Fear Dr. Day

Supporters of health care held their collective breath last month as the votes were counted in the election for the president of Doctors of BC. This was a runoff vote; the first one ended in a tie.

dr-alan-ruddiman

Dr. Alan Ruddiman, OPD Newsfeed

The candidates for president couldn’t have been more different in their vision for healthcare. Dr. Ruddiman wants to preserve our universal system in which patients are treated regardless of their ability to pay. His opponent, Dr. Day wants to set up a two-tier system in which wealthy patients buy treatment.

To the relief of everyone, Dr. Ruddiman won by a substantial margin although the turnout was only 50 per cent. Shortly after winning the physician from Oliver urged his colleagues to take a stand in defence of public health care. “It is fundamental that the medical profession take a firm stand for our publicly funded health care system (Globe and Mail, June 23, 2015)”

However, it’s too early to break out the champagne just yet. Dr. Day is determined undermine publicly funded health care and he doesn’t have to be president of Doctors of BC to do it. The B.C. Ministry of Health found that Dr. Day had been illegally charging patients. In one month alone, his Cambie Surgery Centre had billed patients $500,000.

Billing patients is illegal. The Medicare Protection Act of B.C., which parallels the Canada Health Act, states that the goals are to “preserve a publicly managed and fiscally sustainable health care system for British Columbia in which access to necessary medical care is based on need and not an individual’s ability to pay.

In retaliation to the audit from the B.C. Ministry of Health, Dr. Day launched a court case against the provincial government alleging that the Medical Protection Act violated his rights under the Canadian Charter of Rights and Freedoms.

In a warped sense of justice, Dr. Day sees himself a victim of a single-payer system. Wait times could be reduced, he argues, if patients were allowed to pay for treatment.

On first consideration, Dr. Day’s argument seems to make sense say Drs. Duncan Etches and Michael Klein. “At first glance, it might seem logical that allowing patients to pay privately at for-profit clinics would take paying patients off public wait lists, allowing others to move up the list faster (Monitor, a magazine from the Centre for Canadian Policy Alternatives, March, 2015).”

If it weren’t illegal, if there were an unlimited number of doctors, the argument might make sense. But there is a limited number of doctors. Because some surgeons work in both the private and public systems, for-profit clinics make surgeons unavailable in the public clinics; a phenomenon known as “crowding out” that can be seen in Quebec and Australia that have two-tier systems.

Also, private clinics skim off easier cases leaving difficult ones to the now underserved public system.

Even without the threat from Dr. Day, insidious corporate growth eats away at our healthcare says Dr. Ruddiman. “The threats of the corporatization of medicine and the barriers of layered administration that now exist in delivering efficient health care are a threat to the very ethos of medicine and indeed the profession.”

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