The Petrolia Topic editorialized on Feb.2, 2011 in "Health care system needs work":
"Ontario Health and Long-Term Care Minister Deb Matthews said the province is "...absolutely committed" to keeping Petrolia's hospital emergency department open.
But a politician's promises are like eggs: They are both easily broken. And the ruling Liberals have broken many promises.
Matthews made the comment during a recent Lambton County visit, which included Charlotte Eleanor Englehart Hospital of Bluewater Health.
The emergency department is being kept open with local and provincial doctors easing a chronic shortage of physicians.
The Feb. 2 regional round table discussion held in Petrolia by the Rural and Northern Health Care Panel was a chance for local health care consumers to speak their mind about this and other issues. The discussion is one of 11 regional meetings being held across the province and the panel's report and recommendations are expected later this year. The report will lead to a new rural and northern health care plan.
The executive summary of the panel's interim report lists many challenges in access to health care in rural areas. The summary says "...Local Health Integration Networks, as well as other stakeholders in the (health care) system, struggle to effectively provide services to rural, remote and northern communities."
That's a bit scary, since LHINs are responsible for co-ordinating health care services that meet the needs of local communities.
The summary also lists 12 major challenges in having a health care system that's available and accessible to rural people, including: limited sharing of health records and information among health care professionals; a physician shortage; centralization of the health care system; and a lack of rural perspective applied in planning at the provincial or LHIN levels.
Solving health care access issues in rural areas is a complex problem but steps are clearly needed to help the Erie-St. Clair LHIN and other stakeholders carry out their mandate.
Consulting rural communities is a good start but health care stakeholders must work together and the panel's recommendations must be implemented in a timely manner. And modernizing the health care network with an electronic medical records system is needed to make it more efficient.
Results of the Oct. 6 provincial election could throw a monkey wrench into plans. But at least everyone agrees the health care system is sick and needs to get better."
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So: Petrolia remains open [guess they didn't get their HIP directive from the LHIN yet...] - but the emergency departments in Fort Erie and Port Colborne were closed?!
McGuinty and Smitherman promised to keep them open, as well!!
The Liberals lied about that.
Deb Matthews and her Liberals are "absolutely committed" - to lying, and to enforcing a despotic, unmanageable, unaccountable, single-payer, state-controlled health care monopoly.
The reason that Fort Erie and Port Colborne were shut down is that McGuinty realized that they are closer to better health care in Buffalo.
And not everyone agrees that the health care system is "sick" - not one Liberal admits that!
Jim Bradley certainly won't!
And what's with the "chronic shortage of physicians" mentioned in this article? If you read the tax-payer-funded propaganda put out by Caroline Bourque at the Liberal-controlled NHS, you would be led to believe that there is NO doctor shortage!!
That's what devious Deb's sayin' as well!
What is truly sick is that editorials such as these are a dime-a-dozen throughout the province; they always dance around the edge of the issue, recognizing that there's a health care problem, yadda yadda.. yet they never quite get around to addressing the real problem: even though they realize that politicians lie, and admit they understand that McGuinty's Liberals have lied - these editorial writers never seem to correlate the idea that these VERY SAME POLITICAL LIARS run a no-patient-choice health-care MONOPOLY.
They are loathe to recognize that the real problem is that health care in Ontario is a puppet of state control. Get the liars and political opportunists away from controlling the health care system by de-monopolizing it.
Just get Dalton McGuinty and Deb Matthews and Jim Bradley the f*ck OUT of their cosy monopolist health care racket.
Deny the Liberals the ability to freely TAKE, and then SQUANDER, our money, while smugly pretending to know 'what's best' for us.
As with many other health care editorials throughout Ontario (and as we've seen in St. Catharines as well) this one from Petrolia recognizes part of the problem; but then stands helplessly and confusedly on the edge, unable or unwilling to put the rest of the pieces together; clinging desperately to the belief that their preferred "solution" (specifically: single-payer, state-run health-care) somehow is not the actual problem.
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Showing posts with label doctor shortage. Show all posts
Showing posts with label doctor shortage. Show all posts
Wednesday, February 2, 2011
Sunday, November 15, 2009
Another surgery cancellation in McGuinty's health care monopoly: who cares?
Jonathan Jenkins wrote (St.Catharines Standard, Nov.13, 2009) of Crohn's disease patient Tina Peek, 51, whose surgery was cancelled unexpectedly at Sunnybrook hospital. Ms. Peek "had driven in from her Barrie home with her husband on Tuesday morning, bracing herself for an operation to fix a hernia and move her iliostomy from one side of her stomach to the other.
It's just the latest in a litany of procedures she's faced over the past two years and she says she had to psych herself up for the potential five-day hospital stay. To prepare, she washed for several days with anti-bacterial soap and stopped eating Sunday.
But after a three-hour wait, including a painful 45-minute effort to get an IV into her weary veins, Peek was told her surgery was cancelled because Sunnybrook had no bed for her.
Peek decided to take her complaint to the top. After confronting the secretary, she was introduced to a patient relations consultant whose office was nearby.
"I pulled my pants down for her too. I've never done that before in my life," Peek said.
"I was pretty hysterical. I still had the IV in my hand.
"My husband had left to go back home. I have no phone, I have no money, I have nothing. I have a hospital card and a health card because they tell you not to bring anything. She gave me a parking voucher good for one time and a $20 food voucher."
Peek has been given a new surgery date of Dec. 16.
Craig Duhamel, Sunnybrook vice-president for patient relations, said the hospital regrets having to cancel Peek's date -- one of four that were put off that day -- but simply couldn't accommodate any more patients."
Let's remember that during the 2007 election campaign (at an all-candidates meeting at Ridley College) St.Catharines Liberal MPP Jim Bradley brought up Sunnybrook as he bragged about how well McGuinty's Liberals were doing in health care.
So let's ask Jim Bradley now about what happened to Tina Peek at Sunnybrook.
You can bet Jimmy, our illustrious health-care monopolist, doesn't know, and furthermore, couldn't care less.
Bed shortage? What bed shortage? Bradley and his McGuinty-monopolist-ideologues have made it clear Liberals are not interested in providing more hospital beds: see here )
Wasn't Ms. Peek's situation predetermined and predictable, and directly linked to Dalton McGuinty's monopolist ideology?
Liberals will simply 'fob off' (to use Jim Bradley's phrase) Ms. Peek's entire experience as 'just an anomaly' !!!!
[see here, where I wrote:
"After five years of Liberal rule, the doctor shortage in Niagara remains virtually unchanged.
Peter Downs wrote in “Is there a doctor in the house”, (St. Catharines Standard, Feb.16, 2008) that “20,000 people in the city are searching for a doctor.”
20,000 out of a population in St. Catharines of what, about 130,000? Are these the kinds of numbers that St. Catharines' Liberal MPP Jim Bradley is proud of?
Wrote Downs: “St. Catharines is short approximately 20 family doctors, while the region as a whole is down about 95, according to Ministry of Health figures.”
Downs wrote of some doctors who are interviewing potential patients before taking them on, for a variety of reasons. No mention was made in the article as to MPP Jim Bradley’s views on this blow back to his Liberal government’s Commitment to the Future of Medicare Act. Bradley’s government has forced patients to only compensate their doctor through the government’s medicare-monopoly-middleman. Will Bradley’s Liberals now begin forcing doctors to accept any and all patients, too? Will the Liberals simply enact provisions forcing all doctors to become salaried state employees?" ]
So, who was the Liberal health minister in Feb. 2008, during which time the St.Catharines Standard's Mr.Downs was reporting the doctor shortage?? Why, yes - it was George Smitherman - who (in his Nov.2009 bid to run for mayor of Toronto) now trumpets his claim here that he "got doctors for 600,000 more Ontarians"!
Why isn't anyone investigating Smitherman's blatant spin? Why isn't the St.Catharines Standard examining what Smitherman now says he did, with what was actually being reported locally at the time?
In Feb. 2008, the Standard reported that 20,000 people in St.Catharines didn't have a doctor; that St.Catharines was short of 20 family doctors. Seeing that Smitherman (thank goodness) was shuffled out as health minister in June 2008, HOW MANY DOCTORS DID SMITHERMAN actually 'get' for St.Catharines?
Should we just take Smitherman's current claims as truth, and pretend Downs' account was never written?!
Is Smitherman taking credit for doctors that his Liberal government "got" only during his term as health minister (2003-Jun.2008), or is he referring to the sum total from 2003 to Nov.2009?
Has anyone asked local Liberal MPP Jim Bradley to specifically comment on the bed shortage AND doctor shortage numbers (both locally in Niagara and Ontario-wide) during Smitherman's time as health minister?
Like all McGuinty Liberals, Jim Bradley is more concerned with propagating the ideological health of his failing single-payer health-care monopoly, than he is about the health of suffering patients who are held hostage within it.
It's just the latest in a litany of procedures she's faced over the past two years and she says she had to psych herself up for the potential five-day hospital stay. To prepare, she washed for several days with anti-bacterial soap and stopped eating Sunday.
But after a three-hour wait, including a painful 45-minute effort to get an IV into her weary veins, Peek was told her surgery was cancelled because Sunnybrook had no bed for her.
Peek decided to take her complaint to the top. After confronting the secretary, she was introduced to a patient relations consultant whose office was nearby.
"I pulled my pants down for her too. I've never done that before in my life," Peek said.
"I was pretty hysterical. I still had the IV in my hand.
"My husband had left to go back home. I have no phone, I have no money, I have nothing. I have a hospital card and a health card because they tell you not to bring anything. She gave me a parking voucher good for one time and a $20 food voucher."
Peek has been given a new surgery date of Dec. 16.
Craig Duhamel, Sunnybrook vice-president for patient relations, said the hospital regrets having to cancel Peek's date -- one of four that were put off that day -- but simply couldn't accommodate any more patients."
Let's remember that during the 2007 election campaign (at an all-candidates meeting at Ridley College) St.Catharines Liberal MPP Jim Bradley brought up Sunnybrook as he bragged about how well McGuinty's Liberals were doing in health care.
So let's ask Jim Bradley now about what happened to Tina Peek at Sunnybrook.
You can bet Jimmy, our illustrious health-care monopolist, doesn't know, and furthermore, couldn't care less.
Bed shortage? What bed shortage? Bradley and his McGuinty-monopolist-ideologues have made it clear Liberals are not interested in providing more hospital beds: see here )
Wasn't Ms. Peek's situation predetermined and predictable, and directly linked to Dalton McGuinty's monopolist ideology?
Liberals will simply 'fob off' (to use Jim Bradley's phrase) Ms. Peek's entire experience as 'just an anomaly' !!!!
[see here, where I wrote:
"After five years of Liberal rule, the doctor shortage in Niagara remains virtually unchanged.
Peter Downs wrote in “Is there a doctor in the house”, (St. Catharines Standard, Feb.16, 2008) that “20,000 people in the city are searching for a doctor.”
20,000 out of a population in St. Catharines of what, about 130,000? Are these the kinds of numbers that St. Catharines' Liberal MPP Jim Bradley is proud of?
Wrote Downs: “St. Catharines is short approximately 20 family doctors, while the region as a whole is down about 95, according to Ministry of Health figures.”
Downs wrote of some doctors who are interviewing potential patients before taking them on, for a variety of reasons. No mention was made in the article as to MPP Jim Bradley’s views on this blow back to his Liberal government’s Commitment to the Future of Medicare Act. Bradley’s government has forced patients to only compensate their doctor through the government’s medicare-monopoly-middleman. Will Bradley’s Liberals now begin forcing doctors to accept any and all patients, too? Will the Liberals simply enact provisions forcing all doctors to become salaried state employees?" ]
So, who was the Liberal health minister in Feb. 2008, during which time the St.Catharines Standard's Mr.Downs was reporting the doctor shortage?? Why, yes - it was George Smitherman - who (in his Nov.2009 bid to run for mayor of Toronto) now trumpets his claim here that he "got doctors for 600,000 more Ontarians"!
Why isn't anyone investigating Smitherman's blatant spin? Why isn't the St.Catharines Standard examining what Smitherman now says he did, with what was actually being reported locally at the time?
In Feb. 2008, the Standard reported that 20,000 people in St.Catharines didn't have a doctor; that St.Catharines was short of 20 family doctors. Seeing that Smitherman (thank goodness) was shuffled out as health minister in June 2008, HOW MANY DOCTORS DID SMITHERMAN actually 'get' for St.Catharines?
Should we just take Smitherman's current claims as truth, and pretend Downs' account was never written?!
Is Smitherman taking credit for doctors that his Liberal government "got" only during his term as health minister (2003-Jun.2008), or is he referring to the sum total from 2003 to Nov.2009?
Has anyone asked local Liberal MPP Jim Bradley to specifically comment on the bed shortage AND doctor shortage numbers (both locally in Niagara and Ontario-wide) during Smitherman's time as health minister?
Like all McGuinty Liberals, Jim Bradley is more concerned with propagating the ideological health of his failing single-payer health-care monopoly, than he is about the health of suffering patients who are held hostage within it.
Friday, July 24, 2009
Three ER doctors leave Niagara Falls hospital - no comment from local Liberals Bradley or Craitor
Above: story "Falls' hospital loses ER docs" by Alison Bell, (Niagara This Week, Jul.24, 2009)(click photo to read)
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Why weren't local Liberal MPP's Kim Craitor or Jim Bradley interviewed in this story? Wow - it's like their Liberal health monopolism has nothing to do with the doctor shortage which just occurred before our very eyes.
You damn well know that if this had occurred while Bradley was in opposition, he'd be screaming his FLICKING ass off at the "Harris neo-con health cuts and resultant doctor shortages"!!! You know it.
Yet today - not a bloody peep from our local Liberal health care monopolists.
Nothing in the press here; no mention of any Liberal being asked to comment on the loss of THREE doctors in THREE months at GNGH.
Unbelievable.
'Oh we can't comment on this, it's a personnel matter' the Grits might say (if anyone were to ask, that is!!); but you sure as hell would see the Liberals commenting if they weren't in power, and this wasn't happening under their noses in their Liberal under-funded system!
Apparently, when Good Ole Jim Bradley was in opposition, why, there was a severe doctor shortage crisis (no doubt caused - yes, wait for it... by Harris neo cons!!! haha) But now, the press doesn't mention any doctor shortage crisis, and it doesn't mention any Liberal either!
Let's ask Liberal health monopoly-enforcers Jim 'I hate doctors' Bradley and Kim Craitor - or if they're afraid to answer, then David Caplan, or his boss, Dalton McGuinty, to explain what is going on here at the NHS's ER, and whether patients or service at the Niagara Falls ER could become compromised.
And what's this crap mentioned in the news report about changing the hospital staffing model, putting (forcing??) fee-for-service doctors onto the NHS payroll, thereby preventing them from speaking out in public against hospital mis-management?! WTF is this?!
Didn't reporter Alison Bell find this at all worthy of follow up - getting a response or comment from the local Liberal politicians, you know, the Liberals who claim there are no problems in their single-payer monopoly monstrosity?!
Was any Liberal even asked for a comment; were they asked, but then declined; or, were the Liberals basically hiding? Or, were they just let off the hook, with no one even bothering to ask?
Time and again , we see that Liberal healthcare duplicity is rampant. (see:
http://rightinniagara.blogspot.com/2007/08/liberal-healthcare-duplicity-ontario.html )
Ontario's single-payer status-quo sucks, as do the Ontario Liberals.
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Friday, February 29, 2008
Is Jim Bradley "fobbing off" doctor shortage in Niagara?
After five years of Liberal rule, the doctor shortage in Niagara remains virtually unchanged.
Peter Downs wrote in “Is there a doctor in the house”, (St. Catharines Standard, Feb.16, 2008) that “20,000 people in the city are searching for a doctor.”
20,000 out of a population in St. Catharines of what, about 130, 000? Are these the kinds of numbers that St. Catharines Liberal MPP Jim Bradley is proud of?
Wrote Downs: “St. Catharines is short approximately 20 family doctors, while the region as a whole is down about 95, according to Ministry of Health figures.”
Downs wrote of some doctors who are interviewing potential patients before taking them on, for a variety of reasons. No mention was made in the article as to MPP Jim Bradley’s views on this blow back to his Liberal government’s Comittment to the Future of Medicare Act. Bradley’s government has forced patients to only compensate their doctor through the government’s medicare-monopoly-middleman. Will Bradley’s Liberals now begin forcing doctors to accept any and all patients, too? Will the Liberals simply enact provisions forcing all doctors to become salaried state employees?
Back in Nov.17, 1999, when Jim Bradley was in opposition, the St. Catharines Standard wrote in “Witmer, Bradley don’t see eye to eye: Health minister 'fobbing off' duty to alleviate Niagara ophthalmologist shortage, MPP says”:
"Health Minister Elizabeth Witmer "fobbed off responsibility" Tuesday when confronted with the issue of Niagara's eye doctor shortage, St. Catharines MPP Jim Bradley says.
Bradley, speaking in the legislature, raised the issue in the form of a question to the minister. He demanded the lifting of an annual billing cap that may cause at least some of Niagara's 13 ophthalmologists to close their doors.
The request wasn't granted.
Instead, Witmer referred to the role of the physician services committee in establishing policies that govern billing cap exemptions. She also stressed how much the government is spending on health care.
"There's no question they're looking for ways of worming out of their commitment to health care," Bradley said afterward by telephone from Toronto.
A news release from his office says he was "disappointed that the minister ... fobbed off responsibility for the shortfall to the physician services committee. ..."”
Bradley was quoted saying: "Minister, will you now do the right thing for the people in the Niagara region -- for patients, particularly elderly patients, in the Niagara region?
"Will you now remove the cap on ophthalmologist billings in the Niagara region so that patients in Niagara can receive the kind of eye care they need and deserve?"
So, there was a link in Bradley’s message at that time (when Good Ole Jimmy was in opposition) between the lifting of salary caps and doctor productivity. Yet, why doesn’t Bradley continue this line of endeavour now (seeing that Jimmy's monopoly-pushing Liberals are in power) for any doctor in any specialty?
Upon whom is Bradley “fobbing off” the doctor shortage today, after five years of his Liberal rule?
When Bradley talked then about “worming” out of health care commitments, it’s ironic that in 2004 his Liberals proceeded to delist previously covered (and supposedly "universal") health coverage, AND to gouge Ontarians with a multi-billion dollar new Health Tax.
The St. Catharines Standard (Jun.7, 2000) reported in “Need a doctor? Look in Hamilton: "Please note that there are currently no family physicians accepting new patients in St. Catharines at the present time." Telephone message at the Lincoln Academy of Medicine” that “The number of family doctors in Niagara dropped about 17 per cent between 1996 and 1999, says a recent report compiled by Niagara's physician resources planning task force. The task force estimates about 100 more family doctors are needed in Niagara.”
The story also reported:
“The doctor shortage in St. Catharines is so critical that some people have been told to look outside Niagara for a family physician.
"I've told a couple of people who were really desperate to go to Hamilton," said Niagara Health System interim chief of staff Dr. Heime Geffen on Tuesday.
Several family physicians in the Hamilton and Stoney Creek area are accepting new patients, according to the Hamilton Academy of Medicine.
"It is regrettable they (doctors) have to give people that advice, but it's understandable in the current situation," said St. Catharines Liberal MPP Jim Bradley.
His office receives about six calls a week from concerned Niagara residents who can't find doctors for themselves or family members.
"There is no question it is an acute problem," said Bradley. "The crisis has been on our steps for the past five years."”
Yet again we need to ask: after five years now of Bradley’s Liberals - what’s changed?!
The shortage remains essentially the same: Niagara region reportedly needed 100 doctors in 2000; it is still short 95 physicians now in February of 2008 - under Bradley’s Liberal government.
It was a "CRISIS" Bradley (along with a giddy, ever-helpful St.Catharines Standard) crowed back then - yet the numbers of doctors Niagara needs essentially hasn't changed; so why isn't Bradley calling it a "CRISIS" today, under his own government's rule?!
And now that is Bradley and his Liberals who are in power, well... ummm... the St.Catharines Standard can't be bothered to focus on that!!
It was “understandable” Bradley said back then…why? …because Bradley, safely in opposition, could conveniently "fob off" the shortage at that time onto the then-Conservative government?!
How many patients are calling Bradley’s office today, looking for doctors?
Has Bradley told us? (The St.Catharines Standard hasn't! Can't embarrass ole Liberal Jimmy - only Conservatives!!)
Have these patients, who were seeking doctors, miraculously vanished from Bradley's office on the very day Bradley's Liberals took office?! I wonder if Bradley finds this “understandable” now in 2008?
Certainly thousands upon thousands of Ontario patients don’t find Jim Bradley's wormy Liberal health-care duplicity “understandable”.
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Peter Downs wrote in “Is there a doctor in the house”, (St. Catharines Standard, Feb.16, 2008) that “20,000 people in the city are searching for a doctor.”
