Responses are still coming in about my recent column on the B.C. NDP government’s effort to crack down on people paying for their own health care.
It seems many people are tired of waiting in pain while Canada maintains its socialist vision in the face of a surging senior population, rapid advances in medical technology and the collapse of the family doctor model.
Today’s medical school graduates are reluctant to set up an office and plug into a pay-per-visit system where patients must be run through quickly in order to cover the overhead. Some doctors put up signs warning patients to discuss only one problem per visit, the very opposite of holistic health care.
Some doctors take shifts at a walk-in clinic to avoid the 365-day demands of a family practice, in a society where people are taught that the government must solve all problems. The annual rush of influenza-infected people into our overcrowded emergency rooms is but one example.
“As a retired family doctor, I despair at anything changing for many more years,” a Vancouver Island reader writes. “I really fear for my grandchildren as the tsunami of grey-haired Canadians overwhelms the resources that our government is willing to commit.”
Others cling to the old U.S. comparison. “Tom, why don’t you do Canadians a favour and move to Trump territory,” advises another reader.
Fortunately, not everyone is trapped in this blind alley. Several readers pointed to the World Health Organization’s ranking of national health systems, which currently has Canada in 30th place. The good news is we are ahead of the U.S., which is number 37 despite a vastly greater total expenditure on health care.
The top 20, in order of performance: France, Italy, San Marino, Andorra, Malta, Singapore, Spain, Oman, Austria, Japan, Norway, Portugal, Monaco, Greece, Iceland, Luxembourg, Netherlands, United Kingdom, Ireland and Switzerland. The common feature is a mix of public and privately funded care.
Here is how now-Health Minister Adrian Dix put his position to me 10 years ago: “What we do here in Canada, it seems to me, is we combine social justice and administrative efficiency.” Regarding efficiency, see list above. And “social justice” is NDP code for sticking it to the rich, or pretending to. Dix hasn’t changed, but the world has.
One angry reader informs me that there is a Vancouver hospital that posts the cost of emergency visits. Somehow this negates my argument that our system doesn’t know its costs, because Canada is one of the last countries in the world that still funds hospitals in a single block payment.
Ottawa enforces this system, with Dix its enthusiastic cop. Extra-billing audits are underway at six private clinics, with the total amounts to be deducted from federal transfer payments to B.C., and fines plus repayment to be imposed starting this fall. All essential service must be paid by the B.C. Medical Services Plan, soon to be funded by a job-killing payroll tax.
The tide may be changing. Seeing the federal-provincial legal machine stretching out Vancouver surgeon Brian Day’s case to extend a 2005 Quebec win to B.C., a judge adjourned to allow Day to fundraise. The Canadian Constitution Foundation has taken on the project.
As Beverley McLachlin, now retired as Chief Justice of the Supreme Court of Canada, wrote in the Quebec decision: “Access to a waiting list is not access to health care.”
Tom Fletcher is B.C. legislature reporter and columnist for Black Press. Email: firstname.lastname@example.org