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?

Thursday, April 20, 2006

Don't Let Them Escape!

My gut reaction to the Herald’s “Alberta Warned on Health Reforms”, and “Ottawa may cut $1.75 B in Funds”, was “That’s OK, Alberta will cut 2 billion to Ottawa from our Equalization funds. And this all seems to be from the notion that Alberta may allow doctors to work both in the private and in the public systems.
It would indeed take courage to allow that to happen. After all, Dr. Tom Noseworthy, director at the Center for Health and Policy Studies at the University of Calgary, said, “it’s ridiculous” for the provincial government to work both sides of the fence, arguing it would “wreck the fundamentals” of health care. Now he didn’t say what those fundamentals were or how these fundamentals would be wrecked, but I imagine it will be the usual drivel about depleting the care givers in the public system, etc.
Wait a minute, maybe that’s the clue to his saying it would wreck the fundamentals of health care. He knows that physicians, since the advent of Medicare, have fallen way behind most other professionals and tradesmen in the “fee for service” category. He knows that because physicians are locked into a monopoly of a one payer system, the government has absolute control over physician’s fees. For ethical reasons physicians will never go on a full fledged strike (withdrawal of all services). If they did, the government would legislate them back to work in a second, and rightly so. The result is there are never true negotiations; the profession is handicapped by their allegiance to the patient, and the government has the power. History has shown time and again that things would be even worse for us if it were not for the support of the voting public.
So let us take a brief look at whether this is what Dr. Noseworthy meant when he said it would wreck the fundamentals of Medicare. Certainly, in the private system they would no longer have to go through the “mock negotiations” with government. They could look at the fee schedules of other groups and compare---perhaps may even want to do some catching up? Good heavens, the public system will have to compete instead of mandate!
So I thought I would do some checking. I knew that the furnace guy I called a couple of weeks ago charged $90.oo for a 20 minute service. I phoned some large animals veterinarians and they said their fee for a visit to their facility was $67.oo. Small animal veterinarians office visits are around $50.oo. They also informed me that the initial fee is for one problem, so if your horse has a sore foot, a skin condition, and you want to know if she is pregnant, you will be charged for three things (the fee for each varies). If you see your family physician with three complaints, he/she is paid one fee for an office visit. A friend of mine told me recently that he was charged $150.oo (no material) for a visit by a plumber. The visit took 15 minutes of the plumber’s time (my friend lives in a very nice condominium in Calgary, and maybe the plumber had just previously made a “freebee” call on a low income family?).
When I started practice in 1963, I believe a family physician got paid $6.oo for an office visit and $10.oo for a general check-up. I recall having a filling done about that time and was charged $10.oo. Maybe I was given a good deal because I was poor but I think not. Filling a tooth now can set you back $90.oo to $200.oo, a nine to twenty fold increase over the past 44 years. Your family physician will get paid approximately $29.oo for your office visit today, and approximately $60.oo for a complete check-up, representing a five to six fold increase over the last 44 years. A house call by a family doctor pays $64.53, less than a plumber, an electrician, or a veterinarian.
While speaking with a veterinarian, I asked whether they were restricted in what they could charge. The answer was “No, but it is easy to price yourself out of the market”. There seems to be an abundance of veterinarians,----- and dentists,----- and lawyers, but a shortage of physicians in Canada,---strange.
Is it possible that Dr. Noseworthy suspects that doctors will try to escape the financial ravages of a monopolistic health care system that is, and has been “a fundamental” of Medicare? Personally, in spite of all of the above, I have more faith in the medical profession. Those that were looking for more financial remuneration have mostly already left Canada. But it certainly would make the system more accountable as to how they treat their care givers and physicians. And Freedom can be like a pandemic and spread like a prairie fire. Dr. Noseworthy is probably right. The best is to avoid all discussion on the matter, and simply call it “ludicrous”!


Blogger Lanny said...

Unbelievable. The Alberta government is apparently backing out of the option for doctors to work in both systems. Doctors enslavement shall continue and be promoted.

21/4/06 10:13 AM  
Blogger Al said...

Read today's blog!

21/4/06 10:32 AM  

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