20,000 out of a population in St. Catharines of what, about 130, 000? Are these the kinds of numbers that St. Catharines Liberal MPP Jim Bradley is proud of?
Wrote Downs: “St. Catharines is short approximately 20 family doctors, while the region as a whole is down about 95, according to Ministry of Health figures.”
Downs wrote of some doctors who are interviewing potential patients before taking them on, for a variety of reasons. No mention was made in the article as to MPP Jim Bradley’s views on this blow back to his Liberal government’s Comittment to the Future of Medicare Act. Bradley’s government has forced patients to only compensate their doctor through the government’s medicare-monopoly-middleman. Will Bradley’s Liberals now begin forcing doctors to accept any and all patients, too? Will the Liberals simply enact provisions forcing all doctors to become salaried state employees?
Back in Nov.17, 1999, when Jim Bradley was in opposition, the St. Catharines Standard wrote in “Witmer, Bradley don’t see eye to eye: Health minister 'fobbing off' duty to alleviate Niagara ophthalmologist shortage, MPP says”:
"Health Minister Elizabeth Witmer "fobbed off responsibility" Tuesday when confronted with the issue of Niagara's eye doctor shortage, St. Catharines MPP Jim Bradley says.
Bradley, speaking in the legislature, raised the issue in the form of a question to the minister. He demanded the lifting of an annual billing cap that may cause at least some of Niagara's 13 ophthalmologists to close their doors.
The request wasn't granted.
Instead, Witmer referred to the role of the physician services committee in establishing policies that govern billing cap exemptions. She also stressed how much the government is spending on health care.
"There's no question they're looking for ways of worming out of their commitment to health care," Bradley said afterward by telephone from Toronto.
A news release from his office says he was "disappointed that the minister ... fobbed off responsibility for the shortfall to the physician services committee. ..."”
Bradley was quoted saying: "Minister, will you now do the right thing for the people in the Niagara region -- for patients, particularly elderly patients, in the Niagara region?
"Will you now remove the cap on ophthalmologist billings in the Niagara region so that patients in Niagara can receive the kind of eye care they need and deserve?"
So, there was a link in Bradley’s message at that time (when Good Ole Jimmy was in opposition) between the lifting of salary caps and doctor productivity. Yet, why doesn’t Bradley continue this line of endeavour now (seeing that Jimmy's monopoly-pushing Liberals are in power) for any doctor in any specialty?
Upon whom is Bradley “fobbing off” the doctor shortage today, after five years of his Liberal rule?
When Bradley talked then about “worming” out of health care commitments, it’s ironic that in 2004 his Liberals proceeded to delist previously covered (and supposedly "universal") health coverage, AND to gouge Ontarians with a multi-billion dollar new Health Tax.
The St. Catharines Standard (Jun.7, 2000) reported in “Need a doctor? Look in Hamilton: "Please note that there are currently no family physicians accepting new patients in St. Catharines at the present time." Telephone message at the Lincoln Academy of Medicine” that “The number of family doctors in Niagara dropped about 17 per cent between 1996 and 1999, says a recent report compiled by Niagara's physician resources planning task force. The task force estimates about 100 more family doctors are needed in Niagara.”
The story also reported:
“The doctor shortage in St. Catharines is so critical that some people have been told to look outside Niagara for a family physician.
"I've told a couple of people who were really desperate to go to Hamilton," said Niagara Health System interim chief of staff Dr. Heime Geffen on Tuesday.
Several family physicians in the Hamilton and Stoney Creek area are accepting new patients, according to the Hamilton Academy of Medicine.
"It is regrettable they (doctors) have to give people that advice, but it's understandable in the current situation," said St. Catharines Liberal MPP Jim Bradley.
His office receives about six calls a week from concerned Niagara residents who can't find doctors for themselves or family members.
"There is no question it is an acute problem," said Bradley. "The crisis has been on our steps for the past five years."”
Yet again we need to ask: after five years now of Bradley’s Liberals - what’s changed?!
The shortage remains essentially the same: Niagara region reportedly needed 100 doctors in 2000; it is still short 95 physicians now in February of 2008 - under Bradley’s Liberal government.
It was a "CRISIS" Bradley (along with a giddy, ever-helpful St.Catharines Standard) crowed back then - yet the numbers of doctors Niagara needs essentially hasn't changed; so why isn't Bradley calling it a "CRISIS" today, under his own government's rule?!
And now that is Bradley and his Liberals who are in power, well... ummm... the St.Catharines Standard can't be bothered to focus on that!!
It was “understandable” Bradley said back then…why? …because Bradley, safely in opposition, could conveniently "fob off" the shortage at that time onto the then-Conservative government?!
How many patients are calling Bradley’s office today, looking for doctors?
Has Bradley told us? (The St.Catharines Standard hasn't! Can't embarrass ole Liberal Jimmy - only Conservatives!!)
Have these patients, who were seeking doctors, miraculously vanished from Bradley's office on the very day Bradley's Liberals took office?! I wonder if Bradley finds this “understandable” now in 2008?
Certainly thousands upon thousands of Ontario patients don’t find Jim Bradley's wormy Liberal health-care duplicity “understandable”.
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Monday, January 14, 2008
Towns forced to find doctors while Liberals look away
The National Post wrote in “A boost in pay and the doctor will stay, MD recruitment” (Jan.14, 2008), of “towns offering money, homes to lure physicians”, due to Canada's doctor shortage. "It is estimated that as many as five million Canadians are without a family physician".
If Ontario towns are offering money or homes to physicians, why isn’t such municipal activity being challenged by Health Minister George Smitherman under his Commitment to the Future of Medicare Act?
Why should a mayor and council have the right to bribe doctors to their town with financial incentives, yet individual residents are forbidden by law to pay a doctor for their own medical care?
Why should municipalities be forced to cover for the Liberal’s mis-managed health-care policies?
What’s next…local city halls sourcing and paying for surgeries, while Smitherman looks the other way?
Talk about creeping, indirect taxation and the blurring of boundaries!
Premier Dalton McGuinty and George Smitherman are responsible for Ontario's health care monopoly.
They must be held to account.
If Ontario towns are offering money or homes to physicians, why isn’t such municipal activity being challenged by Health Minister George Smitherman under his Commitment to the Future of Medicare Act?
Why should a mayor and council have the right to bribe doctors to their town with financial incentives, yet individual residents are forbidden by law to pay a doctor for their own medical care?
Why should municipalities be forced to cover for the Liberal’s mis-managed health-care policies?
What’s next…local city halls sourcing and paying for surgeries, while Smitherman looks the other way?
Talk about creeping, indirect taxation and the blurring of boundaries!
Premier Dalton McGuinty and George Smitherman are responsible for Ontario's health care monopoly.
They must be held to account.
Friday, January 11, 2008
Canada "immediately" needs 26,000 doctors
R. Bobak wrote in "Re: Ontario is Losing The Battle For Doctors, Janice Willett, Nov.15", (National Post, Jan.10, 2008):
"The Post states that "approximately 1.5 million Canadians cannot find a family physician." Yet, the Ontario Medical Association's Janice Willett claimed in your paper back in November, 2007, that "Ontario is currently short 2,000 doctors, a shortfall that impacts one million adults and 130,000 children." Has the doctor shortage vastly improved in the last two months, or is one of these figures off?"
Given the above figures, and given that Ontario's population is approx. 13 million (within Canada' s total of about 32 million) then it would mean that in the rest of Canada (outside of Ontario) with a remaining population of about 19 million, only 370,000 people don't have a doctor. Does anyone get these figures? Is this an apples/oranges question, where I'm counting grapes, or what?
What's needed would be the per-capita ratio of existing doctors to existing population, for each province. Then, by province, we'd know how many doctors per-capita are still needed; that is, assuming that all provinces even have the same requirements!
The St. Catharines Standard, Jan.9, 2008, reported: "To bring Canada's medical workforce even up to minimum standards set up by the Organisation for Economic Co-operation and Development, the country would need to immediately add 26,000 doctors, [CMA president Brian] Day said from Vancouver."
We're short a minimum of 26,000 doctors?? Does this include other medical staff, or is this strictly just MDs??
Again, if Ontario (13 million people) is short 2,000 doctors (according to Willett above), then the rest of Canada (19 million people) must then be short 24,000 doctors! These comparative ratios don't make sense.
The St Catharines Standard (Jan.9, 2007) also wrote "An estimated four to five million Canadians do not have a family doctor."
In this case, if in Ontario (per Willett) 1.13 million (out of 13 million) don't have a doctor, then in the rest of Canada [based on 4.5 million national shortage, a compromise of Day's 4 to 5] it would mean that 3.87 million people (out of 19 million) don't have a doctor.
But these figures show a large gap in that 8.7% of 13 million Ontarians have no doctor; while 20.4% of 19 million in the rest of Canada have no doctor.
What's missing here?
"The Post states that "approximately 1.5 million Canadians cannot find a family physician." Yet, the Ontario Medical Association's Janice Willett claimed in your paper back in November, 2007, that "Ontario is currently short 2,000 doctors, a shortfall that impacts one million adults and 130,000 children." Has the doctor shortage vastly improved in the last two months, or is one of these figures off?"
Given the above figures, and given that Ontario's population is approx. 13 million (within Canada' s total of about 32 million) then it would mean that in the rest of Canada (outside of Ontario) with a remaining population of about 19 million, only 370,000 people don't have a doctor. Does anyone get these figures? Is this an apples/oranges question, where I'm counting grapes, or what?
What's needed would be the per-capita ratio of existing doctors to existing population, for each province. Then, by province, we'd know how many doctors per-capita are still needed; that is, assuming that all provinces even have the same requirements!
The St. Catharines Standard, Jan.9, 2008, reported: "To bring Canada's medical workforce even up to minimum standards set up by the Organisation for Economic Co-operation and Development, the country would need to immediately add 26,000 doctors, [CMA president Brian] Day said from Vancouver."
We're short a minimum of 26,000 doctors?? Does this include other medical staff, or is this strictly just MDs??
Again, if Ontario (13 million people) is short 2,000 doctors (according to Willett above), then the rest of Canada (19 million people) must then be short 24,000 doctors! These comparative ratios don't make sense.
The St Catharines Standard (Jan.9, 2007) also wrote "An estimated four to five million Canadians do not have a family doctor."
In this case, if in Ontario (per Willett) 1.13 million (out of 13 million) don't have a doctor, then in the rest of Canada [based on 4.5 million national shortage, a compromise of Day's 4 to 5] it would mean that 3.87 million people (out of 19 million) don't have a doctor.
But these figures show a large gap in that 8.7% of 13 million Ontarians have no doctor; while 20.4% of 19 million in the rest of Canada have no doctor.
What's missing here?
Health-care: competition; Medicare: protectionism and monopoly
The National Post had a number of reader’s letters on Jan.10, 2007, regarding their Jan.8 editorial on Canada's doctor shortage.
In “What’s wrong with health care? Four MDs respond”, Dr. Graham Berlyne wrote:
“The hypothesis in your editorial that what is condescendingly called “socialized medicine’ is somehow responsible for the physician shortage in Canada - and that by dismantlement will somehow cure this shortfall – is very difficult to believe."
Does this doc have a problem with dismantling a health monopoly that interferes with an individual’s right to choose how to pay for health services?
If Berlyne wants to work in a medicare-only system, he can stay in the public system. Others (patients and physicians) who don’t, can go to a private-parallel system. It’s Berlyne’s choice to do what he wants, but it isn’t Berlyne’s choice to stop others from choosing what they wish to do. Who is he to impose his superior morality on others? A public system must recognize the right of the individual, not subjugate the individual within a failing monopoly brimming with supposedly good-intentions.
Also, is Berlyne himself condescendingly intimating that Canadian medicare is NOT socialized? What, then, is a single-payer, government-run monopoly health system?!
I’m seeing more lefties starting to spout this deceptive meme, pretending that the socialized single-payer health care system which Canada has had for 40 years, was not really socialized health care, that it was something else!!
So now, they will logically say, if we only had real socialized health care, instead of the socialized healthcare which for the last 40 years we really didn’t have, then... ... really, my head hurts at this Brave New world/Animal Farm style revisionism.
If Berlyne thinks the State - through its single-payer socialized control of health care - had no hand in the doctor shortage in the early 1990’s, he’s mistaken.
Berlyne only has to talk to then-NDP (now Liberal) Bob Rae, or Rae's then-Deputy Health Minister, Michael Decter. They cut med school enrolments, based on their facile interpretation of the Barer-Stoddart [BS] report. The State - the single-payer – suddenly felt it wanted to control health-care costs by getting rid of older doctors (early retirement), limiting billing hours on current MDs, and cutting back on new med school enrolments. They seriously thought that having too many doctors was actually a problem!
There are many newspaper articles in the 1991-1993 period chronicling and attesting to this state-instigated phenomenon in Ontario; for example:
“ ‘Drastic' steps pending to cut number of MDS in metro area” (Toronto Star, by Lisa Priest, Oct.24, 1992)
“Tough medicine: UT med school cuts enrolment” (The Hamilton Spectator, by Suzanne Morrison, Feb.19, 1993)
“Battered MDs now being told how many can practices” (Toronto Star, by Lisa Priest, Mar.3, 1993)
“Over-65 MDs blamed for cuts. Should retire official says” (The Hamilton Spectator, May 26, 1993)
Dr. Roy Eappen and Dr. Darryl D. LaBuick , who also wrote letters in the National Post, Jan.10, 2008, were correct when they said the CMA warned about the repercussions of these government-run-interventionist moves at that time.
Berlyne says “I would bet my Ontario Health Premium that privatization won’t help a jot.” A “jot”? Is that more, or less, than a lot? Given his handsome state-paid salary, why is Berlyne only betting $900.00 from his health TAX ? (Berlyne knows, doesn’t he, that it was not, as he says, a “premium” at all. That word was condescendingly used by Ontario’s Liberals to deceive the electorate.)
So, doc, use the proper definition of what it was: a Liberal-created health TAX. Cut your Liberal politically-correct DoubleSpeak.
Berlyne concludes that privatization won’t help a jot/lot - as if the Chaoulli court case never happened in Quebec (!)... but, what if did help a “BIT”?
What if it helped “SOME’?
Would that not be worth trying, Dr. Berlyne?
Or do we condescendingly dismiss the whole idea, regardless? Berlyne’s status–quo arguments remind me of the same kind of defense Ted Marmor used, without success, to defend Quebec’s health-care charter infringements in 2005’s Chaoulli case.
If you want health-care, you need competition. If you want medicare, you want protectionism and monopoly.
*
In “What’s wrong with health care? Four MDs respond”, Dr. Graham Berlyne wrote:
“The hypothesis in your editorial that what is condescendingly called “socialized medicine’ is somehow responsible for the physician shortage in Canada - and that by dismantlement will somehow cure this shortfall – is very difficult to believe."
Does this doc have a problem with dismantling a health monopoly that interferes with an individual’s right to choose how to pay for health services?
If Berlyne wants to work in a medicare-only system, he can stay in the public system. Others (patients and physicians) who don’t, can go to a private-parallel system. It’s Berlyne’s choice to do what he wants, but it isn’t Berlyne’s choice to stop others from choosing what they wish to do. Who is he to impose his superior morality on others? A public system must recognize the right of the individual, not subjugate the individual within a failing monopoly brimming with supposedly good-intentions.
Also, is Berlyne himself condescendingly intimating that Canadian medicare is NOT socialized? What, then, is a single-payer, government-run monopoly health system?!
I’m seeing more lefties starting to spout this deceptive meme, pretending that the socialized single-payer health care system which Canada has had for 40 years, was not really socialized health care, that it was something else!!
So now, they will logically say, if we only had real socialized health care, instead of the socialized healthcare which for the last 40 years we really didn’t have, then... ... really, my head hurts at this Brave New world/Animal Farm style revisionism.
If Berlyne thinks the State - through its single-payer socialized control of health care - had no hand in the doctor shortage in the early 1990’s, he’s mistaken.
Berlyne only has to talk to then-NDP (now Liberal) Bob Rae, or Rae's then-Deputy Health Minister, Michael Decter. They cut med school enrolments, based on their facile interpretation of the Barer-Stoddart [BS] report. The State - the single-payer – suddenly felt it wanted to control health-care costs by getting rid of older doctors (early retirement), limiting billing hours on current MDs, and cutting back on new med school enrolments. They seriously thought that having too many doctors was actually a problem!
There are many newspaper articles in the 1991-1993 period chronicling and attesting to this state-instigated phenomenon in Ontario; for example:
“ ‘Drastic' steps pending to cut number of MDS in metro area” (Toronto Star, by Lisa Priest, Oct.24, 1992)
“Tough medicine: UT med school cuts enrolment” (The Hamilton Spectator, by Suzanne Morrison, Feb.19, 1993)
“Battered MDs now being told how many can practices” (Toronto Star, by Lisa Priest, Mar.3, 1993)
“Over-65 MDs blamed for cuts. Should retire official says” (The Hamilton Spectator, May 26, 1993)
Dr. Roy Eappen and Dr. Darryl D. LaBuick , who also wrote letters in the National Post, Jan.10, 2008, were correct when they said the CMA warned about the repercussions of these government-run-interventionist moves at that time.
Berlyne says “I would bet my Ontario Health Premium that privatization won’t help a jot.” A “jot”? Is that more, or less, than a lot? Given his handsome state-paid salary, why is Berlyne only betting $900.00 from his health TAX ? (Berlyne knows, doesn’t he, that it was not, as he says, a “premium” at all. That word was condescendingly used by Ontario’s Liberals to deceive the electorate.)
So, doc, use the proper definition of what it was: a Liberal-created health TAX. Cut your Liberal politically-correct DoubleSpeak.
Berlyne concludes that privatization won’t help a jot/lot - as if the Chaoulli court case never happened in Quebec (!)... but, what if did help a “BIT”?
What if it helped “SOME’?
Would that not be worth trying, Dr. Berlyne?
Or do we condescendingly dismiss the whole idea, regardless? Berlyne’s status–quo arguments remind me of the same kind of defense Ted Marmor used, without success, to defend Quebec’s health-care charter infringements in 2005’s Chaoulli case.
If you want health-care, you need competition. If you want medicare, you want protectionism and monopoly.
*
Sunday, December 16, 2007
Shame on universal-health-care
Here's a health-care thread from the St. Catharines Standard, starting with John Hartig, who wrote in "Preserve universal health-care", (St. Catharines Standard, Jul.2, 2005):
“Universal health care is being killed by the greed of our doctors.
Three huge changes have occurred in the past year -- changes that should be scary for anybody in society who is getting older:
- Six per cent increase in salary for doctors per year over the next four years
- Removal of their salary cap
- The proposed opening of a privately run cancer clinic in Toronto
A family physician used to earn close to $200,000 per annum with the cap -- which was not bad, for a part-time job, considering that many doctors stopped work on Wednesday afternoons and Fridays once their earnable limit was reached. The doctor shortage was therefore artificially created by the doctors themselves.
The billion dollars so recently injected into the system (which was meant to reduce waiting lists) will instead be siphoned into doctor salaries and administrative costs and not into the eventual care of patients. Nothing will change. Once the four-year deal runs out, we'll face more demands from doctors. The pattern we are facing so helplessly at the gas pumps we will also face at the counters of our health-care facilities -- which will mean additional service charges in the system: Anything from a $10 clinic visit to a $30 blood test.
A privately run cancer clinic in Toronto proposes to charge an initial $2,500 registration fee and $12,000 per year after that for care. Canadians would have to mortgage their houses and empty life- long savings accounts. Insurance companies would love these new circumstances so they can make more money out of "extra coverage" -- giving us an unjust society.
Universal health care should be a right equally available for everybody in a civilized society but the concept is shrewdly being dismantled by professionals in power. Shame on you, doctors!”
*
R. Bobak wrote in “Blame everyone for health-system woes” (published in the St. Catharines Standard, July 14, 2005):
“Further to John Hartig’s July 2, 2005 letter, shamelessly blaming doctors for all of Canada’s health care woes, why stop there? How about those greedy, profligate politicians who over-tax and then bribe us with our money to stay in power? Or those greedy, P3-hatin’ unionized activists whose main concern is to protect their cozy no-choice monopoly? How about all those greedy nurses, and paramedics, and lab technicians and pharmacists and hospital administrators? Don’t forget to blame the sick, too; without them, we wouldn’t even need those lazy, pesky doctors.
It truly is an unjust society when you won’t share the blame, which could be traced back to Canada’s patron saint, Tommy Douglas. The Father of today’s Fatal Perpetual Waiting List would himself be sick to witness the sad depths to which the rabid supporters of socialized health care have sunk in their dogmatic, self-righteous fervor. Today’s politicized health care system is but an unrecognizable Frankensteinian devolution of T.C.’s founding vision.
It's so helpful to begin the long overdue "civilized" health system debate by bashing our doctors. Frankly, are Canadians politically retarded?"
