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CMA Head Says Privatization Possible Within Public Health System

Posted on: Wednesday, 22 August 2007, 18:20 CDT

By CAMILLE BAINS

VANCOUVER (CP) - The incoming president of the Canadian Medical Association says the country's public health-care system is headed for crisis, but a greater role for private health care could help.

Dr. Brian Day said in his inaugural speech to Canada's medical establishment Wednesday that contracting out health services isn't new and has helped slash wait lists. "Let's be clear: Canadians should have the right to private medical insurance when timely access is not available in the public system," he said to applause from about 270 delegates at the annual convention.

Day, a Vancouver orthopedic surgeon, said the Supreme Court of Canada has already made a decision favouring such a move.

The Chaouilli case, named after the Quebec doctor who initiated it, struck down Quebec's ban on private insurance in 1995, saying it contradicted the provincial charter of rights.

Day said injured workers in some provinces are treated in private facilities, saving workers' compensation boards millions of dollars in wages and keeping people off long waiting lists.

Day, who opened Canada's first private surgery clinic in 1995, has often been criticized for his pro-privatization views that some say could pave the way for a for-profit system much like in the United States.

"No one I know wants to adopt a so-called American-style health system," he told delegates at the association that represents 65,000 doctors across Canada.

He said the private-versus-public debate is largely irrelevant and counterproductive but that new ideas and concepts are bound to face opposition and skepticism.

Day said the declining health of the country's aging population will have a profound social and economic impact and the time has come to change the status quo.

"Canadians face difficult choices, but we must act," he said. "We and our patients remain frustrated by waiting periods that exceed all ethical standards."

But while he advocated more choice in the private sector, Day said the ability to pay should never be a factor for any patient needing health care in Canada.

He called for the modernization of the Canada Health Act, saying it's based on principles developed over 40 years ago and no longer meets the needs of today's population.

"My support for universal health care is unequivocal, but I believe the act must be revised."

Day also said provinces must change the way hospitals are funded because they suck the largest amount of money out of the health-care budget.

The current system of block, or global, funding doesn't reward efficiencies or penalize failure to deliver service to patients, Day said.

"Hospitals must have incentives to reopen operating rooms, increase the number of beds available, hire more staff and treat more patients."

Day is an advocate of the British system of funding hospitals, which get public money based on the number of procedures they perform as an incentive to cut that country's wait lists.

He said the scheme has some problems but that Canada could adapt what's working in Britain.

"There are those that dismiss these concepts of success and excellence as elitist or undesirable. They support the status quo and dismiss the plight and suffering of patients."

Canada's shortage of doctors and other health-care professionals is at a crisis point, Day said, adding medical graduates leave the country every year because they don't have the operating-room time and other resources they need to stay here.

Day also called for the use of technology, such as electronic medical records, in the health-care field to deliver safe, efficient care.

"We are in the information age and medicine needs to catch up," he said. "Sadly, our access to new and valuable technologies is at a point where we rank near the bottom of developed countries. This must change."

Source: Canadian Press

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