As some may know, I am currently a candidate for president-elect of Doctors of BC (formerly the British Columbia Medical Association). When asked why a former Canadian Medical Association president would seek a provincial leadership role my answer is simple: At this time in Canadian medical politics, that is where physicians have the best chance to influence change.
The CMA is a wonderful organization but the reality is that healthcare is, for the most part, a provincial responsibility. National unity and a strong national body are vitally important but change will likely come from the bottom up, not from the top down.
I will face opposition in the election but I will respect the opinion of the majority vote here in B.C. My opponents are incumbents on the board of Doctors of BC and have interesting platforms. One of them is adopting the "I support public healthcare" hat, which, in my opinion, gives B.C. doctors a clear choice: namely to accept the status quo or vote for change. I must say that I do not know a single physician who does not wish for Canada to have a strong public system, but it is clear what we have right now is not working, either for doctors or for patients. The recent pressure on Ontario and Alberta doctors is a taste of what we have in store if we stay passive in the political process.
We must not consider ours as a socialist system. All such countries (even communist China, Vietnam, Laos and Cuba, and the more radical North Korea) embrace a hybrid private system alongside the public system. I love to blame bureaucrats for many of our problems and it is true that most (not all) of them resist competition. This represents the reality of our health system, where they are determined to maintain monopoly control of the near $220 billion in annual funding. In the BBC series "Yes, Minister" the term "creative inertia" was coined to define their strategy of maintaining the status quo when it suited them.
I have reported previously that the Commonwealth Fund (a group that promotes improved access, quality and efficiency for society's most vulnerable, including low-income people, minority groups, children and the elderly), recently ranked Canada's system 10th of 11 developed countries (the U.S. was last). The fact that the poor and underprivileged in Canada have the worst outcomes and the worst access was clear to them. We need to learn from those countries ranked ahead of us, all of which embrace patient choice and competition for their public systems. It will be no surprise to anyone that enabling this in B.C. and Canada will continue to be the thrust of my future efforts.
At www.brianday.ca I have laid out more of my thoughts on these issues.
Dr. Brian Day is a Vancouver-based orthopedic surgeon who served as President of the Canadian Medical Association in 2007-08.
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