*
Joan Crook wrote in “Ask your doctor what a MD’s life is like”, (St. Catharines Standard, Jul.13, 2005):
"I read John Hartig's July 2 letter in The Standard (Preserve universal health care). You need to wake up, Mr. Hartig; I wouldn't be surprised if your own general practitioner read you the facts of life about being a doctor.
Although $200,000 per year might sound great to you, you need to know that most doctors need to have some form of staff to assist them in their practice.
As for them "having a part-time job" well, maybe you need to see what they do when not in their office.
I know my own doctor is as close to being a workaholic as one can be.
Yes, his office is closed on Wednesday afternoon -- he is often still there seeing to phone calls that have come in and to the remaining patients who are often still waiting in his waiting room.
I have been in hospital for surgery and this same doctor has come in even on Sunday to see how I was, and when I asked him if he ever takes time off he said yes, but the patients come first.
As for the doctors creating the so- called shortage of doctors, well you must have not read about the limit that a former provincial government put on new medical students in the province.
I have a daughter who had tried at that time to get into medical school. She already had a bachelor of nursing degree and had worked in the surgical ICU for a number of years.
When she was not accepted she went to the University of Buffalo to take her master's degree in nurse anaesthesiology, and she is still employed there as a nurse anesthetist."
*
These are the kinds of great assets that are lost by government intervention. Yet, the lefties 'blame the doctors'! For the love of... it's enough to make one sick.
*
“Universal health care is being killed by the greed of our doctors.
Three huge changes have occurred in the past year -- changes that should be scary for anybody in society who is getting older:
- Six per cent increase in salary for doctors per year over the next four years
- Removal of their salary cap
- The proposed opening of a privately run cancer clinic in Toronto
A family physician used to earn close to $200,000 per annum with the cap -- which was not bad, for a part-time job, considering that many doctors stopped work on Wednesday afternoons and Fridays once their earnable limit was reached. The doctor shortage was therefore artificially created by the doctors themselves.
The billion dollars so recently injected into the system (which was meant to reduce waiting lists) will instead be siphoned into doctor salaries and administrative costs and not into the eventual care of patients. Nothing will change. Once the four-year deal runs out, we'll face more demands from doctors. The pattern we are facing so helplessly at the gas pumps we will also face at the counters of our health-care facilities -- which will mean additional service charges in the system: Anything from a $10 clinic visit to a $30 blood test.
A privately run cancer clinic in Toronto proposes to charge an initial $2,500 registration fee and $12,000 per year after that for care. Canadians would have to mortgage their houses and empty life- long savings accounts. Insurance companies would love these new circumstances so they can make more money out of "extra coverage" -- giving us an unjust society.
Universal health care should be a right equally available for everybody in a civilized society but the concept is shrewdly being dismantled by professionals in power. Shame on you, doctors!”
*
R. Bobak wrote in “Blame everyone for health-system woes” (published in the St. Catharines Standard, July 14, 2005):
“Further to John Hartig’s July 2, 2005 letter, shamelessly blaming doctors for all of Canada’s health care woes, why stop there? How about those greedy, profligate politicians who over-tax and then bribe us with our money to stay in power? Or those greedy, P3-hatin’ unionized activists whose main concern is to protect their cozy no-choice monopoly? How about all those greedy nurses, and paramedics, and lab technicians and pharmacists and hospital administrators? Don’t forget to blame the sick, too; without them, we wouldn’t even need those lazy, pesky doctors.
It truly is an unjust society when you won’t share the blame, which could be traced back to Canada’s patron saint, Tommy Douglas. The Father of today’s Fatal Perpetual Waiting List would himself be sick to witness the sad depths to which the rabid supporters of socialized health care have sunk in their dogmatic, self-righteous fervor. Today’s politicized health care system is but an unrecognizable Frankensteinian devolution of T.C.’s founding vision.
It's so helpful to begin the long overdue "civilized" health system debate by bashing our doctors. Frankly, are Canadians politically retarded?"
*
Joan Crook wrote in “Ask your doctor what a MD’s life is like”, (St. Catharines Standard, Jul.13, 2005):
"I read John Hartig's July 2 letter in The Standard (Preserve universal health care). You need to wake up, Mr. Hartig; I wouldn't be surprised if your own general practitioner read you the facts of life about being a doctor.
Although $200,000 per year might sound great to you, you need to know that most doctors need to have some form of staff to assist them in their practice.
As for them "having a part-time job" well, maybe you need to see what they do when not in their office.
I know my own doctor is as close to being a workaholic as one can be.
Yes, his office is closed on Wednesday afternoon -- he is often still there seeing to phone calls that have come in and to the remaining patients who are often still waiting in his waiting room.
I have been in hospital for surgery and this same doctor has come in even on Sunday to see how I was, and when I asked him if he ever takes time off he said yes, but the patients come first.
As for the doctors creating the so- called shortage of doctors, well you must have not read about the limit that a former provincial government put on new medical students in the province.
I have a daughter who had tried at that time to get into medical school. She already had a bachelor of nursing degree and had worked in the surgical ICU for a number of years.
When she was not accepted she went to the University of Buffalo to take her master's degree in nurse anaesthesiology, and she is still employed there as a nurse anesthetist."
*
These are the kinds of great assets that are lost by government intervention. Yet, the lefties 'blame the doctors'! For the love of... it's enough to make one sick.
*
Thursday, December 13, 2007
Pseudo-doctors in Ontario's pretend health-system
Terence Corcoran wrote in “Ontario doctors sold out again”, (National Post, Nov.6, 2004):
"Throughout next week, Ontario's 20,000 doctors, members of the Ontario Medical Association union monopoly, will vote by phone on a new four-year agreement with the province. The OMA has a long history of selling out its members, stripping doctors of their freedom and sacrificing patient care at the altar of socialized medicine. This new union contract, reached in secrecy two months ago, sets new lows in undermining doctor and patient rights.
More than a decade ago, I wrote: "The Canadian health care system creeps relentlessly toward its ultimate destination, the Soviet model, a centrally planned monster run by commissars issuing directives in a futile attempt to control the uncontrollable. The end result of the Soviet system, extensively documented, is chaos and corruption and collapse." With the new OMA-government agreement, Ontario appears to be entering the second phase of that progression.
The agreement, which includes classic blunders of central planning to manipulate doctor behaviour (35% pay gains for docs who do what the government wants; 4% or even less for those who don't), further co-opts individual doctors into the OMA strategy, which seems mostly aimed at embedding OMA top brass deeper into the Ontario health care politburo. Forgive me for deploying old Soviet jargon, but nothing else does justice to the union's latest pact with the bureaucratic and political devils who manage the province's health care monopolies.
The worst highlight of the agreement is a one-page "letter of understanding regarding the improvement of drug therapy." From the moment it was leaked to the media more than a month ago (everything was going to be secret prior to the vote, until the leaks started), critics branded it a corrupting breach of medical ethics. Under the drug agreement, the OMA agrees that doctors will undertake to cut $150-million from their drug prescription costs by 2007. If the "savings" target is met, the doctors will get a $50-million bonus.
The $50-million bonus was immediately labelled a kickback by critics, and a breach of medical ethics. Doctors would be put in the position of cutting back on patient drug prescriptions -- a dubious objective in itself -- in return for a payment from the government. One anesthesiologist (among many doctors who appeared anonymously in media reports for fear of government and OMA retaliation), told The Toronto Star: "The government does not have the right to coerce me or try to buy me off into providing substandard care."
Alas, the OMA negotiators have agreed to take away that doctor's rights. Even more, it contemplates direct and constant government control over the prescriptions of each doctor. "It is agreed that the Parties will develop a Drug Utilization Review that will provide, where practical, direct, confidential feedback to physicians regarding their prescribing practices." The implications are vast and disturbing.
Remember that "the Parties" here are the OMA and the Minister of Health, George Smitherman. He co-signed the secret drug agreement, which means Mr. Smitherman and his staff (through the review) will begin collecting individual prescription information from each doctor on each patient, information the government does not now have access to. Doctor and patient prescription records remain confidential, even when paid by the provincial hospital insurance plan. The government would, under the agreement, begin monitoring doctors and patients through prescription information.
Even more perverse is that the kickback scheme is worth much more than the $50-million mentioned in the agreement. Thanks to information circulated by Dr. Arnold Aberman, professor of medicine and former dean of medicine at the University of Toronto, we learn that the scale of the kickback is $200-million, not $50-million.
In a widely circulated critique of the union contract and the drug side agreement, Dr. Aberman reports that the OMA's chief negotiator, Dr. Stewart Kennedy, told an information meeting that the value of the drug deal to doctors is actually $200-million. Dr. Kennedy said, and other officials confirm, that the original OMA agreement with the health minister was considered to be $150- million too rich for the government's finance and management board officials. To get around their objections, the OMA and health ministry officials "devised the drug deal to get the $150-million" from another area of Ontario's health spending, the $2.8-billion drug budget. If the doctors can save the drug budget $150-million, they can keep the money. Thinking they had a good thing going, they threw in another $50-million as a later bonus. It turns out, writes Dr. Aberman, "that the OMA is getting all of the $200-million ... Don't we all feel much better now -- knowing the OMA sold out our patients' interests for $200-million, not only $50-million."
Other parts of the overall four-year contract, reportedly worth more than $1-billion in new spending, take away more and more of doctors' freedoms. Payment schemes are clearly designed to draw doctors into salaried positions as members of "family health teams." As part of teams, family physicians will receive 35% wage increases; fee-for-service docs will receive increases of 4%. Most of the payment increases occur in later years of the contract.
The agreement is filled with clauses and conditions that will transfer more doctor powers and decisions to bureaucrats and committees. In hospitals, for example, the agreement calls for "comprehensive standardization of prodecures and products." A task force will begin planning for the development and use of a common provincial drug formulary for hospitals. It will also oversee "the selection and use of surgical devices."
Even if doctors should be foolish enough to approve the contract, it apparently is not binding on the government beyond two years. Two years into the contract, before any significant wage gains are in place, the government has the right to unilaterally reassess the contract. A legal opinion from Toronto lawyer Brian Shell to the Coalition of Family Physicians states that the four-year contract, as written, "amounts to [a] two-year low-increase arrangement, with little likelihood and certainly no certainty" that the three- and four-year increases will ever be paid.
The OMA has sold out its members in the past. Back in 1991, the OMA agreed to become a province-wide closed shop, making the OMA union a total monopoly, beyond anything Buzz Hargove could dream about. Any autoworker can quit GM and and work as a non-union worker somewhere else. Doctors have no such right, thanks to the OMA, which decided years ago to join the government health care dictatorship rather than fight it.
The OMA was also part of the central planning fiasco of the early 1990s that created the current doctor shortage. Back in 1993, the University of Toronto medical school agreed to be paid $10-million a year not to produce doctors. Enrollment at the medical school was cut 30%. The planning reason: Ontario had too many doctors. Foreign doctors were systematically kept out of the province. The OMA also agreed later to schemes that capped the annual revenue of specialists at $400,000, thus limiting the supply of specialists. Under the new contract, that cap will not be lifted until 2008, but more likely it will never be lifted.
Doctors in Ontario, and across Canada, are no longer bearers of noble principles aimed at the health and welfare of their patients. They are already indentured servants of bureaucrats, politicians and union bosses at the OMA. This is exactly as planned.
A federal-provincial health policy paper, written by two eminent members of the Canadian Institute for Advanced Research, Morris Barer and Greg Stoddart, concluded back in 1991 that doctors were no longer to be in charge of their destinies. "There is a continuing evolution from the view of physicians as private agents for their patients and their own interests, to the view of physicians as clinically skilled agents serving the collective goals of a publicly funded health care system."
The OMA union monopoly has offered its doctors a contract that further entrenches that trend. Let's hope, as patients, that Ontario doctors have the courage to turn it down."
*
2004 was a giddy year for the Liberals - they got their Commitment to the future of medicare act, they started the LHINs monster, they pretended their newly instituted multi billion dollar health tax was just a premium, and they paid off/settled with the OMA for four years.
Well, in 2008, the four years is up, and we'll see what McGuinty has to shell out to keep our doctors as vassals to the provincial overlords. The insiduousness of this system, the interdependence of all levels on the state, is shocking. And what do we have to show for it - shortages, wait-lists, line-ups, suffering , death, and , truly, no-one - they have made sure of it - can be held liable. The circle almost always points elsewhere up or down the line. You can't blame the doctors for organizing - Tommy Douglas set that puppy's tail wagging the minute the state began to socialize the insurance system, which has impacted every aspect of health delivery. It's always in the state's favour to fan the proletariat to blame doctors for their system's ills - but when you outlaw and remove the accountability which stems from a contractual payment relationship between doctor and patient, the state noses its way in as the monopoly payer, with good intentions, originally, of course, and then skews the market with its interventionist whims, acting really like the Soviet's central-planning fiasco.
Laura Callaghan (St. Catharines Standard, Dec.12, 2007) wrote in "Give alternate-care providers more responsibilities":
"The OMA also opposes changes to the scope of practice in the current legislation, which would allow them a larger role in providing health care within a hospital or community."
She asks "What will it take for the NHS to start focusing on displacing the demands of the OMA with the needs of the people of Niagara?" So, contract time is coming in 2008, the shortages, etc. are piling up...the time is ripe for some good old labour politics. "The needs of the people"...will be met by, what... by not giving them health-care payer/provider choices?!? By more monopolism?! Really, Laura?
The "needs of the people" will only be met by force-feeding patients more monopolistic Tommy Douglas single-payer-rearrrange-the-deck-chairs-while-the-ship-sinks crap? Really, Laura?!
It's sad it has come to this. What if a patient WANTS a qualified DOCTOR?
We aready have a pretend universal health system, with systemic problems directly associated with its inherent command-and-control structure: a bait-and-switch system that promises medicare, but can't deliver it; now, after McGuinty's Liberals cut coverage while increasing premiums (...mull that hypocrisy, that contradiction of so-called "universal healthcare" for a while...) the next thing on the list to try, in a desperate attempt to beat Ontario's dead horse of a single-payer system to life, is having pseudo-doctors in our pretend system!!
Isn't that just perfect? So the OMA can be demonized again: lookit thare - dem docters is aginst cost-savings! Save the costs!!
It's Barer-Stoddart-style B.S. all over again, from another side. Get rid of doctors, but still pretend that you have the same system.
If I wanted a nurse practitioner, then I should get a qualified one. If I want a doctor, I should be able to get a doctor, not a reasonable facsimile of a doctor. Will these nurse practitioners have the professional liability to cover themselves for any medical negligence on their part caused to patients? Or, will that too be compromised by the state (against the patient, in favour of the nurses), by having limits on malpractice suits and awards? This is the very reason we need a private parallel health system, with its own facilities and organizational structure, where patient-accountable sanity prevails. When the monopoly is our only choice {therefore it is NOT "a choice" at all} it's the Callaghan's who have the upper hand, certainly not doctors, and least of all, patients.
As the saying goes, too many cooks in the kitchen spoil the broth.
*
"Throughout next week, Ontario's 20,000 doctors, members of the Ontario Medical Association union monopoly, will vote by phone on a new four-year agreement with the province. The OMA has a long history of selling out its members, stripping doctors of their freedom and sacrificing patient care at the altar of socialized medicine. This new union contract, reached in secrecy two months ago, sets new lows in undermining doctor and patient rights.
More than a decade ago, I wrote: "The Canadian health care system creeps relentlessly toward its ultimate destination, the Soviet model, a centrally planned monster run by commissars issuing directives in a futile attempt to control the uncontrollable. The end result of the Soviet system, extensively documented, is chaos and corruption and collapse." With the new OMA-government agreement, Ontario appears to be entering the second phase of that progression.
The agreement, which includes classic blunders of central planning to manipulate doctor behaviour (35% pay gains for docs who do what the government wants; 4% or even less for those who don't), further co-opts individual doctors into the OMA strategy, which seems mostly aimed at embedding OMA top brass deeper into the Ontario health care politburo. Forgive me for deploying old Soviet jargon, but nothing else does justice to the union's latest pact with the bureaucratic and political devils who manage the province's health care monopolies.
The worst highlight of the agreement is a one-page "letter of understanding regarding the improvement of drug therapy." From the moment it was leaked to the media more than a month ago (everything was going to be secret prior to the vote, until the leaks started), critics branded it a corrupting breach of medical ethics. Under the drug agreement, the OMA agrees that doctors will undertake to cut $150-million from their drug prescription costs by 2007. If the "savings" target is met, the doctors will get a $50-million bonus.
The $50-million bonus was immediately labelled a kickback by critics, and a breach of medical ethics. Doctors would be put in the position of cutting back on patient drug prescriptions -- a dubious objective in itself -- in return for a payment from the government. One anesthesiologist (among many doctors who appeared anonymously in media reports for fear of government and OMA retaliation), told The Toronto Star: "The government does not have the right to coerce me or try to buy me off into providing substandard care."
Alas, the OMA negotiators have agreed to take away that doctor's rights. Even more, it contemplates direct and constant government control over the prescriptions of each doctor. "It is agreed that the Parties will develop a Drug Utilization Review that will provide, where practical, direct, confidential feedback to physicians regarding their prescribing practices." The implications are vast and disturbing.
Remember that "the Parties" here are the OMA and the Minister of Health, George Smitherman. He co-signed the secret drug agreement, which means Mr. Smitherman and his staff (through the review) will begin collecting individual prescription information from each doctor on each patient, information the government does not now have access to. Doctor and patient prescription records remain confidential, even when paid by the provincial hospital insurance plan. The government would, under the agreement, begin monitoring doctors and patients through prescription information.
Even more perverse is that the kickback scheme is worth much more than the $50-million mentioned in the agreement. Thanks to information circulated by Dr. Arnold Aberman, professor of medicine and former dean of medicine at the University of Toronto, we learn that the scale of the kickback is $200-million, not $50-million.
In a widely circulated critique of the union contract and the drug side agreement, Dr. Aberman reports that the OMA's chief negotiator, Dr. Stewart Kennedy, told an information meeting that the value of the drug deal to doctors is actually $200-million. Dr. Kennedy said, and other officials confirm, that the original OMA agreement with the health minister was considered to be $150- million too rich for the government's finance and management board officials. To get around their objections, the OMA and health ministry officials "devised the drug deal to get the $150-million" from another area of Ontario's health spending, the $2.8-billion drug budget. If the doctors can save the drug budget $150-million, they can keep the money. Thinking they had a good thing going, they threw in another $50-million as a later bonus. It turns out, writes Dr. Aberman, "that the OMA is getting all of the $200-million ... Don't we all feel much better now -- knowing the OMA sold out our patients' interests for $200-million, not only $50-million."
Other parts of the overall four-year contract, reportedly worth more than $1-billion in new spending, take away more and more of doctors' freedoms. Payment schemes are clearly designed to draw doctors into salaried positions as members of "family health teams." As part of teams, family physicians will receive 35% wage increases; fee-for-service docs will receive increases of 4%. Most of the payment increases occur in later years of the contract.
The agreement is filled with clauses and conditions that will transfer more doctor powers and decisions to bureaucrats and committees. In hospitals, for example, the agreement calls for "comprehensive standardization of prodecures and products." A task force will begin planning for the development and use of a common provincial drug formulary for hospitals. It will also oversee "the selection and use of surgical devices."
Even if doctors should be foolish enough to approve the contract, it apparently is not binding on the government beyond two years. Two years into the contract, before any significant wage gains are in place, the government has the right to unilaterally reassess the contract. A legal opinion from Toronto lawyer Brian Shell to the Coalition of Family Physicians states that the four-year contract, as written, "amounts to [a] two-year low-increase arrangement, with little likelihood and certainly no certainty" that the three- and four-year increases will ever be paid.
The OMA has sold out its members in the past. Back in 1991, the OMA agreed to become a province-wide closed shop, making the OMA union a total monopoly, beyond anything Buzz Hargove could dream about. Any autoworker can quit GM and and work as a non-union worker somewhere else. Doctors have no such right, thanks to the OMA, which decided years ago to join the government health care dictatorship rather than fight it.
The OMA was also part of the central planning fiasco of the early 1990s that created the current doctor shortage. Back in 1993, the University of Toronto medical school agreed to be paid $10-million a year not to produce doctors. Enrollment at the medical school was cut 30%. The planning reason: Ontario had too many doctors. Foreign doctors were systematically kept out of the province. The OMA also agreed later to schemes that capped the annual revenue of specialists at $400,000, thus limiting the supply of specialists. Under the new contract, that cap will not be lifted until 2008, but more likely it will never be lifted.
Doctors in Ontario, and across Canada, are no longer bearers of noble principles aimed at the health and welfare of their patients. They are already indentured servants of bureaucrats, politicians and union bosses at the OMA. This is exactly as planned.
A federal-provincial health policy paper, written by two eminent members of the Canadian Institute for Advanced Research, Morris Barer and Greg Stoddart, concluded back in 1991 that doctors were no longer to be in charge of their destinies. "There is a continuing evolution from the view of physicians as private agents for their patients and their own interests, to the view of physicians as clinically skilled agents serving the collective goals of a publicly funded health care system."
