A future that is public … or private?
There are competing views within medicine on how to fix Canada’s troubled health care system
By Vivian Luk, Special to The Sun March 14, 2013 | The health care system in British Columbia (and across Canada) is flawed and needs to be improved. That much, Dr. Vanessa Brcic and Dr. Brian Day can agree on.
What they cannot agree on is how.
Brcic, a family physician as well as a board member of the Canadian Doctors for Medicare, believes a strong public system is the best option when it comes to access to care. However, she says the current system, which covers primary care and hospital care, is antiquated and unsustainable.
“The problem that we have right now is the current system is very focused on the hospital, and our population is changing over the years,” she said. “Population growth is the first thing, the population aging is the second thing, and we’ve got people living longer with more chronic diseases.”
As our population continues to age, things like physiotherapy, chiropractic, and extensive home and residential care will become increasingly important, said Brcic. However, few of those things are covered under the Medical Services Plan for the average British Columbian. Meanwhile, many people routinely face long waits for emergency and surgical care.
Brcic believes those waiting lists could be reduced if the government would invest in things like home care, so elderly patients could stay at home and not take up hospital beds. Streamlining services could also improve efficiency.
Brcic points to the Oasis Clinic in Vancouver, which triages patients with osteoarthritis, as an example of streamlining care and referrals.
“Who needs knee replacement right now, who are the people who need to stabilize their diabetes and heart disease before they need the surgery, who are the people who haven’t done any physiotherapy and could use an exercise program that will get them in better shape after surgery?” she asked. “They’ve got one program that juggles people based on needs, so they make sure that the next person to get surgery is the person who needs it the most.”
If the government doesn’t invest more in those types of services, Brcic says British Columbians will be left with a health care system filled with gaps.
Day believes allowing all British Columbians the option of seeking private care will fill that gap. Day, who worked in the public system until he opened the Cambie Surgery Centre in Vancouver in 1995, says many of his colleagues at the time were fed up with health care funding cuts that led to reduced access to operating rooms.
“At the time we opened Cambie, I had 450 patients waiting on my public waiting list to get into hospital,” he said. “That’s completely unacceptable.”
The Cambie Surgery Centre offers a range of procedures, including orthopedic surgery, eye surgery and dental surgery. Prices range from $1,000 to $15,000, depending on the procedure.
But under the Medicare Protection Act, only certain classes of B.C. citizens, including Workers’ Compensation claimants, and RCMP and military personnel, can legally take advantage of private health care.
Day is in a legal battle with the province because the Medical Services Commission found out last year that he was extra billing patients for services covered in the public system.
Day, who calls the Medicare Protection Act unconstitutional, says access to private care should be expanded to all British Columbians so those who do not want to wait for procedures in the public system do not have to.
“We have children in this province, more than 50 per cent of them are waiting medically,” he said. “We have adults waiting in pain for a year or two. These people don’t want to wait.”