The Truth About Canada Read Free

CMA, to the dismay of many in the profession, came out strongly in favour of a two-tier healthcare system that would allow doctors to work simultaneously in both the public and private systems, a proposal that would inevitably lead to queue-jumping and a deterioration of public health care. In most countries, doctors are prohibited from practising in both the public and private sectors. Stephen Harper had it right when he wrote to Alberta premier Ralph Klein, “Dual practice creates conflict of interest for physicians as there would be a financial incentive for them to stream patients into the private portion of their practice.” And federal health minister Tony Clement said, “How can you improve access if doctors are spending part of their time inside the system and part of their time outside the system? No one has shown how that can be done.” 7
    Gordon Guyatt, professor of medicine at McMaster University, was direct and to the point in his response to the CMA’s proposal: “The CMA is acting on the basis of self-interest instead of the public interest. For-profit clinics would not lead to the training of a single additional doctor or nurse. Indeed, such clinics would suck desperately needed personnel from not-for-profit hospitals and clinics.” 8
    Wendy Fucile, in the Toronto Star , wrote:
Nurses reject CMA’s recipe and say it is a privatization gimmick. In an open letter to Prime Minister Stephen Harper, the Registered Nurses’ Association of Ontario urged the PM to restate, in no uncertain terms, that physicians will not be allowed to practise simultaneously in both the private and public healthcare systems.
A wealth of evidence shows that allowing physicians to practise in both public and private systems decreases accessto health care, costs taxpayers more, and results in lower quality of care — including higher rates of complications and deaths. A parallel private system siphons healthcare professionals and drains resources out of the public system.
Countries with parallel private hospitals have larger and longer waiting lists in their public hospitals. A parallel private system allows for-profit clinics and the physicians who work in them to benefit from people’s vulnerability in times of illness. These clinics cherry-pick patients who are healthier, younger or have conditions that are cheaper to treat, leaving more complicated cases to a public system with fewer healthcare professionals.
    In February 2007, the Canadian Health Coalition accused the Jean Charest government in Quebec of opening the door to two-tier health care and a major expansion of for-profit surgical clinics. 9 Yet in 2006, only British Columbia was fined by Ottawa for violating the Canada Health Act, although private clinics now operate in six provinces. Quebec now has 16 private MRI clinics, but has not been fined over the past 20 years.
    Those who advocate a two-tier medical system never can adequately answer the question as to what the impact will be on our universal healthcare system. Where will the doctors, nurses, and technicians that would be needed for private healthcare facilities come from?
    A group of senior British doctors has urged their Canadian colleagues not to follow the United Kingdom down the road of privatization. For Dr. Danielle Martin, chair of Canadian Doctors for Medicare,
There is a compelling body of evidence against parallel private insurance in the Canadian context. There is also an inherent conflict of interest for physicians working in dual practice since these physicians could have an interest in promoting longer wait times in the public system to increase use of the more lucrative private system.
Why is the CMA proposing dual practice and private insurance when this would pull nurses, technicians and other needed resources out of the public system? 10
    Good question. Both the Kirby Senate Report and the Romanow Commission had come out in 2002 saying a two-tier medical system would have a detrimental