The OMA union monopoly has offered its doctors a contract that further entrenches that trend. Let's hope, as patients, that Ontario doctors have the courage to turn it down."
*
2004 was a giddy year for the Liberals - they got their Commitment to the future of medicare act, they started the LHINs monster, they pretended their newly instituted multi billion dollar health tax was just a premium, and they paid off/settled with the OMA for four years.
Well, in 2008, the four years is up, and we'll see what McGuinty has to shell out to keep our doctors as vassals to the provincial overlords. The insiduousness of this system, the interdependence of all levels on the state, is shocking. And what do we have to show for it - shortages, wait-lists, line-ups, suffering , death, and , truly, no-one - they have made sure of it - can be held liable. The circle almost always points elsewhere up or down the line. You can't blame the doctors for organizing - Tommy Douglas set that puppy's tail wagging the minute the state began to socialize the insurance system, which has impacted every aspect of health delivery. It's always in the state's favour to fan the proletariat to blame doctors for their system's ills - but when you outlaw and remove the accountability which stems from a contractual payment relationship between doctor and patient, the state noses its way in as the monopoly payer, with good intentions, originally, of course, and then skews the market with its interventionist whims, acting really like the Soviet's central-planning fiasco.
Laura Callaghan (St. Catharines Standard, Dec.12, 2007) wrote in "Give alternate-care providers more responsibilities":
"The OMA also opposes changes to the scope of practice in the current legislation, which would allow them a larger role in providing health care within a hospital or community."
She asks "What will it take for the NHS to start focusing on displacing the demands of the OMA with the needs of the people of Niagara?" So, contract time is coming in 2008, the shortages, etc. are piling up...the time is ripe for some good old labour politics. "The needs of the people"...will be met by, what... by not giving them health-care payer/provider choices?!? By more monopolism?! Really, Laura?
The "needs of the people" will only be met by force-feeding patients more monopolistic Tommy Douglas single-payer-rearrrange-the-deck-chairs-while-the-ship-sinks crap? Really, Laura?!
It's sad it has come to this. What if a patient WANTS a qualified DOCTOR?
We aready have a pretend universal health system, with systemic problems directly associated with its inherent command-and-control structure: a bait-and-switch system that promises medicare, but can't deliver it; now, after McGuinty's Liberals cut coverage while increasing premiums (...mull that hypocrisy, that contradiction of so-called "universal healthcare" for a while...) the next thing on the list to try, in a desperate attempt to beat Ontario's dead horse of a single-payer system to life, is having pseudo-doctors in our pretend system!!
Isn't that just perfect? So the OMA can be demonized again: lookit thare - dem docters is aginst cost-savings! Save the costs!!
It's Barer-Stoddart-style B.S. all over again, from another side. Get rid of doctors, but still pretend that you have the same system.
If I wanted a nurse practitioner, then I should get a qualified one. If I want a doctor, I should be able to get a doctor, not a reasonable facsimile of a doctor. Will these nurse practitioners have the professional liability to cover themselves for any medical negligence on their part caused to patients? Or, will that too be compromised by the state (against the patient, in favour of the nurses), by having limits on malpractice suits and awards? This is the very reason we need a private parallel health system, with its own facilities and organizational structure, where patient-accountable sanity prevails. When the monopoly is our only choice {therefore it is NOT "a choice" at all} it's the Callaghan's who have the upper hand, certainly not doctors, and least of all, patients.
As the saying goes, too many cooks in the kitchen spoil the broth.
*
Monday, November 26, 2007
What Ontario healthcare crisis?
This story by John Robson, "A crisis is coming, and no one cares" (Ottawa Citizen, Oct.12, 2007):
"It is a melancholy reflection that we had to wait for the Ontario provincial election to lurch to a dismal end before we could turn to urgent questions of policy. Melancholy turns to depression at the urgency of health care reform. And tears begin to flow at the thought that the major parties' positions on that topic contrived to be at once irrelevant and profoundly inimical to any sensible solution.
The diagnosis here is grim. On Saturday the Globe and Mail's Jeffrey Simpson wrote, "The Liberals boast they have jacked up health-care spending by 29 per cent over four years, to $37- billion, a staggering eight per cent a year." Strange for a government to boast of its profligacy. Especially as, Mr. Simpson went on to note, the Liberals also promised to reduce the rate of spending increases to five per cent a year, which suggests there was something wrong with their previous behaviour. The Conservatives said they'd do the same, which suggests there was nothing wrong with the Liberals' new promise. Uh, unless you count Mr. Simpson's pointed observation that, "No Ontario government has been able to keep annual increases to five per cent."
Thus we may swiftly conclude that neither party had a plan for doing what they promised, and move on to the next problem. Namely, that if the party leaders did somehow keep their word it is not obvious what advantages would accrue. For one thing, increasing spending faster than revenue generally causes trouble, especially on an item that already devours nearly half of program spending. For another, laying aside the calculator for a stethoscope, how will a health care system that couldn't cope with existing demand while gobbling down eight per cent annual increases deal with the growing needs of aging boomers on just five per cent? Sadly we were not favoured with a discussion of such alarming matters.
Alarming is not too strong a word. Mainstream politicians generally dismiss as "ideological" those of us who saw trouble coming and urged preventive action years ago. But Mr. Simpson is hardly the excitable sort of columnist prone to the print equivalent of leaping about hollering, so you might think his observations would worry the people who run the system. Apparently they don't worry easy.
Most politicians didn't break a sweat when Health Canada warned that Canada will be short 5,800 doctors by 2010. Nor at last week's Citizen report of one Ottawa doctor who predicts that with middle- aged doctors working so hard they're burning themselves out and younger doctors working less in pursuit of a more rational work- life balance, the real shortage might be as large as 10,400. Politicians also shrugged off the Canadian Nurses' Association warning that nationally we'll be short 78,000 nurses by 2011 and 113,000 by 2016 and this week's Citizen story saying we're even short of nursing school faculty to train replacements.
People with weaker nerves would be especially bothered by the demographics that make these problems so hard to fix. Not only are the patients aging, so are doctors, nurses and even the remaining nursing school faculty; the Canadian Nurses' Association says more than half of the latter were over age 50 in 2005.
The one thing I've noticed recently that might make politicians panic is the increasing tendency, noted in Wednesday's National Post, for doctors to bill for various services not covered by socialized medicine, from telephone advice to faxing prescriptions, that most provided free before provincial governments got so tight- fisted with their fee schedules. Apparently, the harder the government throttles the goose that lays the golden eggs, the harder the wretched bird fights for air. But our statesmen's fingers are as strong as their minds are weak.
I do not exaggerate either the seriousness of the crisis or the feebleness of their understanding. From time to time I may inflict upon readers obscure quotations or arcane research. But you'll notice that all the examples in this column are from very recent newspaper stories. You don't have to be smart to uncover this stuff. But you have to be singularly dim to ignore it. And politicians are.
Faced with such atrocious mismanagement of such a key policy issue, I occasionally fantasize about entrusting affairs of state to persons selected by citizens in a competitive process designed to oblige candidates for public office to offer detailed, practical, intelligent solutions on matters of particular import.
Wait a minute. We just did that. * Sob * Could someone please pass me a large, absorbent handkerchief?"
*
Check out my blog essay "Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 " for "obscure" healthcare-politics-related references and stories! Does anyone care?
It is extremely sad that the Oct. 2007 Ontario election took place in a virtual vaccuum of healthcare debate. Well-flamed educational bigotry won -the electorate could have cared less about the Liberal's "atrocious mismanagement" of healthcare. Health minister Smitherman got a free pass to continue his ideological, failing, no-choice, single-payer healthcare monopoly's demagoguery.
We will all suffer for it.
"It is a melancholy reflection that we had to wait for the Ontario provincial election to lurch to a dismal end before we could turn to urgent questions of policy. Melancholy turns to depression at the urgency of health care reform. And tears begin to flow at the thought that the major parties' positions on that topic contrived to be at once irrelevant and profoundly inimical to any sensible solution.
The diagnosis here is grim. On Saturday the Globe and Mail's Jeffrey Simpson wrote, "The Liberals boast they have jacked up health-care spending by 29 per cent over four years, to $37- billion, a staggering eight per cent a year." Strange for a government to boast of its profligacy. Especially as, Mr. Simpson went on to note, the Liberals also promised to reduce the rate of spending increases to five per cent a year, which suggests there was something wrong with their previous behaviour. The Conservatives said they'd do the same, which suggests there was nothing wrong with the Liberals' new promise. Uh, unless you count Mr. Simpson's pointed observation that, "No Ontario government has been able to keep annual increases to five per cent."
Thus we may swiftly conclude that neither party had a plan for doing what they promised, and move on to the next problem. Namely, that if the party leaders did somehow keep their word it is not obvious what advantages would accrue. For one thing, increasing spending faster than revenue generally causes trouble, especially on an item that already devours nearly half of program spending. For another, laying aside the calculator for a stethoscope, how will a health care system that couldn't cope with existing demand while gobbling down eight per cent annual increases deal with the growing needs of aging boomers on just five per cent? Sadly we were not favoured with a discussion of such alarming matters.
Alarming is not too strong a word. Mainstream politicians generally dismiss as "ideological" those of us who saw trouble coming and urged preventive action years ago. But Mr. Simpson is hardly the excitable sort of columnist prone to the print equivalent of leaping about hollering, so you might think his observations would worry the people who run the system. Apparently they don't worry easy.
Most politicians didn't break a sweat when Health Canada warned that Canada will be short 5,800 doctors by 2010. Nor at last week's Citizen report of one Ottawa doctor who predicts that with middle- aged doctors working so hard they're burning themselves out and younger doctors working less in pursuit of a more rational work- life balance, the real shortage might be as large as 10,400. Politicians also shrugged off the Canadian Nurses' Association warning that nationally we'll be short 78,000 nurses by 2011 and 113,000 by 2016 and this week's Citizen story saying we're even short of nursing school faculty to train replacements.
People with weaker nerves would be especially bothered by the demographics that make these problems so hard to fix. Not only are the patients aging, so are doctors, nurses and even the remaining nursing school faculty; the Canadian Nurses' Association says more than half of the latter were over age 50 in 2005.
The one thing I've noticed recently that might make politicians panic is the increasing tendency, noted in Wednesday's National Post, for doctors to bill for various services not covered by socialized medicine, from telephone advice to faxing prescriptions, that most provided free before provincial governments got so tight- fisted with their fee schedules. Apparently, the harder the government throttles the goose that lays the golden eggs, the harder the wretched bird fights for air. But our statesmen's fingers are as strong as their minds are weak.
I do not exaggerate either the seriousness of the crisis or the feebleness of their understanding. From time to time I may inflict upon readers obscure quotations or arcane research. But you'll notice that all the examples in this column are from very recent newspaper stories. You don't have to be smart to uncover this stuff. But you have to be singularly dim to ignore it. And politicians are.
Faced with such atrocious mismanagement of such a key policy issue, I occasionally fantasize about entrusting affairs of state to persons selected by citizens in a competitive process designed to oblige candidates for public office to offer detailed, practical, intelligent solutions on matters of particular import.
Wait a minute. We just did that. * Sob * Could someone please pass me a large, absorbent handkerchief?"
*
Check out my blog essay "Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 " for "obscure" healthcare-politics-related references and stories! Does anyone care?
It is extremely sad that the Oct. 2007 Ontario election took place in a virtual vaccuum of healthcare debate. Well-flamed educational bigotry won -the electorate could have cared less about the Liberal's "atrocious mismanagement" of healthcare. Health minister Smitherman got a free pass to continue his ideological, failing, no-choice, single-payer healthcare monopoly's demagoguery.
We will all suffer for it.
Saturday, November 24, 2007
Doctor shortages and Jim Bradley: Then & Now
This story “More positions needed in medical schools says MPP”, (Welland Tribune, Dec.9, 2000):
“Niagara's doctor shortage could be cured if the provincial government added more medical school positions and provided incentives for physicians to relocate to Niagara.
Calling the physician shortage critical, St. Catharines MPP Jim Bradley urged the government to graduate more physicians, surgeons and family doctors from its medical schools.
Earlier this year the government increased the number of medical school places, but Bradley says even more need to be created.
"At least once a week I get a call at my constituency office from someone whose doctor is retiring or who is new to the area and can't find a doctor," he says.
The need is pressing, Bradley says, since Niagara has the highest per capita rate of citizens over the age of 55. It is doubly pressing since many doctors are also aging.
Anecdotal evidence suggests that as many as two-thirds of ophthalmologists in the province are 55 or older.
He also wants the government to publicize information such as the average age physicians, specialists and surgeons and the expected number that will be needed in the near future.
"I think it's important to keep reminding the government of this problem." ”
*
Seven years later, here’s Niagara This Week’s story, "Province has not determined number of docs needed” (Nov.23, 2007) stating that: “Ontario is spending less money and allocating fewer resources than it may seem on programs targeted directly to help find family doctors…Despite assurances by the government that systems are in place to come to grips with the shortage, it admits it doesn’t know yet how many general practitioners will be needed province wide.”
Say what?
Jim Bradley in opposition lectured and urged others to do all kinds of things his own Liberals haven’t done!!
Is it important to keep reminding Jim Bradley of his own advice?
After four years in office, Bradley’s Liberals have no idea themselves how many doctors are needed in Ontario!?
Doesn’t Bradley get calls today, in 2007, like he said he received in 2000, from people who can’t find doctors? Or, have those calls magically vanished now that his Liberals are in power? All is well, right?
‘Needs are pressing’ said Bradley then; 'incentives should be provided’ Bradley said then; 'shortages are critical' Bradley said then; 'information should be publicized', Bradley said then.
But now…?
“Niagara's doctor shortage could be cured if the provincial government added more medical school positions and provided incentives for physicians to relocate to Niagara.
Calling the physician shortage critical, St. Catharines MPP Jim Bradley urged the government to graduate more physicians, surgeons and family doctors from its medical schools.
Earlier this year the government increased the number of medical school places, but Bradley says even more need to be created.
"At least once a week I get a call at my constituency office from someone whose doctor is retiring or who is new to the area and can't find a doctor," he says.
The need is pressing, Bradley says, since Niagara has the highest per capita rate of citizens over the age of 55. It is doubly pressing since many doctors are also aging.
Anecdotal evidence suggests that as many as two-thirds of ophthalmologists in the province are 55 or older.
He also wants the government to publicize information such as the average age physicians, specialists and surgeons and the expected number that will be needed in the near future.
"I think it's important to keep reminding the government of this problem." ”
*
Seven years later, here’s Niagara This Week’s story, "Province has not determined number of docs needed” (Nov.23, 2007) stating that: “Ontario is spending less money and allocating fewer resources than it may seem on programs targeted directly to help find family doctors…Despite assurances by the government that systems are in place to come to grips with the shortage, it admits it doesn’t know yet how many general practitioners will be needed province wide.”
Say what?
Jim Bradley in opposition lectured and urged others to do all kinds of things his own Liberals haven’t done!!
Is it important to keep reminding Jim Bradley of his own advice?
After four years in office, Bradley’s Liberals have no idea themselves how many doctors are needed in Ontario!?
Doesn’t Bradley get calls today, in 2007, like he said he received in 2000, from people who can’t find doctors? Or, have those calls magically vanished now that his Liberals are in power? All is well, right?
‘Needs are pressing’ said Bradley then; 'incentives should be provided’ Bradley said then; 'shortages are critical' Bradley said then; 'information should be publicized', Bradley said then.
But now…?
Smitherman's skewed, shortage-plagued Liberal health system
This letter by R. Bobak "Local councils shouldn't haggle with doctors", (St. Catharines Standard, Dec.29, 2006):
"Re: Doctor claims offer reneged, The Standard, Dec. 20.
That a family doctor should even have to grovel before some local politicians for "cash incentives" to set up shop shows how skewed and dysfunctional Tommy Douglas' fabled socialist health-care monopoly has become.
Why should any municipality have the right to pilfer doctors from some other municipality by subsidizing them with taxpayers' cash (in itself, a zero-sum game), when it is illegal for a private individual in Ontario to pay a doctor?
Any professional in a free marketplace should be able to operate in an area of their choice, where they believe there is a demand for their services and where they could earn their living.
But in our authoritarian liberal health-care system, skewed by salary caps and central planning, compounded within a non-competitive monopoly, health professionals are being relegated to some kind of salaried civil-servant status.
It's not a local council's mandate to haggle with doctors because of the systemic failure of Health Minister George Smitherman's dogmatic Liberal policies.
Though an Ottawa newspaper earlier this year recommended that Smitherman be fired, for any positive, meaningful health-care reform to occur, the entire Dalton McGuinty crew would need to be exorcised from office."
"Re: Doctor claims offer reneged, The Standard, Dec. 20.
That a family doctor should even have to grovel before some local politicians for "cash incentives" to set up shop shows how skewed and dysfunctional Tommy Douglas' fabled socialist health-care monopoly has become.
Why should any municipality have the right to pilfer doctors from some other municipality by subsidizing them with taxpayers' cash (in itself, a zero-sum game), when it is illegal for a private individual in Ontario to pay a doctor?
Any professional in a free marketplace should be able to operate in an area of their choice, where they believe there is a demand for their services and where they could earn their living.
But in our authoritarian liberal health-care system, skewed by salary caps and central planning, compounded within a non-competitive monopoly, health professionals are being relegated to some kind of salaried civil-servant status.
It's not a local council's mandate to haggle with doctors because of the systemic failure of Health Minister George Smitherman's dogmatic Liberal policies.
Though an Ottawa newspaper earlier this year recommended that Smitherman be fired, for any positive, meaningful health-care reform to occur, the entire Dalton McGuinty crew would need to be exorcised from office."
Time for Ontario towns to declare themselves a medicare-free zone!
Niagara This Week’s series of healthcare stories, “Is there a doctor in the house?”, (Nov.23, 2007) was refreshingly detailed, varied, and surprisingly candid.
We should be asking tough questions about the nature of socialized healthcare and the results it has brought after some forty years of imposition.
It’s unfortunate this story didn't appear prior to the Oct. 2007 Ontario election, because healthcare is a provincial responsibility, and this election sadly took place in a virtual vacuum of healthcare debate.
St. Catharines Liberal MPP Jim Bradley barely said anything about healthcare: all was good. Any problems were typically glossed over and downplayed. He’s building us a hospital, you see, soon…well, eventually…so we should be grateful to Bradley and his Liberals for their great effort to do this favour on our behalf!
Healthcare was always ‘in crisis’ when Bradley’s Liberals were in opposition, you see. Now, as far as Grits would have us believe, all is well.
NTW wrote “The OMA estimates Ontario needs at least 1,000 family doctors now”.
However, I’ve read reports (National Post, Nov.15, 2007) where the Ontario Medical Association’s Janice Willett says Ontario is short 2,000 GP’s and specialists. The Liberals aren't close to delivering either number.
Gord Bowes column “Faith-based funding should be all or nothing” was equally refreshing: this is a writer who should appear more often. McGuinty and his Liberals were nothing less than “smarmy” in how they hypocritically flamed the faith-based-funding issue, pandering to an embarrassing latent bigotry in the populace. Yet, about 1.2 million Ontarians (which is almost 10% of our population) don’t have a family doctor, and this wasn’t even an election issue!
Mike Williscraft’s comments in “Doctor shortage needs more attention”, regarding physicians and “priority” waiting lists are also timely and worth further debate.
Why are local councils subsidizing health care in the first place - it’s a provincial responsibility. Our medicare myth has for too long promulgated the illusion that there are no priorities or preferences, let alone waiting-lists, in socialized healthcare. Many of us cling to the perception that socialized medicare delivered by a single-payer government monopoly, in and of itself, can’t be the source of our current problems.
It is an insidious argument that just because a fed-up municipality foolishly puts up, for example, $50,000 to lure doctors to their jurisdiction (because the province failed to fulfil its obligations) somehow then entitles that municipality’s citizens to preferential treatment. This is specifically the kind of muddled, egalitarian argument that is bogging down our entire system.
You want socialized medicare, but then you want to claim entitlement to priority socialized medicare?! You want the doctor beholden to government lists as a servile civil servant?
Such meddling by various layers of government, constant interference, and centralist manipulation, mixed with a blind belief that just a little bit more big-government intervention will cure healthcare’s woes, is manifest all around us: it’s even emotionally ingrained to be part of our patriotic national psyche.
It would be interesting to see those municipalities who use taxpayer cash to lure doctors to their jurisdiction try something bold, something radical – to rise up in the face of Ontario’s restrictive, failing healthcare monopoly and declare their jurisdiction a government-monopoly-medicare-free zone to encourage medical practices. It could be a kind of incubator functioning in the vacuum of the province’s ineptitude to deliver on its obligations, and to alleviate the market-restrictions of its health monopoly. They’ll then see how fast Health Minister George Smitherman flies over to complain and shut them down!
