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Many American doctors openly envy Canadians for their working conditions

Private clinics in Canada undermining universality of health care.

Health care based on need resonates with Canadians - Dhalla[Featuring YouTube video]. There are many advantages for doctors to be working in Canada, according to Dr. Irfan Dhalla of Canadian Doctors for Medicare. They don't have to chase down patients who haven't paid their bills or deal with insurance companies that second-guess them, leaving them more able to do what they went into medicine to do - to treat their patients. In an interview with Ish Theilheimer of Straight Goods News at the Canadian Health Coalition 30th anniversary event in November, Dr. Dhalla said that private clinics violate the principles of the Canada Health Act, that it is essential that care be based on need, not ability to pay.

Here is a transcription of the interview provided by volunteer Andrew S. McEwen:

IT: We're at the 30th anniversary gala celebration of The Canadian Health Coalition and we're talking about threats to Medicare and the future of Medicare. And I thought we were just listening to a panel at which you were talking, Doctor Dhalla, and I was interested, for a start, in your account of talking to some physicians from Texas who happened to be in Toronto for a conference. Could you contrast your experience as a Doctor with theirs?

ID: Sure, well I think you know one of the things we're here doing also is celebrating Medicare and that became I think very apparent in this conversation I had with a group of physicians from Texas a few months ago. You know it's very clear working in a system like ours that our patients have great access to physician and hospital services. We don't have to worry about whether they'll be able to pay a bill or not. It's also a lot simpler for physicians who work here and you know talking to these Doctors from Texas it was really interesting to hear their perspective on how much time they spend dealing with insurance companies and doing paper work compared to how little time I have to spend doing those kinds of things here. Which of course lets me and my colleagues spend our time focusing on patients, which is ultimately what we want to do, and why we went to medical school in the first place. So you know I thought that was actually quite instructive and as we were talking I could see these Doctors from Texas becoming quite envious in fact with the way certain aspects of our health care system are structured.

IT: So you find, as a Doctor, there are material benefits to having the kind of Medicare system we have here as opposed to the privatized approach in the States.

ID: Yeah, I think those are clear. I mean the biggest benefit for sure is for our patients because they don't have to worry about having to pay for health care, any patient can walk in off the street in Canada so long as they're a resident of the Province they'll have access to the best health care available. Which is not something that can be said about the system in the United States. But, there are also these other benefits for Doctors namely that our paper requirements are less, we don't have to chase unpaid bills, we don't have to deal with insurance companies. I work in Ontario, the Ontario Health Insurance program, they never call me up and tell me I can't do something or that I have to discharge a patient. In speaking with these physicians from Texas, those kinds of things are fairly routine occurrences down there.

IT: There are some real threats to our Health Care system in the form of some of the private clinics that are springing up. You mentioned for instance the Copeman Clinics in British Columbia and I was pretty shocked to hear some of the practices they use in order to "skirt" the rules of our system. Could you mention a few of these details for our readers and listeners?

ID: Sure. So since the advent of Medicare there have always been some clinics charging user fees or having annual fees or deductibles for patients and it was those kinds of activities that lead to the passage of the Canada Health Act in 1984. Since the passage of that Bill were supposed to be having a system where user fees are not allowed, deductibles are not allowed but over the last few years we have seen a proliferation of some private clinics and especially private surgical centers that operate at the margins of Medicare. I'm not a lawyer I can't be sure that they're violating the law. As it's written, I mean there may be some loop holes, but it's pretty clear here that they're violating the spirit of the Canada Health Act and this fundamental principle that Health care should be based on need. So people who need health care get health care. Health care should be based on need and not ability to pay and that's a value that resonates with most Canadians, the vast majority. You know if you do surveys it's generally well over 80 or 90 percent of Canadians believe in that value, that health care is a fundamental right and that it should be based on need.

IT: With the support for our Health Care system in Canada is being undermined in many cases by service concerns.

ID: I think the public supports these values but of course at the end of the day they want to see a high quality health care system that is there for them when they need it and you know they deserve that and I think Canadians have the right to that. What that means practically is that if wait times become excessively long it's only natural, I suppose, that will see public support diminish. In my view, the solution to that is to make sure that we have a high performing health care system. One that provides high quality care to people when they need it, where they need it, and the way that they need it. Some wait times are definitely too long.

Posted: November 30, 2009

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