Monday, April 09, 2007

The return of the son of the revenge of the wife of private healthcare, part XVIII.

I have to give Mark Godley, medical director of the False Creek clinic in Vancouver, some credit. He doesn't give up. According to the Globe and Mail, the clinic is reopening after being shut down under legal threat by the provincial government. His plan now is to try to do an end-run around the legal challenge by hiring physicians from out of province, who aren't under BC's Medical Services Plan. (A better argument for nationalizing the insurance scheme I have yet to hear.)

It's not news that physicians can do this. (AFAIK, there's nothing in Ontario law to prevent a physician from just opting out of OHIP altogether and trying to privately bill.) It's, more often than not, bloody stupid, though: most people walking in off the street aren't going to be thinking about carrying cash; instead, they'll pull out their health cards. It's sort of like operating a fast-food restaurant and not taking debit cards (I'm looking at you, Tim Hortons): you can do it, but you'll lose customers that way. What Godley et al. are gambling on, clearly, is that there's enough people with enough money to jump the line and keep the clinic afloat.

They may be right. But there are two worrying things about this development. The first is that physicians, who are in short supply across the country, have been poached from different provinces. I find the moral reasons behind taking a physician away from, potentially, thousands of patients in order to serve hundreds (at best) to be quite weak, if not non-existent. (Apparently, Godley et al. are more concerned with a quick profit than thousands of Albertans and Manitobans who have lost potential physicians.) T

he second is that it's a clear step towards two-tier medicine. Not because the backing for the clinic is private, but because money has been used to lure physicians away from the public system. This is exactly the kind of thing that opponents of for-profit healthcare have been warning is a necessary consequence of opening up the public scheme to monied interests, and it has now happened. It's not necessarily the case, of course, that the physicians hired by for-profit clinics are better than those who remain in the public system. But, ceteris paribus, when confronted with the option of doing less work for more money, physicians will tend to take it; and, when given the choice between a mediocre physician and a good one, those offering the money will take the latter; thus, already has begun the process of bleeding good physicians away from the public system in order to serve a select few in a private one.

I knew I couldn't rely on the Campbell government to do anything to actually help people in BC, but come on: can they really not see the problem here?

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