Let him try.
Such a symbolic declaration by towns across Ontario would show the extent of the problem and the unnecessary discontent and suffering Smitherman's monopoly is causing.
Ontario’s Liberals are already facing a constitutional court challenge from plaintiffs Lindsay McCreith and Shona Holmes, similar to Quebec’s Chaoulli challenge, which brings into question the Liberal government’s “right” to deny patients timely medical treatment, while at the same time banning patients the option of arranging for their care themselves.
Williscraft is correct in observing that “what is being done is not enough”. It depends on whether you believe in shared market solutions or government–only solutions. What the Liberals are doing is putting Ontarians at risk in waiting lines, then exporting patients to the States for treatment that medicare is unable to provide here.
Should we continue to dump more money into Ontario's plainly-evident failure of socialized medicare? (As premier Dalton McGuinty himself said during the televised leaders' debate during the last campaign, Ontario already spends 50% of its budget on healthcare).
Or should the Ontario Liberals reform their failed Commitment To The Future of Medicare Act, before the courts do their job for them and render that authoritarian legislation obsolete?
Should we remove the federal Canada Health Act from its pedestal, and make it more accountable to actual patients, rather than function as an 'enabler' maintaining the status-quo? The CHA could be reformed so it would no longer be used as a shield to cover inept provincial health systems which operate exclusively as single-payer, single-provider monopolies.
Patients should have access to choice in buying private health insurance, and Ontario’s restrictive OHIP health marketing board should face payer and provider competition.
We should seek a healthy private-parallel health-care system.
*
We should be asking tough questions about the nature of socialized healthcare and the results it has brought after some forty years of imposition.
It’s unfortunate this story didn't appear prior to the Oct. 2007 Ontario election, because healthcare is a provincial responsibility, and this election sadly took place in a virtual vacuum of healthcare debate.
St. Catharines Liberal MPP Jim Bradley barely said anything about healthcare: all was good. Any problems were typically glossed over and downplayed. He’s building us a hospital, you see, soon…well, eventually…so we should be grateful to Bradley and his Liberals for their great effort to do this favour on our behalf!
Healthcare was always ‘in crisis’ when Bradley’s Liberals were in opposition, you see. Now, as far as Grits would have us believe, all is well.
NTW wrote “The OMA estimates Ontario needs at least 1,000 family doctors now”.
However, I’ve read reports (National Post, Nov.15, 2007) where the Ontario Medical Association’s Janice Willett says Ontario is short 2,000 GP’s and specialists. The Liberals aren't close to delivering either number.
Gord Bowes column “Faith-based funding should be all or nothing” was equally refreshing: this is a writer who should appear more often. McGuinty and his Liberals were nothing less than “smarmy” in how they hypocritically flamed the faith-based-funding issue, pandering to an embarrassing latent bigotry in the populace. Yet, about 1.2 million Ontarians (which is almost 10% of our population) don’t have a family doctor, and this wasn’t even an election issue!
Mike Williscraft’s comments in “Doctor shortage needs more attention”, regarding physicians and “priority” waiting lists are also timely and worth further debate.
Why are local councils subsidizing health care in the first place - it’s a provincial responsibility. Our medicare myth has for too long promulgated the illusion that there are no priorities or preferences, let alone waiting-lists, in socialized healthcare. Many of us cling to the perception that socialized medicare delivered by a single-payer government monopoly, in and of itself, can’t be the source of our current problems.
It is an insidious argument that just because a fed-up municipality foolishly puts up, for example, $50,000 to lure doctors to their jurisdiction (because the province failed to fulfil its obligations) somehow then entitles that municipality’s citizens to preferential treatment. This is specifically the kind of muddled, egalitarian argument that is bogging down our entire system.
You want socialized medicare, but then you want to claim entitlement to priority socialized medicare?! You want the doctor beholden to government lists as a servile civil servant?
Such meddling by various layers of government, constant interference, and centralist manipulation, mixed with a blind belief that just a little bit more big-government intervention will cure healthcare’s woes, is manifest all around us: it’s even emotionally ingrained to be part of our patriotic national psyche.
It would be interesting to see those municipalities who use taxpayer cash to lure doctors to their jurisdiction try something bold, something radical – to rise up in the face of Ontario’s restrictive, failing healthcare monopoly and declare their jurisdiction a government-monopoly-medicare-free zone to encourage medical practices. It could be a kind of incubator functioning in the vacuum of the province’s ineptitude to deliver on its obligations, and to alleviate the market-restrictions of its health monopoly. They’ll then see how fast Health Minister George Smitherman flies over to complain and shut them down!
Let him try.
Such a symbolic declaration by towns across Ontario would show the extent of the problem and the unnecessary discontent and suffering Smitherman's monopoly is causing.
Ontario’s Liberals are already facing a constitutional court challenge from plaintiffs Lindsay McCreith and Shona Holmes, similar to Quebec’s Chaoulli challenge, which brings into question the Liberal government’s “right” to deny patients timely medical treatment, while at the same time banning patients the option of arranging for their care themselves.
Williscraft is correct in observing that “what is being done is not enough”. It depends on whether you believe in shared market solutions or government–only solutions. What the Liberals are doing is putting Ontarians at risk in waiting lines, then exporting patients to the States for treatment that medicare is unable to provide here.
Should we continue to dump more money into Ontario's plainly-evident failure of socialized medicare? (As premier Dalton McGuinty himself said during the televised leaders' debate during the last campaign, Ontario already spends 50% of its budget on healthcare).
Or should the Ontario Liberals reform their failed Commitment To The Future of Medicare Act, before the courts do their job for them and render that authoritarian legislation obsolete?
Should we remove the federal Canada Health Act from its pedestal, and make it more accountable to actual patients, rather than function as an 'enabler' maintaining the status-quo? The CHA could be reformed so it would no longer be used as a shield to cover inept provincial health systems which operate exclusively as single-payer, single-provider monopolies.
Patients should have access to choice in buying private health insurance, and Ontario’s restrictive OHIP health marketing board should face payer and provider competition.
We should seek a healthy private-parallel health-care system.
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Sunday, November 11, 2007
Can McGuinty's Liberals be held negligently liable for the suffering of Ontario patients?
Since McGuinty's Liberals were re-elected on Oct. 10, 2007 , there have been a number of news stories about our doctor shortage. How can we have a doctor shortage in 2007, after four glorious years basking in Ontario's Liberal Shining Path Of Light? Is this problem new?
Here's a thread of healthcare letters and related topics, from the National Post, starting in Oct. 2003, which can shine some light on the healthcare debate.
Let's remember, when McGuinty's Liberals were newly elected in Ontario (Oct. 3, 2003), Chretien was still Prime Minister, and Paul Martin was still the annointed PM-in-waiting. Quebec's Chaoulli decision was two years in the future. Michael Moore's Sicko was yet to be propagated.
As you read these letters and opinions, and as you see the time fly by, it's astounding at how thick-headed the "status-quo" was and still is, and how many patients have suffered in our healthcare monopoly since these letters were written.
Ontario's Liberal government must have known, or should have known, that its restrictive health monopoly would cause harm to Ontario citizens.
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I'll start with a National Post Editorial from Oct 25, 2003:
“Losing our doctors, risking our health
More and more, Canadians are finding, the doctor is out. Since 1993, the number of physicians in Canada has declined 5%, while the general population has risen nearly 13%.
At 2.1 doctors per 1,000 residents, as the Organization for Economic Co-operation and Development reported last week, Canada has one-third fewer doctors per capita than the average among industrialized countries -- and only slightly more than half as many as France, Germany and the United States. In our largest metropolitan areas, this has led to so many doctors capping their patient lists that finding a family practitioner in one's own neighbourhood can be next to impossible. And in many of our smallest centres, there are no doctors at all.
The principal cause of this shortfall is easy to discern. In the early 1990s, federal and provincial health ministers sought to reduce the number of students admitted to medical schools, encouraged older doctors to retire early and limited the number of foreign-trained docs entering the country. The theory was that fewer physicians would result in lower medicare billings and fewer hospital admissions, thus producing savings to public treasuries -- as though doctors control who gets sick and how many seek treatment.
Then there is the exodus of doctors to the United States. Upwards of 300 Canadian doctors move southward each year. Some go for the higher pay and lower taxes. But many doctors are also migrating out of frustration with the inability to practise up-to-date medicine in Canada. In earlier reports, in fact, the OECD revealed that Canada ranks among the worst-developed nations for access to high-tech diagnostic and treatment equipment. Hungary has more MRIs, the Czech Republic more CT scanners. Only a handful of OECD members have fewer lithotripters that use shockwaves to break up kidney stones. As a result, we have far too many risky kidney operations as a substitute.
And as the Fraser Institute pointed out again this week, waiting lists grow longer each year. Nearly 900,000 Canadians are currently waiting for diagnosis or treatment for what ails them. Waits lengthened in 2003 to an average of 17.7 weeks nationally for all procedures, up from 16.5 weeks the year before. More troubling still, Fraser found that specialists now believe "over 90% of waiting times are ... beyond clinically reasonable times." Hundreds die annually waiting for treatment that would come much faster in other nations; thousands more live with severe pain or disability.
The problem, contrary to popular wisdom, is not insufficient tax dollars in the system: Canadian public health care spending has actually risen by 35% in inflation-adjusted, per-capita terms since 1993. Some of this money went to buy new diagnostic machines and to hire new specialist doctors. Most, though, went to higher wages for unionized health care workers. And any additional public money will likely go in the same direction. Because of the monolithic structure of our single-payer medicare system, health care workers can hold it hostage. Politicians, who cannot bear the wrath of voters over hospital strikes, will always capitulate.
We are not knocking the nurses, technicians, aids and orderlies who change our bandages and refresh our linens: The only reason Canada's health system has continued for so long to produce acceptable health outcomes, such as high recovery rates and longevity, is the hard work and innovation of these caregivers. But a way has to be found to infuse the system with more money for new equipment and more doctors.
Governments have proven themselves hopeless at getting the money to where it will do the most good, so the task should be left to the rest of us. By freeing patients to buy extra care, or faster care, our health system will receive the market signals so vital to determining the balance between supply and demand. Private spending will also increase the amount of money in the system as a whole, thus permitting governments to redirect the amount they spend to the needy patients who need it most.
Until Ottawa and the provinces permit private spending on primary health care, new monies will be directed away from new doctors and badly needed technological upgrades, and Canadians won't receive the world-class level of health care they deserve."
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"Bitter medicine for Canadians" by dr. Joseph Berger (National Post, Oct.27, 2008):
"Re: Losing Our Doctors, Risking Our Health Care, editorial, Oct. 25.
Your editorial clearly expresses the concerns Canadians have with decreases in the proportion of doctors, our falling behind much- poorer countries in terms of advanced medical diagnostic equipment, and the necessity for introducing a private, alternative health care system. But you finished off an otherwise excellent summary with an unwarranted and unjustifiable assumption that without changes, "Canadians won't receive the world-class level of health care they deserve."
As a collective entity, Canadians don't deserve better health care. Over the past two decades, they have consistently rejected, and continue to reject, private alternatives. Through the representatives they elect, Canadians have collectively stuck with a socialist monopoly system that everywhere else has always been associated with deteriorating standards of care, deteriorating motivation of care-givers and less-than-adequate medical equipment.
It is not "Ottawa and the provinces" who need to change their outlook radically, it is the majority of Canadians who need to think differently if they indeed want to have a world-class level of health care. Through their votes, they are saying the status quo is what they want. Not even the new leader of the federal Progressive Conservative party could bring himself to advocate the acceptance of a private, alternative health care system.
Dr. Joseph Berger, president, Ontario District Branch, American Psychiatric Association, Toronto."
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"Second-class health care" by Dr. Joseph Berger (National Post, Jun 24, 2004):
"As a recent past chairman of two large medical groups (Toronto branch of Ontario Medical Association and Ontario branch of American Psychiatric Association), I take strong exception to the comments by Dr. Sunvil V. Patel, president of the Canadian Medical Association. Most doctors that I know are not members of the CMA.
It does not represent my views, nor the views of most sensible physicians I know.
Most rational physicians do not believe that the rapidly deteriorating Canadian health care system can be saved by having more money poured into it, or by it remaining restricted exclusively to the socialist public-funding model."
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"Doctor shortage" by Dr. Joseph Berger (National Post, Jan 29, 2005):
"How ironic that the source for the article MD Shortage Critical (Jan. 27) is Michael Decter, chairman of the Health Council of Canada. Many doctors remember Mr. Decter as being the deputy health minister in Bob Rae's NDP government in Ontario, which reduced the number of available training positions for doctors and whose policies drove doctors from this province.
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"Seeking a fair deal for Ontario" by Premier of Ontario Dalton McGuinty (National Post, Apr. 6, 2005)
"Ontario is the heart of Canada. And Canada is the soul of Ontario. We don't have a monopoly on patriotism. Yet no group identifies more closely with Canada than Ontarians.
Ontario and Canada need each other -- and if we work together in three areas in particular, we can prosper together.
The first area is medicare -- a Canadian idea that's not only one of our defining characteristics, it's absolutely central to Ontario's future prosperity because it's also one of our greatest competitive economic advantages. Only a strong Canada led by a strong central government can preserve medicare and preserve this advantage.
The second area is immigration, a powerful driver of economic growth in Ontario. With populations ageing and skills shortages growing, jurisdictions the world over are in a race to attract the best and brightest the globe has to offer. Canada's estimable reputation in the world has given Ontario a lead in this race. The combination of a Canadian passport and an Ontario job has proved to be a powerful magnet for immigrants.
A third area is the need to develop our greatest asset -- our people. The most important thing we can do to attract good jobs and investment in the 21st century is to invest in our future prosperity. In a world where automation is replacing rote work, where communication technology makes global outsourcing possible, and where there will always be another place where people will settle for lower pay and lower standards, there is only one way to build a thriving, sustainable economy: build the world's best- educated, most highly skilled workforce.
Investing in our people and our future prosperity is absolutely essential, and it is in this context that I've been writing and talking about the $23-billion gap -- the difference between what Ontario gives the federal government in taxes and what we get back every year. Put another way, $23-billion is the amount Ontarians give to the federal government for distribution in the rest of the country.
We're proud to be Canada's economic engine. We're proud to contribute to social programs across the country. But to share wealth, we must first create wealth. And the gap has grown so much over the last ten years -- from $2-billion to $23-billion -- it now compromises our ability to invest in Ontario's future prosperity -- the prosperity our country depends on.
We want Ontario to lead the nation in health care reform. That's why our agreement with our doctors will encourage new ways of practising, with family health teams that prevent, as well as treat, illness. But it's difficult to fund reforms, as well as maintain services, when Ontario ranks ninth out of 10 provinces in federal funding for health care.
We want Ontario to continue to be a magnet for new Canadians, and indeed, over the past three years we've attracted 57% of the country's immigrants. It's difficult to leverage all that talent into jobs and investment, however, when you receive only 34% of federal funding for their settlement.
Is that fair to these new Canadians? And is it the smart thing for Canada to do?
We want to build the best-educated, highly skilled workforce in North America. In his recently released solid report on post- secondary education, former Ontario premier Bob Rae concluded we need to invest another $1.3-billion in our universities, just to bring our funding up to the national average. Right now, we rank tenth out of 10 provinces when it comes to university funding.
Do any of these situations make sense when we're sending $23- billion to the federal government to support higher levels of funding in other provinces?
Of course they don't.
That's why we need to narrow this gap and invest more in our future so we can generate the wealth our people deserve and our country depends on.
I know that some in the federal government are a little taken aback by my insistence that Ontario be treated fairly. Some believe it is unseemly for an Ontario premier to even raise this issue -- as if Ontario's role in Confederation is only to supply fairness, never to seek it.
I see it differently. My responsibility, as the person privileged to serve Ontarians as their Premier, is to advance any cause, make any claim and demand any concession that helps strengthen my province and my country.
I want to be able to look our hardworking health care professionals, our students and faculty, and new Ontarians right in the eye. I can't do that unless I'm satisfied that I've done all I can on their behalf. So I'll continue writing and talking about the $23-billion gap.Ontario is the heart of Canada. Let's make sure that heart is strong enough to face the challenges -- and vibrant enough to seize all the opportunities -- of the 21st century."
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"Canada doesn't stop at Ontario's borders", by Colin Gosselin (National Post, Apr 7, 2005):
"Re: Seeking A Fair Deal For Ontario, Dalton McGuinty, April 6.
Despite what the Premier seems to believe, Ontarians are not more Canadian than those in the rest of the country. And while I know it can be really hard to tell at times in this great federation of ours, brace yourself, Mr. McGuinty: Ontario is not Canada.
Just as Canadian as you. Colin Gosselin, Edmonton."
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"McGuinty misguided", Dr. Joseph Berger (National Post, Apr 9, 2005)
"Re: Seeking A Fair Deal For Ontario, Dalton McGuinty, April 6.
As a physician I was profoundly offended by the whining drivel offered by the Premier of Ontario. The problem is not that the federal government isn't passing enough money to Ontario; it's that Mr. McGuinty remains committed to an obsolete socialist system that interferes with the emergence of any really significant improvements in health care. As Ontario's Premier, he has the opportunity to show leadership by encouraging the development of a parallel alternative private health care system which is the only thing that will improve medical care."
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“Private health care already ... near” by David Saul, MD (National Post, Apr.11, 2005)
"Re: McGuinty Misguided, Letter, April 9.
Dr. Joseph Berger, claims the only way to improve medical care in Ontario is for Premier McGuinty to "encourage the development of a parallel alternative private health care system."
While I agree there are many faults in the present health care delivery system, there is already an alternative system in place, where Ontarians can arrange next-day investigative procedures, such as MRI and CT scans. They can also arrange almost next-day service for hip and knee replacement, as well. They need only make a trip across the border to the United States. And all it takes is cash, which is exactly what would come to pass if Premier McGuinty allowed a private alternative to our present health care system. The only difference would be the drive."
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"U.S. health care better than ours", by Dr. Joseph Berger (National Post, Apr 21, 2005):
"Re: Confessions of An American MD, Philip Alper, April 19.
Dr. Alper expresses many of the same complaints about government- managed care that I have heard from American colleagues at meetings I attend as Ontario representative to the Assembly of the American Psychiatric Association.
However, when comparisons are made between the American and Canadian health care systems, there are three vital areas that have been maintained in the United States but have been lost in the Canadian socialist system. They are promptness, excellence and choice. For both U.S. patients and physicians, advanced examination and treatment are available almost immediately while waiting lists here are an abomination.
Under the highly competitive U.S. system, standards of excellence remain in many areas of medicine while the Canadian socialist system encourages mediocrity. And in the United States, both patients and physicians have choice in terms of whether or not they participate in the managed care system. In Canada, our health system imposes enormous restrictions on both patients and physicians."
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"Canada needs shared care" by John G. Kelton (National Post, Apr 25, 2005):
"John G. Kelton, MD, is dean, Faculty of Health Sciences, including the Michael G. DeGroote School of Medicine, and vice-president, McMaster University, Hamilton.
The Canadian health care system is a house slowly burning down. An occasional shower of sparks flies as another wall falls in, but it's mostly a slow, relentless burn. Many Canadians can't find a family physician. For those with doctors, referral to a specialist starts with a wait, and then you line up for surgery. And the lines are getting longer. Our emergency departments are backed up because our hospitals are overflowing.
The delays and barriers to care have moved past inconvenience and now contribute to unnecessary deaths, as shown by a recent medical study that reported more deaths among Canadian heart attack patients compared with Americans. Yet, options and solutions do exist. It is true that we don't have enough physicians, but other health professionals can also deliver quality care. Unfortunately, barriers prevent patients from accessing other health caregivers. The problem is further compounded by the complexity of our health care system. Yes, it is underfunded. Yes, we're behind most developed countries in availability of cutting-edge medical equipment and yes, discussions about models of care delivery quickly collapse into politics, ideology and turf battles.
The solution is not one big revolution, but many small evolutions. Even the much anticipated Romanow report proved disappointing. Rather than serving as a catalyst for change, its central theme was more of the same, just add money. One recommendation, now being implemented, is for a national body to study the waiting times for procedures such as hip surgery or cataract operations. This is simply bad policy. Deterioration of health care will continue. However, it will be well-studied.
And yet, a deteriorating system offers the greatest opportunity for dramatic change. Many small and by themselves minor changes can, in their totality, transform the entire system. For example, two provinces, Alberta and Quebec, are tentatively experimenting with alternative delivery systems.
A burning house needs firefighters and their equipment. But others can also help put out the flames. Our universities train many different types of health care professionals. Better education has given these individuals greater skills. Yet, their ability to use these health care skills remains restricted. For example, in Ontario, if a patient with an eye infection sees an optometrist, that patient cannot be given a prescription for the needed medication. It is illegal. Instead, the patient must go to his or her family physician or the local emergency department for evaluation and the prescription. But, in the United States and many other provinces of Canada, the optometrist is permitted to prescribe the appropriate medication. Good care is received and an unneeded trip to the family physician or emergency room is avoided.
