What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Tuesday, January 03, 2006

AT THE BEGINNING

I started family practice in Medicine Hat, Alberta in 1963. At that time there was no Canada Health Act. There was however, total hospital care coverage and cancer care coverage. Doctors' fees were covered by insurance plans such as London Life, Medical Services Incorporated, welfare, Federal coverage(R.C.M.P.) and about 5%to 10% of my practice did not have coverage for doctor visits. Keep in mind, as I said, everyone had cancer coverage and hospital coverage. I wrote off 10% to 15% of my billings every year.Some of the people in my practice suspected that I "underbilled" them, but no-one was ever made to feel ashamed of their financial status.
Alberta and Ontario were the last provinces to sign on to Universal Health Care and in 1969 Canadians had what they thought was going to be the best health care system in the world. They were told that they no longer had to be responsible for their health. They did not have to think about "should I see the Doctor, have a house call, or get a second oppinion". They were told they were entitled to these things on demand. They were told government would look after the old, the poor and the chronically ill---infering that this group was not being looked after by the present medical system and doctors. They said no-one would lose their homes because of medical debt. In my 5 yrs. of practice before the Canada Health Act, I knew of no-one who even lost a tetevision set because of medical bills. At that time governments were already using "American Medicine" as a boogey-man to support the Canada Health Act and garner votes.
What was not said was that in 1969 Canada already had a much different haelth care system than the U.S., that physicians in Canada, like Canadians as a whole, were much more compassionate than their U.S. counterparts, and that by effectively conscripting physicians into a "one payer" system, physicians in Canada became Civil Servants. The expression " he who pays the piper calls the tune" would from 1969 on, continue to erode the Doctor--Patient relationship and eventually remove physicians as advocates for the patient and make them advocates for the system. Terms such as "Gatekeepers to the public purse" would have horrified physicians when I graduated. This now is considered to be one of the primary functions of primary medical care.
During the hepatitis inquiries the question was asked; "When physicians become buisiness men(make recommendations based on someone elses bottom line, e.g. cost effectiveness) who do we the people turn to for medical advice?" On this blog site I would hope to encourage some true discussion of issues pertaining to health care in Canada. Perhaps we,the people, can redirect health care and our tax dollars where they should be in a "just society",--caring for the poor, the frail elderly, and the chronically ill, and puting in place incentives that are not counterproductive.
Dr. Al Wilke.

3 Comments:

Blogger michie said...

This perspective is very interesting. Many of us are ignorant of some of these details... Even those of us who have heard you rant in person for years and years;)

I look forward to future posts!

3/1/06 11:24 AM  
Blogger Al said...

Mich;
Maybe it's new bwcause kids rarely listen to their parents when tney rant!!

4/1/06 10:11 AM  
Blogger michie said...

I'm glad that you've now found a forum Dad. Perhaps you won't need to rant to us anymore? Or perhaps that's wishful thinking;)

4/1/06 12:06 PM  

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