New President Of The CMA Wants Two-Tiered Health System

...We must take action on the most pressing issues, five of which I would like to briefly highlight today. First. We must first modernize the Canada Health Act, which is based on principles developed over 40 years ago - a time when the Berlin Wall was being built.

The Act must meet the needs of the 21st Century. In the Chaoulli case, the Supreme Court of Canada ruled that existing laws violated the rights to life, liberty, and security of person.

They unanimously ruled that patients experienced "physical and psychological suffering," and the system imposed the risk of death and irreparable harm to waiting patients.

The basis of the Canada Health Act and our Medicare system is the 1961 Saskatchewan Medical Insurance Act of Tommy Douglas. Three of the eight principles that Tommy Douglas described as essential were omitted from our current Act. Those principles were "effective", "efficient", and "responsible". Let us demand that those principles be enshrined in an updated Canada Health Act. This will help ensure accountability.

I want to be very clear.

My support for universal health care is unequivocal, but I believe the Act must be revised, reformed and updated. The second action we must take is to look at hospital funding - the single biggest expense to our health system.

Our current system of block funding does not reward productivity, customer service, excellence, or efficiencies. Nor does it penalize failure to deliver on those key indicators.

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.

Their beliefs have become prejudices that do not serve the underprivileged in our society.

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

Hospitals must view patients as individuals deserving of outstanding care, not as a drain on their predetermined budget.

Last year the Organization for Economic Co-operation and Development better known as OECD, released a report stating, "Market-orientated mechanisms reduce costs of hospital services, even when primarily government operated."

Patient-focused funding, where government resources follow the patient, must be considered as the alternative to block funding that puts the system first rather than the patient.

Third: We must emphasize that the shortage of doctors and other health professionals has reached a crisis level in Canada.

In 1970, when public insurance was first fully applied to physician services in Canada, we ranked second among developed countries in the number of physicians per capita.

We now rank 26th.

We have 17 medical schools, yet face a critical shortage of doctors. Every year, the equivalent of two full medical schools of graduates have left Canada. Fifty per cent of all newly trained orthopaedic surgeons and neurosurgeons leave within five years of graduation. Why? - - - - Because we can't offer these talented and highly trained young doctors the resources they need to work. Because doctors graduate with average debts of $160,000, and are forced to factor in their debt as they make career choices. Because doctors, and the services they recommend for patients, are considered a drain on the budget. We must address these issues.

Fourth. I especially want to address the issue of technology. I have been a long time believer in its vast potential.

As long ago as 1979, I sponsored a paper on electronic medical records by Dr. Myles Clough.

Twenty-two years ago I had the privilege of being involved in developing the world's first surgical robot, and that same year was one of two participants in the first-ever live two-way telemedicine session from North America to Mainland China.

These examples were ahead of their time, and not cost effective, but what was impractical then is a reality now.

Knowledge and data and information-processing are fundamental to sound decision-making and delivering safe, efficient care.

We are in the Information Age, and medicine needs to catch up. Technology will further change our practices in ways we have still not dreamt of.

Sadly, our access to new and valuable technologies is at a point where we rank near the bottom of developed countries. This must change.

My fifth and final action is the possible role of private health care in our public system.

I realize it will surprise some of you that I raise this topic.

Let's be clear: Canadians should have the right to private medical insurance when timely access is not available in the public system.

The CMA didn't decide that, I didn't decide that, the Highest Court in the land decided that.

Contracting out public health services to the private sector to reduce wait lists is not a new idea and does not spell the end of universality.

Most of the care of injured workers in BC has been contracted out in this way.

The result?

Injured workers do not wait for consultations or investigations or procedures, including surgery. Most importantly they don't suffer the physical and psychological distress of waiting, they pay nothing and the Workers' Compensation Board of BC has saved hundreds of millions of dollars in wage benefits and health costs.

http://www.cma.ca/index.cfm/ci_id/53598/la_id/1.htm

[The Investment Canada Act & Competition Act are being reviewed right now, the Telecommunications Act has been reviewed, I don't think there's any reason the Canada Health Act couldn't be reviewed also. The last time the government looked at it was 1983. Or the government could just implement some of the Romanow Report's recommendations... -- NSay]