In other countries, health care can be provided by nurse practitioners, some of whom specialize in diabetic care, or hypertensive care, or cancer care. But across Canada, this practice is limited and will only occur under the supervision of a physician. Other examples abound. In Canada, pharmacists dispense medications. But, in the United States, they can give vaccines and other treatments. Medical studies consistently show that skilled health professionals (sometimes nurses, sometimes optometrists, sometimes pharmacists) can provide care in a safe, effective and high-quality fashion. Physicians then are freed up to care for others.
If these models of shared care work, why not implement them in Canada? The answer is three words: "scope of practice." These represent a series of broad rules and regulations developed by the various professional bodies and government officials. These rules were developed with the best of intentions to ensure Canadians receive good care. But these rules also restrict who can provide specific types of care. Cynics might say that certain health care professional bodies have a vested interest in protecting their memberships. But, when I talk to health care professionals across the country, I hear a growing interest in change. There are just not enough anesthetists, family physicians, surgeons, midwives (or virtually any health professional) to go around.
It would be too simplistic to think that Canada's health care problems could be easily fixed by merely broadening the scope of practice. But this would be a logical first step. Perhaps, more symbolically, such a step would also be a signal that we're not stuck on the past. Canadians are ready for real changes in health care."
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"Don't 'play' doctor" by David Saul (National Post, Apr 27, 2005):
"Re: Canada Needs Shared Care, John Kelton, April 25.
Dr. Kelton, dean of the medical school at McMaster, in Hamilton, Ont., suggests one solution to the present health care crisis is to have health care provided through a shared system. Under this system doctors would share duties with nurse practitioners, optometrists, pharmacists and other health care providers.
Houston, we have a problem here. These allied health workers are not medical doctors, but will be acting as if they were. They also will not have to go to university, med school or residency for a minimum of nine years -- like real doctors -- to work in the clinic and see patients.
This slippery slope of allowing non-MDs to provide MD services threatens the entire health care system. Part of the Ontario Health Ministry's mandate for primary care reform has already begun positioning nurse practitioners to work as members of the "health care delivery team," allowing them to independently assess patients, establish a working diagnosis, order any laboratory or diagnostic testing and prescribe medications.
Soon, the Health Ministry will simply do away with family doctors and replace them with nurse practitioners, medical assistants, pharmacists and maybe even naturopaths, because they will all work at a substantially reduced cost compared to the MD.
As dean of a medical school Dr. Kelton knows only too well the amount of education and training necessary to produce a fully functioning MD. Let doctors stick to medicine, nurses to nursing, optometrists to eye exams, pharmacists to filling prescriptions. We have better solutions for improving health care delivery."
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"Private health care is no threat" by Dr. Joseph Berger (National Post, Jun 9, 2005):
"Re: Medicare Future At Stake, June 8.
Exaggerated comments by people such as Mike McBane, spokesperson for something called the Canadian Health Coalition, has delayed Canada keeping up with the rest of the world when it comes to health care. The public universally accessible service is not in any way threatened by the development of a parallel private system -- other perhaps than the possible raising of its standards by the presence of competition."
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"A vote against medicare" by Dr. Joseph Berger (National Post, Aug 12, 2005):
"Re: A Vote For Medicare, letter to the editor, Aug. 10.
Doctors have been listening very carefully to what our patients say. What they have been telling us is that they are absolutely horrified with the endless waits in emergency rooms on stretchers. They are fed up with the long delays in obtaining consultations with specialists. And our patients know that better functioning, better equipped, more effective and more responsive systems exist in many other countries where there is a private, alternative system."
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"We need a safety valve" by Ruth Collins-Nakai, MD, president of the Canadian Medical Association (National Post, Aug 22, 2005):
"Every day, in every region of Canada, doctors are helping Canadians -- finding cures, easing pain, bettering lives and listening.
Last week, doctors from across the country took some time away from their patients to meet at the Canadian Medical Association (CMA) General Council in Edmonton. Although away from their clinics, the doctors still had their patients in mind as they discussed how to make the Canadian health care system even better. Amid heart- wrenching stories of frustration and worry, doctors spoke passionately about how the system was failing their patients, and how they needed to put the interests of those patients first.
Politicians also stress the need for ready access. What does it mean when Canada's doctors talk about putting patients first? For the only truly national organization representing 62,000 doctors, it means this: Our patients must have access to the care they need when they need it. It also means that patients' access to care must be based on medical need, not the ability to pay. Period.
Day after day, in every part of Canada, physicians deal with the human consequences of political gamesmanship. We see, with our own eyes, the terrible price being paid by ordinary Canadians who deserve more but are getting less and less. The CMA supports what our patients tell us: they need a "safety valve." They need a way to deal with their pain and suffering when, and only when, the public system fails to provide care within a medically acceptable wait time benchmark.
Some suggest this is a new and radical idea. It isn't. The CMA first proposed this concept three years ago when Roy Romanow, was leading his Commission on the Future of Health Care in Canada. Senator Michael Kirby proposed a similar care guarantee in his six- volume Report on the Health of Canadians -- The Federal Role. Most recently, the Supreme Court of Canada ruled that it was unconstitutional to restrict access to care in the private sector when the public system fails to provide timely care. Indeed, four Canadian provinces -- Newfoundland and Labrador, Nova Scotia, New Brunswick and Saskatchewan -- already permit parallel private health insurance.
In essence, what the CMA is proposing reflects what the highest court in the land is already saying. Most significantly, it is what our patients are saying. Canadians have a right to medical services when they need them. This is a fundamental right and a key characteristic of what it means to be Canadian. It is also something the CMA strongly supports in principle and our members support in practice.
Our ongoing commitment to building a strong public system shone through as general council delegates passed resolutions calling on governments to establish and implement wait time benchmarks and to address the critical shortage of health care providers to ensure Canadians get the medical attention they need, when they need it. The national crisis that is our worsening shortage of doctors, nurses and other health care professionals threatens to undermine any and all steps we can take to renew the system. Governments must move now to address this issue.
Canada's doctors will continue to work to ensure the public system has the resources needed to provide care to all Canadians. We will not let governments off the hook. We will also continue to push for a Canada-wide health access fund to make sure Canadians can get the care they need, when they need it. The creation of such a fund would obviate the need for supplementary private health insurance.
Most importantly, Canadians can trust that their doctors are in their corner speaking out for their patients. Within the next six months, the CMA will provide Canadians with a report on the best way to give patients access to the "safety valve" they are demanding. The report hasn't been written yet -- but two important principles will guide it.
One, access to care must be based on medical need, not on the ability to pay. Two, no Canadian should have to pay out of pocket to access medically necessary care.
Putting patients first is not a slogan for doctors. Ensuring timely access to care is not a slogan for doctors. It is our mission and our life's work. It is at the core of the oath we took when we joined the profession.
Canada's physicians will not shy away from the difficult questions and problems facing the future of health care -- even if some politicians think we should. Our patients deserve better and we plan to make sure they get it."
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" 'Safety valve' won't fix health care" by Dr. Joseph Berger (National Post, Aug 24, 2005):
"Re: We Need A Safety Valve, Ruth Collins-Nakai, Aug. 22.
I am not a member of the Canadian Medical Association. Therefore the wishy-washy nonsense its bureaucrats requested their president, Dr. Collins-Nakai, to sign does not represent my views.
I am appalled by such rubbish as "medically acceptable wait time benchmarks" or the utter stupidity of the idea of a "Canada-wide health access fund [that would] obviate the need for supplementary private health insurance."
It is not "Canada's doctors" who have "to work to ensure the public system has the resources needed to provide care." It is the general public who have to demand that of their elected public officials.
What doctors can do is offer the options and the standards of excellence that simply may not be available or affordable in a general system that tries to guarantee at least a basic minimum standard for everyone. Therefore, those higher standards and greater options may have to be privately paid for -- as their equivalents are in every other area of life.
The CMA states that all patients want is a "safety valve." I and many of my colleagues believe Canadians want far more than that."
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"Cutting back on doctors never a good idea", Dr. Joseph Berger (National Post, Aug 31, 2006):
"Re: Prescription: More Doctors, editorial, Aug. 30.
To whom was cutting back on the number of doctors a good idea?
Certainly not to me and many of my medical colleagues who fiercely opposed the stupidity of the Peterson Liberal and Rae NDP governments of Ontario, which pushed forward these ideas.
We warned our appeasement-minded colleagues in the OMA and CMA as well as the general public about the likely long-term consequences of their proposals.
Who were "we"? For the most part, we were doctors of British origin and we were supported by doctors of eastern European origin, all of us having experienced the disaster that a socialist government-controlled system produces. Britain today, since Margaret Thatcher, has a thriving private system, alongside a decaying, over- regulated, bureaucratically obese public system.
Lesson to be learned: Cutting back on doctors is never a good idea. There are always geographic areas that are under-serviced, new techniques that require new expertise, more research that needs to be done."
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"In praise of user fees" editorial (National Post, Feb 6, 2007):
"Now that federal Health Minister Tony Clement has admitted the obvious -- that Ottawa cannot ensure Canadians will receive medical treatment within guaranteed wait times -- can we all please stop pretending that the status quo public health care monopoly is sustainable?
Granted, Mr. Clement did not confess that the Conservative government would never be able to arrive at wait-time guarantees. He still holds out hope that a deal with the provinces can be worked out someday. But on the weekend, he admitted that he would not be able to reach such an agreement before the next election.
A more fruitful approach for Mr. Clememt and his provincial counterparts would be to consider Quebec's new health legislation as a model for reform.
Bill 33, adopted in December, permits Quebec's health clinics to bill medicare for certain treatments, while also allowing patients to be charged private user fees for supplies and uninsured tests. Clinics can also offer enhanced recovery rooms, extra tests or superior medical appliances for an additional fee. Before the Canada Health Act was passed in 1984, many provinces sanctioned such "extra billing," and wait times were considerably shorter than they are now.
Predictably, unions and friends of medicare are up in arms. In Thursday's edition of Montreal's Gazette, a group of five dozen sociologists, activists, lawyers, political scientists and health professionals signed an open letter charging that "private clinics that charge patients for access to insured services damage the publicly funded health care system of Quebec."
Not necessarily. In the 1990s, when Alberta was permitting tax- paid cataract surgeries to be performed in for-profit clinics, those in a hurry paid extra to have it done outside the plodding public system. As a result, the competition drained patients from public wait lists and spurred public hospitals to improve their own cataract procedures. Wait times for public eye surgeries went from 24 months to three.
Also, when provinces still permitted doctors to "balance bill" or "extra bill" for office expenses, telephone consultations or medical supplies used during physicals, doctors' office and emergency room visits were less frequent. After it became entirely cost-free to see a doctor or visit an emergency ward, usage spiked by between 10% and 20%. The pattern reflects basic microeconomics: Make something free and people will consume too much of it. That's why our emergency rooms are full of people with minor scrapes and back aches, as well as seniors who are merely lonely, confused or depressed.
Of course, wait times are caused by a complex mix of factors, such as expensive new technologies and an ageing patient population. But any time a decision carries no personal consequences, people tend to make their choices casually. Permitting user fees at clinics and even hospitals would help cut down on unnecessary visits and help shorten waits for all."
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“MD: user fees aren't the answer” By Dr. David Saul (National Post, Feb 10, 2007):
"Re: In praise of user fees, Feb. 6.
The only thing your editorial board got right was that "wait times are caused by expensive new technologies and an ageing patient population." Perhaps you should go sit in any emergency department, where you will find them full of very sick people and patients being wheeled in with acute major trauma. Using the new initiatives in Quebec of "nickel and diming" sick patients as a model for Canada is wrong. Quebec's health system is the lowest funded in the country and Quebec docs are paid, guess what -- the lowest in Canada.
Doctors were allowed to "extra bill" patients from the 1970s into the 1980s, to make up the short-fall due to provincial health ministries suddenly and unilaterally dropping the payments to doctors from 90% to 70% of provincial Medical Association billing rates. Numerous studies also point to "user fees" causing increased health care costs as patients wait until the late stages of illnesses before seeking treatment, when earlier diagnosis and treatment would have been cheaper in the long run.
The health care system we have in place in Canada may not always fulfill the needs and desires of the public, but after 30 years in practice, I see it working more than adequately and I sure don't want to start talking money with my patients. The next time you are sick, I'm you sure won't want to either."
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“We deserve better health care”, By Roman Bobak (National Post, Feb 13, 2007):
"Re: MD: User Fees Aren't The Answer, letter to the editor, Feb. 10.
Dr. David Saul has gall to offer up his sugar-coated placebo that our health care system works "more than adequately." Thanks for that underwhelming reassurance, but I'd seek a second opinion. It is shameful that despite 40 years' worth of various incantations of Tommy Douglas's pipe dream promises; and despite $34-billion worth of government health care spending last year in Ontario, people still die on waiting lists.
Regardless of Dr. Saul's aversion to "talking money" with potential patients, consumers should be able to pay for services currently protected from competition under OHIP's monopoly. For the public good, consumer choice in health care should no longer be banned, accursed and
derided. It should be reclaimed as every individual's intrinsic right."
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"Building hospitals will break the bank” by Dr. David Saul (National Post, Apr 26, 2007)
"Re: Why doctors are leaving Canada, editorial, April 16, and resulting letters.
What seems strangely to be missing from this one-sided debate on health care in Canada, foreign vs. home-trained doctors and the doctor shortage is the money issue. I'm not talking about fee for- service or that doctors make more money in the U.S. than in Canada. It has to do with hospital budgets, which consume 50% of the total health care expenditure. Check any hospital in Canada and you will find that the wards are full, with no empty beds; the operating room daily schedules are solid, with a few emergencies "squeezed in"; and the out-patient procedures are over-booked with patients waiting in the hallways.
Surgeons need operating rooms and internists require hospital beds to perform the work they were trained to do. There is no more room in the existing hospital system to allow for more surgeons or internists to practise medicine in this country. Letting more doctors work in primary-care "family medicine" is not the answer either, as most of this work can be adequately performed by trained nurse practitioners in primary care reform group health care centres.
Provincial and federal health ministers are aware of these issues, but also are cognizant that doubling hospital space will "break the bank" of the health care budget. Canadians, therefore, have a choice: Work with the system we have, which doesn't cost anyone a cent, or pay substantially more in taxes for an expanded hospital-based public system, or pay personal health insurance, U.S.- style, for new private hospitals. I vote for the status quo."
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"Health truths (II)” by Dr. David Saul (National Post, Jul 14, 2007):
"Re: Health Truths, letter, July 13.
Forget whether Canada has the best health system in the world. What matters to Canadians is that the system will work when they need it, for life-threatening emergencies and cancer treatments. Letters regularly printed in the National Post highlight mistakes, backlogs and inadequacies of the health care system. Where are the thank-you letters that I and many of my colleagues receive daily from our patients?
In my practice of 30 years, it is very rare to hear patients complain about how the system failed them. The doctors, nurses and support staff, who are the backbone of the system, bust their asses day in and day out to provide the best medical care we can. We wouldn't mind a hug once in a while, too, instead of the bad- mouthing."
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"Should doctors be paid in hugs?" by R. Bobak, National Post (Jul 16, 2007):
"Re: Health Truths (II), Letter To The Editor, July 14.
It's unfortunate that letter-writer Dr. David Saul complains that he and many others "busts their asses day in and day out" and get no respect. Not only does personal reward and respect come from the knowledge of a job well done, but so should your compensation.
If Dr. Saul has a problem with anything, it should be with the sicko Canadian health care monopoly which he so champions. If health care workers want to get paid with hugs rather than money, it might be prudent to leave the examination-room doors wide open."
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“Willing to bet on U.S. health care” by Dr. Leonard Hamm (National Post, Sep 26, 2007):
"Re: Doctor Defends Canadian Health Care, letter to the editor, Sept. 22.
Dr. David Saul thinks that the U.S. health care system is a "horror." However, one must consider the flip-side of such a horror: As someone who practised medicine in Canada during the dawn of socialized medicine, I can tell you that when you don't place any expectation on the patient -- when care is "free" -- it removes most of the incentive for the patient to assume control over his care and retards any efforts by the medical system to educate the public about personal health care.
Fortunately for Dr. Saul, he "knows where to do the research and find the world's expert opinions," which is a veiled way of saying that he can wend his way quickly through the system using his influence. Pity the average Canadian who may not have the same advantages.
Dr. Leonard Hamm, Point Roberts, Wash."
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"Validating failed health policies" by Jack Sands (National Post, Sep 21, 2007):
"Re: The Coming Health Revolution, editorial, Sept. 19.
Did anyone expect Roy Romanow, a dyed-in-the-wool socialist, to recommend substantive changes to our dysfunctional socialized health care system? In setting up the Health Council of Canada, he did precisely what the Liberal government that appointed him intended; he validated their failed policies and took them off the hook for making any politically messy changes."
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"The coming health revolution" editorial (National Post, Sep 19, 2007):
"A few years from now, when Canada finally joins every other free nation on Earth by permitting citizens to pay for their own health needs with their own money, we will look back and say: Why did that take so long? We have known for years that the financial burden of our single-payer health system is unsustainable. How come forward- thinking politicians of the Mulroney, Chretien and Martin eras didn't lay the groundwork for a European-style health model that combined private options with a robust system of universal care?
Historians will point to a number of factors: inertia, well- oiled propaganda campaigns orchestrated by public unions and their supporters, our pathetic dependence on medicare as a crutch of Canadian identity. But another less known factor is a sheaf of paper: the final report of the Royal Commission on the Future of Health Care in Canada --better known as the Romanow Report, after its one-man brain trust, former Saskatchewan premier Roy Romanow.
Released in December, 2002, the Romanow Report arrived at an important juncture. By 2002, a critical mass of Canadians were beginning to agitate for change, and reform advocates hoped that politicians finally
would break the taboo against discussion of a European-style mixed public-private system. Instead, Mr. Romanow advocated throwing more money and bureaucracy at the status quo, repackaging the old wine of our government health monopoly in fancy new bottles with grandiose labels such as "Canadian Health Covenant," "Health Council of Canada" and "Canada Health Transfer."
In Ottawa, the report gave relieved politicians cover to continue sticking their heads in the sand -- which is what just about all of them did. It is fair to say that Mr. Romanow single-handedly set back the cause of real health reform in this country by at least five years.
But thanks to long waiting lists, and provincial budgets groaning under the growing cost of Canada's Soviet-style public health monopoly, the winds of reform are starting to blow once again. Two years ago, in the case of Chaoulli vs. Quebec, the Supreme Court of Canada ruled that Quebecers facing health-threatening queues in the public system can't be denied access to private care. A vibrant network of private health clinics has sprung up in Montreal, Toronto, Vancouver and elsewhere. The new president of the Canadian Medical Association, Dr. Brian Day, founded the Cambie Surgery Centre in Vancouver, the first private multi-specialty surgical centre in Canada.
Perhaps the most telling sign that things have changed came courtesy of the Toronto Star. Last Friday, the left-leaning newspaper sought to goad its readers into righteous fury with a front-page story reporting that Liberal MP Belinda Stronach recently had sought treatment for breast cancer at a U.S. medical clinic. Ms. Stronach, who's become a political punching bag in recent years for a variety of unrelated reasons, clearly was being set up for a cascade of abuse and accusations of hypocrisy.
But that cascade never came. Instead, Star readers told the newspaper's editors to butt out. "Far from outrage, early reaction seems to be heavily on Stronach's side," a Star writer reported in a follow-up article. "Star readers, responding in a Web forum, were largely saying yesterday that it was no one's business where the Magna executive decided to pay for her own treatment outside Canada's medicare system. The Star's 'Speak Out' forum received comments such as: 'Good for Belinda,' and 'There's no issue,' and 'Please, please, please, leave her alone.' At least a couple of readers questioned the Star's judgment in making this front-page news."
All of this shows that Canadians are ahead of their politicians on health care. Ordinary people are ready for real reform -- it's the politicians who are mired in Trudeau-era dogmas.
We expect proof of this to emerge soon. As the National Post reported on its front page yesterday, Dr. Albert Schumacher, a former president of the Canadian and Ontario medical associations, has kicked off a cross-country series of town-hall fora in which citizens will get a chance to discuss their opinions on our health system. In February, Dr. Schumacher will release his report. One hopes it will get the same careful attention in the country's health ministries as did Mr. Romanow's.
Dr. Schumacher, whose tour is sponsored by the right-of-centre National Citizens Coalition, makes no secret of his frustration with Canada's stultified health-care debate. "One of the difficulties until now is that politicians will immediately cast any spokesperson for debate and discussion as pro-American, pro-private, two-tier health care," he says. "Everybody's afraid to talk about it. The politicians won't touch it with a 10-foot pole."
