The Canadian Medical Association's new "Medicare Plus" vision, announced by outgoing president Dr Colin McMillan (right) in a Charlottetown speech July 30, has stirred up the debate about the role of privately funded healthcare in Canada.
In the new CMA policy document (PDF), released the day of Dr McMillan's speech, the group asks governments and the public to:
- Allow doctors to practise in the private and public systems at the same time;
- Expand wait-time benchmarks to more areas of medical care;
- Guarantee treatment within those benchmarks and, if they cannot be met, subcontract the private sector -- as has already been mandated to a limited degree in Quebec with Bill 33, following the Supreme Court's Chaoulli decision;
- Create a national strategy to increase the number of healthcare workers;
- Expand public insurance to cover individuals' "catastrophic" drug expenses and long-term care costs.
"Any collection of doctors are entitled to their opinion and there are many things we agree with them on, but on the issue of physicians having a dual practice or two-tier system, we're not going down that road." - "Two-Tier" Tony Clement, federal Minister of Health
"[While] many doctors disagree strongly with proposals that would undermine public health care, the CMA leadership has chosen self-interest over public interest." - Dr Gordon Guyatt, Canadian Health Coalition
"Is the CMA SiCKO?" - Canadian Health Coalition
"Politicians should not look at this option for very long... It is hard to avoid the conclusion that the prime beneficiaries of the CMA's policy would be the CMA members." - The Globe and Mail editorial
"Rather that [sic] dismantling our public health-care system piece by piece, the CMA would do better to concentrate on solving challenges in Canadian health care within medicare..." - Danielle Martin, Canadian Doctors for Medicare
Not everyone's opposed to the CMA policy, however:
"Now that’s a refreshing look at health-care reality. Plus, it’s high time the official voice of 60,000 Canadian doctors entered the fray and realized Canada’s health-care system is about to kick the bucket unless it receives a massive injection of policy-change truth serum." - Bruce Strachan, former BC MLA, writing in the Prince George Citizen
“If there are ways to combine public money and private business practices in ways that make the health system more efficient, we should use them, and we certainly can't be afraid to discuss the options openly.” - Ottawa Citizen editorial
"In fact, the CMA's consideration of more private care is both cautious and modest... The doctors aren't exactly throwing open the doors to unregulated, jungle medicine. What they are doing is insisting that a level-headed discussion ensue, for the sake of patients, not profits. There's nothing radical about that." - Kingston Whig-Standard editorial
For their part, the CMA claim 62% of 1,802 Canadians surveyed support the plan (PowerPoint file).
What's next in the debate? Well, mark your calendars for August 19, when the CMA Annual Meeting kicks off and Brian "Dr Profit" Day takes the reins of the group. Unlike Dr McMillan, he's unlikely to wait a full year to let his opinions be known. (Read NRM's Q&A with Dr Day from last fall, after he was elected CMA president.)
Update, August 8, 2007: CMA Public-Private Interface Committee co-chairs Dr. Robert Hollinshead and Dr. Suzanne Strasberg defend the Medicare Plus plan in an op/ed to The Globe and Mail: "The physicians of Canada make no apologies for raising these issues on behalf of their patients. In fact, we think it is our responsibility."
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