November 25, 2010

We expect politicians to act on their convictions. So it isn't surprising that Health Minister Kevin Falcon is introducing competition into health care.

It is surprising that his convictions would go so far as to allow clinics in B.C. to operate illegally; clinics such as the Cambie Surgery Centre in Vancouver run by Dr. Day that operates in open defiance of the law. Day crows: "It is a violation of the B.C. Medicare Protection Act and I make no apologies for that." His goal is to relieve the rich of their suffering and money. Dennis Geidt of Revelstoke walked into Dr. Day's clinic with a fistful of dollars and left $7,010 lighter, his shoulder repaired.

In B.C.'s lawless Wild West health care system, the B.C. Liberal government sits on its hands while money talks. Dr. Day taunts: "What is wrong with Canadians spending their own, after-tax dollars on their own health care? No politician I've ever asked has had an answer to this question."

Well, Dr. Day, I'm about to answer the question that politicians won't. Canadians should be able to buy whatever they want. And governments should limit what is sold. You can buy anything you want as long as it's safe. The rich can't buy infant formulas that contain insect parts, as were recently found in the U.S., because they are hazardous to public health. Governments prohibit the sale of poorly-wired dangerous lamps because in civilized countries, laws trump the almighty dollar.

The purchase of health care is illegal in Canada because it is hazardous to public health. It robs public resources to pay for private procedures. Despite his entrepreneurial claims, Dr. Day accepts public money from governments to pay for claims from Worker's Compensation (WorkSafeBC), military personnel, RCMP and prison inmates. Those public funds help subsidize his operations.

Dr. Day's practice is dangerous because it erodes the fundamental principle of the single-payer system: an internationally recognized way to keep health insurance costs down. It's not just a financial consideration. Erosion of public health care reduces access to treatment for ordinary Canadians - - often a matter of life and death.

Day's clinic is a threat to our single-payer health care system not just because it's privately run. Public clinics and hospitals are more efficient because they don't extract profits. So, feel free to run your clinic, Dr. Day, as long as you obey the law. Stop charging extra fees and accept anyone who walks through the door. And stop patient-billing.




 

The issue is not public versus private. Every doctor in B.C. operates a private business within the public health care system. Medical labs do the same. Dentists provide private health care completely outside the public health care system. What matters is where funding comes from. As long as the government is the single payer, costs can be controlled and efficiencies realized.

Another distraction is the definition of universal health care. Our health care is universal only because every person is covered; not because every possible procedure is covered. The public system never was intended to cover every possible treatment or procedure and never will. Politicians must have the courage to define what primary procedures are covered even if they face the wrath of who want to bloat the list beyond the capability of the public system to pay.

Health Minister Falcon is convinced that competition will improve delivery of surgery in hospitals. He thinks that "pay-for-performance" in hospitals will spark competition between hospitals and provide low cost treatment.

Think again, says Dr. Danielle Martin. The chair of Canadian Doctors for Medicare warns that when a similar plan was introduced to Great Britain costs increased for the simple reason that when more surgeries are performed, more money is paid. Pay-for-performance can improve health care, as it did in Ontario, but only when money is added to core funding not taken away from it.

Small hospitals like RIH would never work on a pay-for-performance model because of the volume of cases would never generate enough money to cover costs. The number of operations could be increased but only if we encourage people to drive recklessly or live less healthy, and that's not likely.

We need politicians with conviction to defend our single-payer system and the courage to stand up to those who would profit from the misery of Canadians.

 

David Charbonneau is the owner of Trio Technical.
He can be reached at dcharbonneau13@shaw.ca