Slowly, inexorably, that is changing. Our politicians can ignore the will of the people on a subject as crucial as health care for only so long. Eventually, common sense--and the cause of individual freedom-- will prevail."
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“Doctor defends Canadian health care” Dr. David Saul (National Post, Sep 22, 2007):
"Re: Coming Health Revolution, editorial, Sept. 19.
Your editorial states, "in a few years Canadians will be permitted to pay for their own health needs with their own money," and "the winds of reform are starting to blow against Canada's Soviet-style public health monopoly" and that "ordinary people are ready for real reform." Wanna bet?
Your editorial writers, and most Canadians, have no idea what a simple medical visit to any doctor, clinic or emergency clinic in the United States entails. A decision on what your private health insurance plan covers and how much your co-pay will be has to be decided before any medical issues are discussed. I don't think Canadians are chomping at the bit for this horror.
As Dr. Irfan Dhalla wrote in the July 3 Canadian Medical Association Journal, "despite ever-increasing expenditures, increases in overall spending on health care in Canada are sustainable for the foreseeable future."
But back to your editorial. If I were Belinda Stronach and I had a potentially life threatening illness -- and unlimited funds -- I also would search out the world experts to possibly save my life. But, I'm not Belinda Stronach, I'm just an MD in Toronto who knows where to do the research to find the world's expert opinions, without leaving home. Her example of U.S. interventional treatment of her breast cancer does not support your argument against Canadian health care. It was wrong for the Post to bring it up."
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Belinda Stronach (a Liberal MP once touted as a possible PM of the country), who acted as the Great Liberal Defender of Canadian medicare for everyone, became the Great Liberal Pretender when it involved her own health: typical do as I say, not as I do... the standard motto for the medicare-pushing hypocrites of the left.
Saul wants what...to cover up and not ask questions about why such a high-level pro-medicare politcian couldn't even get proper health treatment in Canada? Well, where does that leave the rest of us, who have no choice (by law) but to suffer in the no-choice healthcare monopoly so favoured and espoused by the ilk of Stronach and Saul and the Smitherman?
And what's with Saul's cryptic claim that he "knows where to do the research" to obtain expert opinions "without leaving home"? What's that mean? Does Saul, who coyly claims he's "just an MD in Toronto" have special treatment insights that Stronach's doctors (or other doctors, or other ill Ontarians) are not aware of? Did Saul try to help Stronach? Or, is he doubting her reasoning for obtaining her treatment in the States?
The circumstances that Stronach faced in Canada are indeed grounds for an investigation into our health monopoly. Saul would be wrong to try to cover it up.
And with this we flew through four years of Medicare discourse (and there will be more), and really, what has changed? Doctor shortages, patients forced to shuffle off to Buffalo and beyond for health treatment...it's like nothing in this post mattered much to the Liberal authoritarians and their medicarista sycophants.
How many more Ontarians will have to suffer for Jim Bradley's, Dalton McGuinty's and George Smitherman's failing Liberal social experiment? Ontario health minister George Smitherman, who already admitted that the Province can't "do it all" when it came to healthcare (St. Catharines Standard, Aug.11, 2005), nevertheless still obstructs Ontarians, by law, from the choice of looking after ourselves.
Shouldn't Smitherman and his Liberal government be held negligently liable for the suffering of Ontario patients?
Here's a thread of healthcare letters and related topics, from the National Post, starting in Oct. 2003, which can shine some light on the healthcare debate.
Let's remember, when McGuinty's Liberals were newly elected in Ontario (Oct. 3, 2003), Chretien was still Prime Minister, and Paul Martin was still the annointed PM-in-waiting. Quebec's Chaoulli decision was two years in the future. Michael Moore's Sicko was yet to be propagated.
As you read these letters and opinions, and as you see the time fly by, it's astounding at how thick-headed the "status-quo" was and still is, and how many patients have suffered in our healthcare monopoly since these letters were written.
Ontario's Liberal government must have known, or should have known, that its restrictive health monopoly would cause harm to Ontario citizens.
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I'll start with a National Post Editorial from Oct 25, 2003:
“Losing our doctors, risking our health
More and more, Canadians are finding, the doctor is out. Since 1993, the number of physicians in Canada has declined 5%, while the general population has risen nearly 13%.
At 2.1 doctors per 1,000 residents, as the Organization for Economic Co-operation and Development reported last week, Canada has one-third fewer doctors per capita than the average among industrialized countries -- and only slightly more than half as many as France, Germany and the United States. In our largest metropolitan areas, this has led to so many doctors capping their patient lists that finding a family practitioner in one's own neighbourhood can be next to impossible. And in many of our smallest centres, there are no doctors at all.
The principal cause of this shortfall is easy to discern. In the early 1990s, federal and provincial health ministers sought to reduce the number of students admitted to medical schools, encouraged older doctors to retire early and limited the number of foreign-trained docs entering the country. The theory was that fewer physicians would result in lower medicare billings and fewer hospital admissions, thus producing savings to public treasuries -- as though doctors control who gets sick and how many seek treatment.
Then there is the exodus of doctors to the United States. Upwards of 300 Canadian doctors move southward each year. Some go for the higher pay and lower taxes. But many doctors are also migrating out of frustration with the inability to practise up-to-date medicine in Canada. In earlier reports, in fact, the OECD revealed that Canada ranks among the worst-developed nations for access to high-tech diagnostic and treatment equipment. Hungary has more MRIs, the Czech Republic more CT scanners. Only a handful of OECD members have fewer lithotripters that use shockwaves to break up kidney stones. As a result, we have far too many risky kidney operations as a substitute.
And as the Fraser Institute pointed out again this week, waiting lists grow longer each year. Nearly 900,000 Canadians are currently waiting for diagnosis or treatment for what ails them. Waits lengthened in 2003 to an average of 17.7 weeks nationally for all procedures, up from 16.5 weeks the year before. More troubling still, Fraser found that specialists now believe "over 90% of waiting times are ... beyond clinically reasonable times." Hundreds die annually waiting for treatment that would come much faster in other nations; thousands more live with severe pain or disability.
The problem, contrary to popular wisdom, is not insufficient tax dollars in the system: Canadian public health care spending has actually risen by 35% in inflation-adjusted, per-capita terms since 1993. Some of this money went to buy new diagnostic machines and to hire new specialist doctors. Most, though, went to higher wages for unionized health care workers. And any additional public money will likely go in the same direction. Because of the monolithic structure of our single-payer medicare system, health care workers can hold it hostage. Politicians, who cannot bear the wrath of voters over hospital strikes, will always capitulate.
We are not knocking the nurses, technicians, aids and orderlies who change our bandages and refresh our linens: The only reason Canada's health system has continued for so long to produce acceptable health outcomes, such as high recovery rates and longevity, is the hard work and innovation of these caregivers. But a way has to be found to infuse the system with more money for new equipment and more doctors.
Governments have proven themselves hopeless at getting the money to where it will do the most good, so the task should be left to the rest of us. By freeing patients to buy extra care, or faster care, our health system will receive the market signals so vital to determining the balance between supply and demand. Private spending will also increase the amount of money in the system as a whole, thus permitting governments to redirect the amount they spend to the needy patients who need it most.
Until Ottawa and the provinces permit private spending on primary health care, new monies will be directed away from new doctors and badly needed technological upgrades, and Canadians won't receive the world-class level of health care they deserve."
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"Bitter medicine for Canadians" by dr. Joseph Berger (National Post, Oct.27, 2008):
"Re: Losing Our Doctors, Risking Our Health Care, editorial, Oct. 25.
Your editorial clearly expresses the concerns Canadians have with decreases in the proportion of doctors, our falling behind much- poorer countries in terms of advanced medical diagnostic equipment, and the necessity for introducing a private, alternative health care system. But you finished off an otherwise excellent summary with an unwarranted and unjustifiable assumption that without changes, "Canadians won't receive the world-class level of health care they deserve."
As a collective entity, Canadians don't deserve better health care. Over the past two decades, they have consistently rejected, and continue to reject, private alternatives. Through the representatives they elect, Canadians have collectively stuck with a socialist monopoly system that everywhere else has always been associated with deteriorating standards of care, deteriorating motivation of care-givers and less-than-adequate medical equipment.
It is not "Ottawa and the provinces" who need to change their outlook radically, it is the majority of Canadians who need to think differently if they indeed want to have a world-class level of health care. Through their votes, they are saying the status quo is what they want. Not even the new leader of the federal Progressive Conservative party could bring himself to advocate the acceptance of a private, alternative health care system.
Dr. Joseph Berger, president, Ontario District Branch, American Psychiatric Association, Toronto."
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"Second-class health care" by Dr. Joseph Berger (National Post, Jun 24, 2004):
"As a recent past chairman of two large medical groups (Toronto branch of Ontario Medical Association and Ontario branch of American Psychiatric Association), I take strong exception to the comments by Dr. Sunvil V. Patel, president of the Canadian Medical Association. Most doctors that I know are not members of the CMA.
It does not represent my views, nor the views of most sensible physicians I know.
Most rational physicians do not believe that the rapidly deteriorating Canadian health care system can be saved by having more money poured into it, or by it remaining restricted exclusively to the socialist public-funding model."
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"Doctor shortage" by Dr. Joseph Berger (National Post, Jan 29, 2005):
"How ironic that the source for the article MD Shortage Critical (Jan. 27) is Michael Decter, chairman of the Health Council of Canada. Many doctors remember Mr. Decter as being the deputy health minister in Bob Rae's NDP government in Ontario, which reduced the number of available training positions for doctors and whose policies drove doctors from this province.
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"Seeking a fair deal for Ontario" by Premier of Ontario Dalton McGuinty (National Post, Apr. 6, 2005)
"Ontario is the heart of Canada. And Canada is the soul of Ontario. We don't have a monopoly on patriotism. Yet no group identifies more closely with Canada than Ontarians.
Ontario and Canada need each other -- and if we work together in three areas in particular, we can prosper together.
The first area is medicare -- a Canadian idea that's not only one of our defining characteristics, it's absolutely central to Ontario's future prosperity because it's also one of our greatest competitive economic advantages. Only a strong Canada led by a strong central government can preserve medicare and preserve this advantage.
The second area is immigration, a powerful driver of economic growth in Ontario. With populations ageing and skills shortages growing, jurisdictions the world over are in a race to attract the best and brightest the globe has to offer. Canada's estimable reputation in the world has given Ontario a lead in this race. The combination of a Canadian passport and an Ontario job has proved to be a powerful magnet for immigrants.
A third area is the need to develop our greatest asset -- our people. The most important thing we can do to attract good jobs and investment in the 21st century is to invest in our future prosperity. In a world where automation is replacing rote work, where communication technology makes global outsourcing possible, and where there will always be another place where people will settle for lower pay and lower standards, there is only one way to build a thriving, sustainable economy: build the world's best- educated, most highly skilled workforce.
Investing in our people and our future prosperity is absolutely essential, and it is in this context that I've been writing and talking about the $23-billion gap -- the difference between what Ontario gives the federal government in taxes and what we get back every year. Put another way, $23-billion is the amount Ontarians give to the federal government for distribution in the rest of the country.
We're proud to be Canada's economic engine. We're proud to contribute to social programs across the country. But to share wealth, we must first create wealth. And the gap has grown so much over the last ten years -- from $2-billion to $23-billion -- it now compromises our ability to invest in Ontario's future prosperity -- the prosperity our country depends on.
We want Ontario to lead the nation in health care reform. That's why our agreement with our doctors will encourage new ways of practising, with family health teams that prevent, as well as treat, illness. But it's difficult to fund reforms, as well as maintain services, when Ontario ranks ninth out of 10 provinces in federal funding for health care.
We want Ontario to continue to be a magnet for new Canadians, and indeed, over the past three years we've attracted 57% of the country's immigrants. It's difficult to leverage all that talent into jobs and investment, however, when you receive only 34% of federal funding for their settlement.
Is that fair to these new Canadians? And is it the smart thing for Canada to do?
We want to build the best-educated, highly skilled workforce in North America. In his recently released solid report on post- secondary education, former Ontario premier Bob Rae concluded we need to invest another $1.3-billion in our universities, just to bring our funding up to the national average. Right now, we rank tenth out of 10 provinces when it comes to university funding.
Do any of these situations make sense when we're sending $23- billion to the federal government to support higher levels of funding in other provinces?
Of course they don't.
That's why we need to narrow this gap and invest more in our future so we can generate the wealth our people deserve and our country depends on.
I know that some in the federal government are a little taken aback by my insistence that Ontario be treated fairly. Some believe it is unseemly for an Ontario premier to even raise this issue -- as if Ontario's role in Confederation is only to supply fairness, never to seek it.
I see it differently. My responsibility, as the person privileged to serve Ontarians as their Premier, is to advance any cause, make any claim and demand any concession that helps strengthen my province and my country.
I want to be able to look our hardworking health care professionals, our students and faculty, and new Ontarians right in the eye. I can't do that unless I'm satisfied that I've done all I can on their behalf. So I'll continue writing and talking about the $23-billion gap.Ontario is the heart of Canada. Let's make sure that heart is strong enough to face the challenges -- and vibrant enough to seize all the opportunities -- of the 21st century."
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"Canada doesn't stop at Ontario's borders", by Colin Gosselin (National Post, Apr 7, 2005):
"Re: Seeking A Fair Deal For Ontario, Dalton McGuinty, April 6.
Despite what the Premier seems to believe, Ontarians are not more Canadian than those in the rest of the country. And while I know it can be really hard to tell at times in this great federation of ours, brace yourself, Mr. McGuinty: Ontario is not Canada.
Just as Canadian as you. Colin Gosselin, Edmonton."
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"McGuinty misguided", Dr. Joseph Berger (National Post, Apr 9, 2005)
"Re: Seeking A Fair Deal For Ontario, Dalton McGuinty, April 6.
As a physician I was profoundly offended by the whining drivel offered by the Premier of Ontario. The problem is not that the federal government isn't passing enough money to Ontario; it's that Mr. McGuinty remains committed to an obsolete socialist system that interferes with the emergence of any really significant improvements in health care. As Ontario's Premier, he has the opportunity to show leadership by encouraging the development of a parallel alternative private health care system which is the only thing that will improve medical care."
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“Private health care already ... near” by David Saul, MD (National Post, Apr.11, 2005)
"Re: McGuinty Misguided, Letter, April 9.
Dr. Joseph Berger, claims the only way to improve medical care in Ontario is for Premier McGuinty to "encourage the development of a parallel alternative private health care system."
While I agree there are many faults in the present health care delivery system, there is already an alternative system in place, where Ontarians can arrange next-day investigative procedures, such as MRI and CT scans. They can also arrange almost next-day service for hip and knee replacement, as well. They need only make a trip across the border to the United States. And all it takes is cash, which is exactly what would come to pass if Premier McGuinty allowed a private alternative to our present health care system. The only difference would be the drive."
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"U.S. health care better than ours", by Dr. Joseph Berger (National Post, Apr 21, 2005):
"Re: Confessions of An American MD, Philip Alper, April 19.
Dr. Alper expresses many of the same complaints about government- managed care that I have heard from American colleagues at meetings I attend as Ontario representative to the Assembly of the American Psychiatric Association.
However, when comparisons are made between the American and Canadian health care systems, there are three vital areas that have been maintained in the United States but have been lost in the Canadian socialist system. They are promptness, excellence and choice. For both U.S. patients and physicians, advanced examination and treatment are available almost immediately while waiting lists here are an abomination.
Under the highly competitive U.S. system, standards of excellence remain in many areas of medicine while the Canadian socialist system encourages mediocrity. And in the United States, both patients and physicians have choice in terms of whether or not they participate in the managed care system. In Canada, our health system imposes enormous restrictions on both patients and physicians."
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"Canada needs shared care" by John G. Kelton (National Post, Apr 25, 2005):
"John G. Kelton, MD, is dean, Faculty of Health Sciences, including the Michael G. DeGroote School of Medicine, and vice-president, McMaster University, Hamilton.
The Canadian health care system is a house slowly burning down. An occasional shower of sparks flies as another wall falls in, but it's mostly a slow, relentless burn. Many Canadians can't find a family physician. For those with doctors, referral to a specialist starts with a wait, and then you line up for surgery. And the lines are getting longer. Our emergency departments are backed up because our hospitals are overflowing.
The delays and barriers to care have moved past inconvenience and now contribute to unnecessary deaths, as shown by a recent medical study that reported more deaths among Canadian heart attack patients compared with Americans. Yet, options and solutions do exist. It is true that we don't have enough physicians, but other health professionals can also deliver quality care. Unfortunately, barriers prevent patients from accessing other health caregivers. The problem is further compounded by the complexity of our health care system. Yes, it is underfunded. Yes, we're behind most developed countries in availability of cutting-edge medical equipment and yes, discussions about models of care delivery quickly collapse into politics, ideology and turf battles.
The solution is not one big revolution, but many small evolutions. Even the much anticipated Romanow report proved disappointing. Rather than serving as a catalyst for change, its central theme was more of the same, just add money. One recommendation, now being implemented, is for a national body to study the waiting times for procedures such as hip surgery or cataract operations. This is simply bad policy. Deterioration of health care will continue. However, it will be well-studied.
And yet, a deteriorating system offers the greatest opportunity for dramatic change. Many small and by themselves minor changes can, in their totality, transform the entire system. For example, two provinces, Alberta and Quebec, are tentatively experimenting with alternative delivery systems.
A burning house needs firefighters and their equipment. But others can also help put out the flames. Our universities train many different types of health care professionals. Better education has given these individuals greater skills. Yet, their ability to use these health care skills remains restricted. For example, in Ontario, if a patient with an eye infection sees an optometrist, that patient cannot be given a prescription for the needed medication. It is illegal. Instead, the patient must go to his or her family physician or the local emergency department for evaluation and the prescription. But, in the United States and many other provinces of Canada, the optometrist is permitted to prescribe the appropriate medication. Good care is received and an unneeded trip to the family physician or emergency room is avoided.
In other countries, health care can be provided by nurse practitioners, some of whom specialize in diabetic care, or hypertensive care, or cancer care. But across Canada, this practice is limited and will only occur under the supervision of a physician. Other examples abound. In Canada, pharmacists dispense medications. But, in the United States, they can give vaccines and other treatments. Medical studies consistently show that skilled health professionals (sometimes nurses, sometimes optometrists, sometimes pharmacists) can provide care in a safe, effective and high-quality fashion. Physicians then are freed up to care for others.
If these models of shared care work, why not implement them in Canada? The answer is three words: "scope of practice." These represent a series of broad rules and regulations developed by the various professional bodies and government officials. These rules were developed with the best of intentions to ensure Canadians receive good care. But these rules also restrict who can provide specific types of care. Cynics might say that certain health care professional bodies have a vested interest in protecting their memberships. But, when I talk to health care professionals across the country, I hear a growing interest in change. There are just not enough anesthetists, family physicians, surgeons, midwives (or virtually any health professional) to go around.
It would be too simplistic to think that Canada's health care problems could be easily fixed by merely broadening the scope of practice. But this would be a logical first step. Perhaps, more symbolically, such a step would also be a signal that we're not stuck on the past. Canadians are ready for real changes in health care."
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"Don't 'play' doctor" by David Saul (National Post, Apr 27, 2005):
"Re: Canada Needs Shared Care, John Kelton, April 25.
Dr. Kelton, dean of the medical school at McMaster, in Hamilton, Ont., suggests one solution to the present health care crisis is to have health care provided through a shared system. Under this system doctors would share duties with nurse practitioners, optometrists, pharmacists and other health care providers.
Houston, we have a problem here. These allied health workers are not medical doctors, but will be acting as if they were. They also will not have to go to university, med school or residency for a minimum of nine years -- like real doctors -- to work in the clinic and see patients.
This slippery slope of allowing non-MDs to provide MD services threatens the entire health care system. Part of the Ontario Health Ministry's mandate for primary care reform has already begun positioning nurse practitioners to work as members of the "health care delivery team," allowing them to independently assess patients, establish a working diagnosis, order any laboratory or diagnostic testing and prescribe medications.
Soon, the Health Ministry will simply do away with family doctors and replace them with nurse practitioners, medical assistants, pharmacists and maybe even naturopaths, because they will all work at a substantially reduced cost compared to the MD.
As dean of a medical school Dr. Kelton knows only too well the amount of education and training necessary to produce a fully functioning MD. Let doctors stick to medicine, nurses to nursing, optometrists to eye exams, pharmacists to filling prescriptions. We have better solutions for improving health care delivery."
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"Private health care is no threat" by Dr. Joseph Berger (National Post, Jun 9, 2005):
"Re: Medicare Future At Stake, June 8.
Exaggerated comments by people such as Mike McBane, spokesperson for something called the Canadian Health Coalition, has delayed Canada keeping up with the rest of the world when it comes to health care. The public universally accessible service is not in any way threatened by the development of a parallel private system -- other perhaps than the possible raising of its standards by the presence of competition."
