The Next City
September 21, 1996
Giving power to consumers will cure Canada’s ailing medicare system
- Lorne Almack , Claremot, Ontario, responds: October 5th, 1996
- James Clark Scarborough, Ontario, responds: Ocotber 14, 1996
- Richard C. Millar Senneville, Quebec, responds: October 19 , 1996
- Charles R. Neill , Edmonton, responds: November 8, 1996
- Walter W. Rosser, M.D. Professor and Chairman, Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, responds: January 24, 1997
The article on Medicare is one of the best I have ever read.
One would think that everyone who pays road taxes is entitled to equal access to highways. Along comes ETR 407 (Express Toll Route 407), and we all think what a great idea and how it will take a lot of congestion off the 401. I don’t hear anyone whining about universality here (i.e., you can’t have anything I can’t have). So what’s the big deal about a two-tier health care system? What’s the big deal about boosting health care with private money, with some being able to pay?
You missed the most devastating and unique thing about health care in Canada: It is the only country in the world where it is forbidden to buy health insurance to cover what OHIP covers (at the time). So now we have a generation who basically will have less and less coverage as OHIP retracts and who were brought up to believe in a free lunch.
Disease insurance has been sold to us as health care just as death insurance is sold as life insurance! OHIP doesn’t cover healthful modalities.
There’s lots more I could add since I am one who sweats in the forced labour camps of OHIP.
Building on Medicare to introduce choice and competition to our medical system with Medical Savings Accounts is a great idea.
Your article “Patients, heal thyselves” in the Fall 1996 issue had many stimulating ideas. I would like to make some comments on the medical mall concept — I have in fact visited Addenbrooke’s Hospital in England to visit a sick relative.
My reservations arise not from Addenbrooke’s but from a Canadian hospital where I spent quite a lot of time as a visitor earlier this year. The atrium has been partially converted to the mall concept and the food facilities have been entirely contracted out — allegedly at the urgings of the staff. The result is that the offerings are heavily weighted toward enormous U.S. style servings of fat-laden food — I watched people ordering ice cream dishes that would have kept an African in calories for a week. The effect on the hospital staff is only too evident; I would guess that at least half of the nurses are suffering from obesity, to a degree that has been apparent in Canada only since the proliferation of American fast food chains. The sight of all those waddling caregivers in an institution supposedly devoted to health is most depressing — one can just see the future medical costs of all this overeating piling up.
I recently read your excellent article “Patients, heal thyselves” with great interest. While it covers many of the important ideas being discussed on the reform of our health care system there is one statement that I believe is a misinterpretation of the situation in Canada and the U.S.
In regard to the number of family physicians compared to specialist physicians, the ratio in Canada is approximately 50/50 compared to only 17/83 in the U.S. You interpret this as an under-trained, unskilled workforce. The Americans have declared a 100,000 surplus of specialist physicians and a 60,000 shortfall of family physicians. Most Americans, and experts around the world, agree that the majority of physicians should be well-trained family physicians and that subspecialty physicians should be the minority. This balance provides the most effective and efficient delivery of health care to our populations.
Contrary to your remark, the Americans are currently striving to achieve the balance we currently enjoy in Canada.