancer, and ultimately treated for it by radical prostatectomy in the spring of 2008. During that period, and at least twice a year since I have had PSA tests, and I have never paid for one out of my own pocket. Again without going into detail, I understand that a good portion of the Armstrong case involved the distinction between "diagnostic" and "screening" PSA tests: the former being covered by MSP and the latter not. I believe that the difference is principally that in order to qualify as a diagnostic test it must be ordered by a physician, whereas screening could be initiated by the patient without a physician's input. I have to admit that before succumbing to prostate cancer I hardly knew I had a prostate, let alone what a PSA test was, and I suspect that most younger men are in much the same state of ignorance in spite of the level of publicity the issue receives today. So the Ministry was successful in defending its position with respect to Armstrong, but what did it actually win? The right to deny an individual a potentially life saving diagnostic procedure? And at what cost? Looks like a pyrrhic victory to me, and it certainly is encouraging in terms of potential outcome, whether my complaint goes any further or not.

This brings me to the issue of appearances, and potentially influencing how our health care dollars are spent. The attitude of the Ministry of Health is obviously that of an entrenched bureaucracy that wishes to be left to its devices without outside interference. Hence the weight of documentation, which at first glance (or prima facie, as I'm sure their counsel, Ms. Pritchard, would prefer to put it) looks like going after a fly with a blunderbuss - which in essence it is. So that rather than look at the complaint on its merits, let's get rid of it so we can continue as before. So first, we get rid of the items that are not specifically within the jurisdiction of the tribunal, and then we go after the ones that are with all the resources that we can bring into play on our side.

In her response to my statement of remedy, Ms. Pritchard begins and ends with the demand that the complaint should be dismissed, and for the rest states that everything in between is not available as a remedy to the complainant. I am sure that any number of legal arguments can be made as to the proper procedure and presentation of my remedies to show that they do not deserve consideration, but the issue of whether or not they represent a positive outcome for the patient and the public at large does not enter the picture. On that basis, I believe it is appropriate to examine the first four, all dealing with efficient communication and legitimacy of billing in light of the most recent commentary on the topic - found in this weekend's (November 14) National Post. The fifth item in my remedies comprises two parts, both of which allege age discrimination. The second, dealing with medicals for drivers over age 80, is deemed by Ms. Pritchard as inapplicable, essentially because I am not yet old enough to have been personally impacted. The first, for which the bulk of this documentation package is aimed, deals with the shingles vaccination, which I predict will fall under MSP coverage within the next five years, and would have done so a good deal earlier if the Ministry spent less on litigation and more on common sense solutions to healthcare issues.

Next Round
On December 7th the mail brought a further extension of proceedings. I now have until the end of the year to respond to the Ministry's application to dismiss my complaint. After that they have until January 14 to provide a written response to my latest submission. Moving at the appropriate pace, I shall send in my next submission on new year's eve, using suitable excerpts from the above review of the Ministry's application to dismiss.

December 31, 2015. My response to the application to dismiss was emailed this morning, and a fairly prompt reply from the tribunal stated that they were unable to access the links, so I had to get the essential ones downloaded and converted to pdf files for attachment to my email.

January 15, 2016. Yesterday the Ministry's response to my year end commentary arrived via email, and it was a bit of a letdown. All Ms. Pritchard could come up with at this time is a legal objection to my bringing up the issue of the 80 plus year old drivers' medical. So now the Tribunal has to decide what next, if anything. My prediction is that it will take at least a couple of months to come up with a firm ruling that the whole effort has been a waste of time, but it's been an interesting diversion.