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"A vote against medicare" by Dr. Joseph Berger (National Post, Aug 12, 2005):
"Re: A Vote For Medicare, letter to the editor, Aug. 10.
Doctors have been listening very carefully to what our patients say. What they have been telling us is that they are absolutely horrified with the endless waits in emergency rooms on stretchers. They are fed up with the long delays in obtaining consultations with specialists. And our patients know that better functioning, better equipped, more effective and more responsive systems exist in many other countries where there is a private, alternative system."
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"We need a safety valve" by Ruth Collins-Nakai, MD, president of the Canadian Medical Association (National Post, Aug 22, 2005):
"Every day, in every region of Canada, doctors are helping Canadians -- finding cures, easing pain, bettering lives and listening.
Last week, doctors from across the country took some time away from their patients to meet at the Canadian Medical Association (CMA) General Council in Edmonton. Although away from their clinics, the doctors still had their patients in mind as they discussed how to make the Canadian health care system even better. Amid heart- wrenching stories of frustration and worry, doctors spoke passionately about how the system was failing their patients, and how they needed to put the interests of those patients first.
Politicians also stress the need for ready access. What does it mean when Canada's doctors talk about putting patients first? For the only truly national organization representing 62,000 doctors, it means this: Our patients must have access to the care they need when they need it. It also means that patients' access to care must be based on medical need, not the ability to pay. Period.
Day after day, in every part of Canada, physicians deal with the human consequences of political gamesmanship. We see, with our own eyes, the terrible price being paid by ordinary Canadians who deserve more but are getting less and less. The CMA supports what our patients tell us: they need a "safety valve." They need a way to deal with their pain and suffering when, and only when, the public system fails to provide care within a medically acceptable wait time benchmark.
Some suggest this is a new and radical idea. It isn't. The CMA first proposed this concept three years ago when Roy Romanow, was leading his Commission on the Future of Health Care in Canada. Senator Michael Kirby proposed a similar care guarantee in his six- volume Report on the Health of Canadians -- The Federal Role. Most recently, the Supreme Court of Canada ruled that it was unconstitutional to restrict access to care in the private sector when the public system fails to provide timely care. Indeed, four Canadian provinces -- Newfoundland and Labrador, Nova Scotia, New Brunswick and Saskatchewan -- already permit parallel private health insurance.
In essence, what the CMA is proposing reflects what the highest court in the land is already saying. Most significantly, it is what our patients are saying. Canadians have a right to medical services when they need them. This is a fundamental right and a key characteristic of what it means to be Canadian. It is also something the CMA strongly supports in principle and our members support in practice.
Our ongoing commitment to building a strong public system shone through as general council delegates passed resolutions calling on governments to establish and implement wait time benchmarks and to address the critical shortage of health care providers to ensure Canadians get the medical attention they need, when they need it. The national crisis that is our worsening shortage of doctors, nurses and other health care professionals threatens to undermine any and all steps we can take to renew the system. Governments must move now to address this issue.
Canada's doctors will continue to work to ensure the public system has the resources needed to provide care to all Canadians. We will not let governments off the hook. We will also continue to push for a Canada-wide health access fund to make sure Canadians can get the care they need, when they need it. The creation of such a fund would obviate the need for supplementary private health insurance.
Most importantly, Canadians can trust that their doctors are in their corner speaking out for their patients. Within the next six months, the CMA will provide Canadians with a report on the best way to give patients access to the "safety valve" they are demanding. The report hasn't been written yet -- but two important principles will guide it.
One, access to care must be based on medical need, not on the ability to pay. Two, no Canadian should have to pay out of pocket to access medically necessary care.
Putting patients first is not a slogan for doctors. Ensuring timely access to care is not a slogan for doctors. It is our mission and our life's work. It is at the core of the oath we took when we joined the profession.
Canada's physicians will not shy away from the difficult questions and problems facing the future of health care -- even if some politicians think we should. Our patients deserve better and we plan to make sure they get it."
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" 'Safety valve' won't fix health care" by Dr. Joseph Berger (National Post, Aug 24, 2005):
"Re: We Need A Safety Valve, Ruth Collins-Nakai, Aug. 22.
I am not a member of the Canadian Medical Association. Therefore the wishy-washy nonsense its bureaucrats requested their president, Dr. Collins-Nakai, to sign does not represent my views.
I am appalled by such rubbish as "medically acceptable wait time benchmarks" or the utter stupidity of the idea of a "Canada-wide health access fund [that would] obviate the need for supplementary private health insurance."
It is not "Canada's doctors" who have "to work to ensure the public system has the resources needed to provide care." It is the general public who have to demand that of their elected public officials.
What doctors can do is offer the options and the standards of excellence that simply may not be available or affordable in a general system that tries to guarantee at least a basic minimum standard for everyone. Therefore, those higher standards and greater options may have to be privately paid for -- as their equivalents are in every other area of life.
The CMA states that all patients want is a "safety valve." I and many of my colleagues believe Canadians want far more than that."
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"Cutting back on doctors never a good idea", Dr. Joseph Berger (National Post, Aug 31, 2006):
"Re: Prescription: More Doctors, editorial, Aug. 30.
To whom was cutting back on the number of doctors a good idea?
Certainly not to me and many of my medical colleagues who fiercely opposed the stupidity of the Peterson Liberal and Rae NDP governments of Ontario, which pushed forward these ideas.
We warned our appeasement-minded colleagues in the OMA and CMA as well as the general public about the likely long-term consequences of their proposals.
Who were "we"? For the most part, we were doctors of British origin and we were supported by doctors of eastern European origin, all of us having experienced the disaster that a socialist government-controlled system produces. Britain today, since Margaret Thatcher, has a thriving private system, alongside a decaying, over- regulated, bureaucratically obese public system.
Lesson to be learned: Cutting back on doctors is never a good idea. There are always geographic areas that are under-serviced, new techniques that require new expertise, more research that needs to be done."
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"In praise of user fees" editorial (National Post, Feb 6, 2007):
"Now that federal Health Minister Tony Clement has admitted the obvious -- that Ottawa cannot ensure Canadians will receive medical treatment within guaranteed wait times -- can we all please stop pretending that the status quo public health care monopoly is sustainable?
Granted, Mr. Clement did not confess that the Conservative government would never be able to arrive at wait-time guarantees. He still holds out hope that a deal with the provinces can be worked out someday. But on the weekend, he admitted that he would not be able to reach such an agreement before the next election.
A more fruitful approach for Mr. Clememt and his provincial counterparts would be to consider Quebec's new health legislation as a model for reform.
Bill 33, adopted in December, permits Quebec's health clinics to bill medicare for certain treatments, while also allowing patients to be charged private user fees for supplies and uninsured tests. Clinics can also offer enhanced recovery rooms, extra tests or superior medical appliances for an additional fee. Before the Canada Health Act was passed in 1984, many provinces sanctioned such "extra billing," and wait times were considerably shorter than they are now.
Predictably, unions and friends of medicare are up in arms. In Thursday's edition of Montreal's Gazette, a group of five dozen sociologists, activists, lawyers, political scientists and health professionals signed an open letter charging that "private clinics that charge patients for access to insured services damage the publicly funded health care system of Quebec."
Not necessarily. In the 1990s, when Alberta was permitting tax- paid cataract surgeries to be performed in for-profit clinics, those in a hurry paid extra to have it done outside the plodding public system. As a result, the competition drained patients from public wait lists and spurred public hospitals to improve their own cataract procedures. Wait times for public eye surgeries went from 24 months to three.
Also, when provinces still permitted doctors to "balance bill" or "extra bill" for office expenses, telephone consultations or medical supplies used during physicals, doctors' office and emergency room visits were less frequent. After it became entirely cost-free to see a doctor or visit an emergency ward, usage spiked by between 10% and 20%. The pattern reflects basic microeconomics: Make something free and people will consume too much of it. That's why our emergency rooms are full of people with minor scrapes and back aches, as well as seniors who are merely lonely, confused or depressed.
Of course, wait times are caused by a complex mix of factors, such as expensive new technologies and an ageing patient population. But any time a decision carries no personal consequences, people tend to make their choices casually. Permitting user fees at clinics and even hospitals would help cut down on unnecessary visits and help shorten waits for all."
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“MD: user fees aren't the answer” By Dr. David Saul (National Post, Feb 10, 2007):
"Re: In praise of user fees, Feb. 6.
The only thing your editorial board got right was that "wait times are caused by expensive new technologies and an ageing patient population." Perhaps you should go sit in any emergency department, where you will find them full of very sick people and patients being wheeled in with acute major trauma. Using the new initiatives in Quebec of "nickel and diming" sick patients as a model for Canada is wrong. Quebec's health system is the lowest funded in the country and Quebec docs are paid, guess what -- the lowest in Canada.
Doctors were allowed to "extra bill" patients from the 1970s into the 1980s, to make up the short-fall due to provincial health ministries suddenly and unilaterally dropping the payments to doctors from 90% to 70% of provincial Medical Association billing rates. Numerous studies also point to "user fees" causing increased health care costs as patients wait until the late stages of illnesses before seeking treatment, when earlier diagnosis and treatment would have been cheaper in the long run.
The health care system we have in place in Canada may not always fulfill the needs and desires of the public, but after 30 years in practice, I see it working more than adequately and I sure don't want to start talking money with my patients. The next time you are sick, I'm you sure won't want to either."
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“We deserve better health care”, By Roman Bobak (National Post, Feb 13, 2007):
"Re: MD: User Fees Aren't The Answer, letter to the editor, Feb. 10.
Dr. David Saul has gall to offer up his sugar-coated placebo that our health care system works "more than adequately." Thanks for that underwhelming reassurance, but I'd seek a second opinion. It is shameful that despite 40 years' worth of various incantations of Tommy Douglas's pipe dream promises; and despite $34-billion worth of government health care spending last year in Ontario, people still die on waiting lists.
Regardless of Dr. Saul's aversion to "talking money" with potential patients, consumers should be able to pay for services currently protected from competition under OHIP's monopoly. For the public good, consumer choice in health care should no longer be banned, accursed and
derided. It should be reclaimed as every individual's intrinsic right."
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"Building hospitals will break the bank” by Dr. David Saul (National Post, Apr 26, 2007)
"Re: Why doctors are leaving Canada, editorial, April 16, and resulting letters.
What seems strangely to be missing from this one-sided debate on health care in Canada, foreign vs. home-trained doctors and the doctor shortage is the money issue. I'm not talking about fee for- service or that doctors make more money in the U.S. than in Canada. It has to do with hospital budgets, which consume 50% of the total health care expenditure. Check any hospital in Canada and you will find that the wards are full, with no empty beds; the operating room daily schedules are solid, with a few emergencies "squeezed in"; and the out-patient procedures are over-booked with patients waiting in the hallways.
Surgeons need operating rooms and internists require hospital beds to perform the work they were trained to do. There is no more room in the existing hospital system to allow for more surgeons or internists to practise medicine in this country. Letting more doctors work in primary-care "family medicine" is not the answer either, as most of this work can be adequately performed by trained nurse practitioners in primary care reform group health care centres.
Provincial and federal health ministers are aware of these issues, but also are cognizant that doubling hospital space will "break the bank" of the health care budget. Canadians, therefore, have a choice: Work with the system we have, which doesn't cost anyone a cent, or pay substantially more in taxes for an expanded hospital-based public system, or pay personal health insurance, U.S.- style, for new private hospitals. I vote for the status quo."
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"Health truths (II)” by Dr. David Saul (National Post, Jul 14, 2007):
"Re: Health Truths, letter, July 13.
Forget whether Canada has the best health system in the world. What matters to Canadians is that the system will work when they need it, for life-threatening emergencies and cancer treatments. Letters regularly printed in the National Post highlight mistakes, backlogs and inadequacies of the health care system. Where are the thank-you letters that I and many of my colleagues receive daily from our patients?
In my practice of 30 years, it is very rare to hear patients complain about how the system failed them. The doctors, nurses and support staff, who are the backbone of the system, bust their asses day in and day out to provide the best medical care we can. We wouldn't mind a hug once in a while, too, instead of the bad- mouthing."
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"Should doctors be paid in hugs?" by R. Bobak, National Post (Jul 16, 2007):
"Re: Health Truths (II), Letter To The Editor, July 14.
It's unfortunate that letter-writer Dr. David Saul complains that he and many others "busts their asses day in and day out" and get no respect. Not only does personal reward and respect come from the knowledge of a job well done, but so should your compensation.
If Dr. Saul has a problem with anything, it should be with the sicko Canadian health care monopoly which he so champions. If health care workers want to get paid with hugs rather than money, it might be prudent to leave the examination-room doors wide open."
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“Willing to bet on U.S. health care” by Dr. Leonard Hamm (National Post, Sep 26, 2007):
"Re: Doctor Defends Canadian Health Care, letter to the editor, Sept. 22.
Dr. David Saul thinks that the U.S. health care system is a "horror." However, one must consider the flip-side of such a horror: As someone who practised medicine in Canada during the dawn of socialized medicine, I can tell you that when you don't place any expectation on the patient -- when care is "free" -- it removes most of the incentive for the patient to assume control over his care and retards any efforts by the medical system to educate the public about personal health care.
Fortunately for Dr. Saul, he "knows where to do the research and find the world's expert opinions," which is a veiled way of saying that he can wend his way quickly through the system using his influence. Pity the average Canadian who may not have the same advantages.
Dr. Leonard Hamm, Point Roberts, Wash."
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"Validating failed health policies" by Jack Sands (National Post, Sep 21, 2007):
"Re: The Coming Health Revolution, editorial, Sept. 19.
Did anyone expect Roy Romanow, a dyed-in-the-wool socialist, to recommend substantive changes to our dysfunctional socialized health care system? In setting up the Health Council of Canada, he did precisely what the Liberal government that appointed him intended; he validated their failed policies and took them off the hook for making any politically messy changes."
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"The coming health revolution" editorial (National Post, Sep 19, 2007):
"A few years from now, when Canada finally joins every other free nation on Earth by permitting citizens to pay for their own health needs with their own money, we will look back and say: Why did that take so long? We have known for years that the financial burden of our single-payer health system is unsustainable. How come forward- thinking politicians of the Mulroney, Chretien and Martin eras didn't lay the groundwork for a European-style health model that combined private options with a robust system of universal care?
Historians will point to a number of factors: inertia, well- oiled propaganda campaigns orchestrated by public unions and their supporters, our pathetic dependence on medicare as a crutch of Canadian identity. But another less known factor is a sheaf of paper: the final report of the Royal Commission on the Future of Health Care in Canada --better known as the Romanow Report, after its one-man brain trust, former Saskatchewan premier Roy Romanow.
Released in December, 2002, the Romanow Report arrived at an important juncture. By 2002, a critical mass of Canadians were beginning to agitate for change, and reform advocates hoped that politicians finally
would break the taboo against discussion of a European-style mixed public-private system. Instead, Mr. Romanow advocated throwing more money and bureaucracy at the status quo, repackaging the old wine of our government health monopoly in fancy new bottles with grandiose labels such as "Canadian Health Covenant," "Health Council of Canada" and "Canada Health Transfer."
In Ottawa, the report gave relieved politicians cover to continue sticking their heads in the sand -- which is what just about all of them did. It is fair to say that Mr. Romanow single-handedly set back the cause of real health reform in this country by at least five years.
But thanks to long waiting lists, and provincial budgets groaning under the growing cost of Canada's Soviet-style public health monopoly, the winds of reform are starting to blow once again. Two years ago, in the case of Chaoulli vs. Quebec, the Supreme Court of Canada ruled that Quebecers facing health-threatening queues in the public system can't be denied access to private care. A vibrant network of private health clinics has sprung up in Montreal, Toronto, Vancouver and elsewhere. The new president of the Canadian Medical Association, Dr. Brian Day, founded the Cambie Surgery Centre in Vancouver, the first private multi-specialty surgical centre in Canada.
Perhaps the most telling sign that things have changed came courtesy of the Toronto Star. Last Friday, the left-leaning newspaper sought to goad its readers into righteous fury with a front-page story reporting that Liberal MP Belinda Stronach recently had sought treatment for breast cancer at a U.S. medical clinic. Ms. Stronach, who's become a political punching bag in recent years for a variety of unrelated reasons, clearly was being set up for a cascade of abuse and accusations of hypocrisy.
But that cascade never came. Instead, Star readers told the newspaper's editors to butt out. "Far from outrage, early reaction seems to be heavily on Stronach's side," a Star writer reported in a follow-up article. "Star readers, responding in a Web forum, were largely saying yesterday that it was no one's business where the Magna executive decided to pay for her own treatment outside Canada's medicare system. The Star's 'Speak Out' forum received comments such as: 'Good for Belinda,' and 'There's no issue,' and 'Please, please, please, leave her alone.' At least a couple of readers questioned the Star's judgment in making this front-page news."
All of this shows that Canadians are ahead of their politicians on health care. Ordinary people are ready for real reform -- it's the politicians who are mired in Trudeau-era dogmas.
We expect proof of this to emerge soon. As the National Post reported on its front page yesterday, Dr. Albert Schumacher, a former president of the Canadian and Ontario medical associations, has kicked off a cross-country series of town-hall fora in which citizens will get a chance to discuss their opinions on our health system. In February, Dr. Schumacher will release his report. One hopes it will get the same careful attention in the country's health ministries as did Mr. Romanow's.
Dr. Schumacher, whose tour is sponsored by the right-of-centre National Citizens Coalition, makes no secret of his frustration with Canada's stultified health-care debate. "One of the difficulties until now is that politicians will immediately cast any spokesperson for debate and discussion as pro-American, pro-private, two-tier health care," he says. "Everybody's afraid to talk about it. The politicians won't touch it with a 10-foot pole."
Slowly, inexorably, that is changing. Our politicians can ignore the will of the people on a subject as crucial as health care for only so long. Eventually, common sense--and the cause of individual freedom-- will prevail."
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“Doctor defends Canadian health care” Dr. David Saul (National Post, Sep 22, 2007):
"Re: Coming Health Revolution, editorial, Sept. 19.
Your editorial states, "in a few years Canadians will be permitted to pay for their own health needs with their own money," and "the winds of reform are starting to blow against Canada's Soviet-style public health monopoly" and that "ordinary people are ready for real reform." Wanna bet?
Your editorial writers, and most Canadians, have no idea what a simple medical visit to any doctor, clinic or emergency clinic in the United States entails. A decision on what your private health insurance plan covers and how much your co-pay will be has to be decided before any medical issues are discussed. I don't think Canadians are chomping at the bit for this horror.
As Dr. Irfan Dhalla wrote in the July 3 Canadian Medical Association Journal, "despite ever-increasing expenditures, increases in overall spending on health care in Canada are sustainable for the foreseeable future."
But back to your editorial. If I were Belinda Stronach and I had a potentially life threatening illness -- and unlimited funds -- I also would search out the world experts to possibly save my life. But, I'm not Belinda Stronach, I'm just an MD in Toronto who knows where to do the research to find the world's expert opinions, without leaving home. Her example of U.S. interventional treatment of her breast cancer does not support your argument against Canadian health care. It was wrong for the Post to bring it up."
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Belinda Stronach (a Liberal MP once touted as a possible PM of the country), who acted as the Great Liberal Defender of Canadian medicare for everyone, became the Great Liberal Pretender when it involved her own health: typical do as I say, not as I do... the standard motto for the medicare-pushing hypocrites of the left.
Saul wants what...to cover up and not ask questions about why such a high-level pro-medicare politcian couldn't even get proper health treatment in Canada? Well, where does that leave the rest of us, who have no choice (by law) but to suffer in the no-choice healthcare monopoly so favoured and espoused by the ilk of Stronach and Saul and the Smitherman?
And what's with Saul's cryptic claim that he "knows where to do the research" to obtain expert opinions "without leaving home"? What's that mean? Does Saul, who coyly claims he's "just an MD in Toronto" have special treatment insights that Stronach's doctors (or other doctors, or other ill Ontarians) are not aware of? Did Saul try to help Stronach? Or, is he doubting her reasoning for obtaining her treatment in the States?
The circumstances that Stronach faced in Canada are indeed grounds for an investigation into our health monopoly. Saul would be wrong to try to cover it up.
And with this we flew through four years of Medicare discourse (and there will be more), and really, what has changed? Doctor shortages, patients forced to shuffle off to Buffalo and beyond for health treatment...it's like nothing in this post mattered much to the Liberal authoritarians and their medicarista sycophants.
How many more Ontarians will have to suffer for Jim Bradley's, Dalton McGuinty's and George Smitherman's failing Liberal social experiment? Ontario health minister George Smitherman, who already admitted that the Province can't "do it all" when it came to healthcare (St. Catharines Standard, Aug.11, 2005), nevertheless still obstructs Ontarians, by law, from the choice of looking after ourselves.
Shouldn't Smitherman and his Liberal government be held negligently liable for the suffering of Ontario patients?
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