Dr. Brian Day @DrBrianDay Twitter

  • Past President Canadian Medical Association
  • Past President Arthroscopy Association of North America
  • Honourary Associate Professor University of British Columbia
  • 2014 Doctors of BC Don Rix Leadership Award

Health care system suffers from monopoly

Aug 25, 2007

Vancouver Sun
Michael Campbell

Oh my gosh, here we go again. With Dr. Brian Day's term as president of the Canadian Medical Association now officially underway, the wagons are going circle in defence of a system that by all indications has seen more people die waiting for medical treatment than there have been Canadian casualties in Afghanistan since 2002.

It's tragically dangerous in Afghanistan, but it may be more dangerous to have to wait for cancer treatment, cardiac surgery, or an organ transplant in the Great White North. In the big tug-of-war between those pushing patients' rights and those protecting the present system, the system continues to come out on top. While the self-proclaimed defenders of the status quo hate it when I put it that way, the results of rationing medical care by limiting access to general practitioners, specialists, the latest medical technologies, and drug therapies are inescapable. Canadians have universal access to waiting lists, and if several thousand Canadians suffer needlessly and some even die -- as the Supreme Court concluded in 2005 -- so what.

Last March, Ontario Health Minister George Smitherman summed up the attitude of those who proudly defend the system by declaring he would rather have people suffer for 10 months than have the government pay the private Don Mills Surgical Unit to perform knee-replacement surgeries for 1,500 patients at a significantly lower price as compared to the public system. What is so sadly typical of the calibre of health care's grandstanding defenders is that Mr. Smitherman didn't bother to explain why his ministry was already contracting out cataract and orthopedic surgeries to Don Mills.

What is amazing is how successful opponents of private delivery have been in propagating mistruths about our current health-care system. They say "no" to private care, but fail to mention that over 30 per cent of the system is already private -- including doctor's offices, x-ray clinics, and medical laboratories. They fail to mention that already federal prisoners, injured unionized workers, RCMP officers and members of the Canadian Forces jump the queue by using private clinics, with the blessing of NDP, Liberal, Bloc and Conservative governments. There's no talk of provincial governments sending patients to private clinics in the U.S., and certainly no mention of union or political leaders using private facilities, while at the same time working to prevent average citizens from doing the same.

In short, the discussion has always been a farce. It has always featured grossly misleading statements, fear-mongering, and blatant hypocrisy. While much is made of the fact that we don't want a two-tiered system (as if it isn't already when it comes to prescription drugs, foreign medical travel, or being a member of a group the government deems worthy of jumping the medical queue), the real issue is competition to the current monopoly.

We can continue to have a government pay system and still allow a massive infusion of competition in order to spur cost efficiencies and innovation, but that is precisely what some defenders of the status quo are afraid of. The Don Mills Surgical Unit proposed to save the government $1,082 per knee replacement. Now multiply that across the country for a variety of other procedures and it adds up to an awful lot of gravy that ends up in some people's pockets.

What the debate over the last 20 years has shown is that those people are not going to give up that money without a fight. And the patients be damned.

Michael Campbell's Money Talks radio show can be heard on CKNW 980 on Saturdays from 8:30 to 10 a.m.