The courts shouldn’t be running our health system

Date:

July 28, 2012

• Tags:
• Health Information & Services
• Legal Assistance

From the Calgary Herald

Re: “Patients deserve relief from growing wait times,” John Carpay, Opinion, July 12.

Access to a waiting list is not access to health care. This is true in anyone’s world.

In a four-to-three split decision, the Supreme Court of Canada determined that the Quebec Health Insurance Act violated the Quebec Charter of Human Rights and Freedoms.

Three of the dissenting justices made the following comments: The wait lists represent rationing … for many years the government has failed to act: the situation continues to deteriorate … the government has the power to decide what measures to take … it cannot choose to do nothing in face of the violation of “right to security” … it does create a monopoly for the public health system … this with significant delays harms the right to security of person … delays in medical treatment could have physical and stressful consequences …

The question of whether the Quebec government has the authority to establish a single–tier health plan or prohibit private health insurance is an issue of public policy and social values. It is not for the courts to decide, but the Quebec National Assembly. The court does not know what a “reasonable wait time is.”

The Canada Health Act states “that continued access to quality health care without financial or other barriers will be critical to maintaining and improving the health and well-being of Canadians.”

Access to health care should be based on health needs and not wealth. Our Alberta government is rationing health care.

Although John Carpay suggests that the Alberta government will resort to fearmongering to avoid a two-tiered system, he notes that one does currently exist. Citizens can jump the queue for treatment if they have a privately paid for MRI, ultrasound or CT scan demonstrating a medical or surgical finding.

Paying a private clinic to obtain around-the-clock medical care is also available.

However, it is not ethical for the doctors to be involved in this manner of care. Professional ethics mandate that physicians do not accept a monetary payment to treat one patient before another patient with a similar problem, nor does working for a corporation that operates a private clinic absolve the doctor from this responsibility.

What happens to our trust in our medical system if physicians do not maintain their code of ethics?

Private health care and its associated coverage with private insurance is more expensive than our public system. This is a proven fact.

Private corporations consider the patient to be a commodity, referring to him/her as a customer and not a patient.

Corporate responsibility is to take into account the shareholder’s best interest before the patient. The shareholder is given first consideration. Money making comes first, increasing the volume of business is also a first, and patient care becomes a diminutive second.

Many American states have this principle enshrined in law.

In order to protect profits, only the young, the healthy middle aged and those without previous or ongoing medical conditions are insured. They cancel or deny seniors’ coverage and that for those who develop serious medical problems. Anything to increase the bottom line.

European countries are often cited as role models, but what is not mentioned is that all citizens are mandated to purchase insurance, or all health care is paid for directly by the government.

The insurance companies are either public, non-profit, or for profit. The governments control the list of included treatments and tests. Profits are strictly controlled by the government. The plans cannot refuse anyone, young or old, sick or well. Most do have copayment fees. Laboratory studies, diagnostic X-ray and ultrasound tests are controlled as to type and charge. Doctors’ incomes are controlled. There is no opting out.

Private hospitals and doctors exist, but the cost is so high, that only the very rich are their patients; approximately three per cent of the population.

All citizens still pay for the public system.

Our Canadian system is in a crisis.

Private insurance does not work in health care. Health care is not a commodity. A single-payer system with everyone included is the only method that can truly work well for all. There should not be special insurance plans or private clinics for those who can manage to pay.

When our government does not do what the majority of citizens want, and when it doesn’t enforce the laws of the land, our democracy is in real trouble.

Providing health care equally to all is a social and moral decision, one that our citizens must decide. They must stand up and be counted.

As John Ralston Saul recently said at a public meeting, voting and belonging to a political party is good, but this is not enough. Our citizens must do more.

Harold Swanson is a Calgary medical doctor.

From the Calgary Herald