A CALL FOR MEDICAL TOURISM
New sources of health revenue must be found, writes Dr. Charles Shaver.
Ontario PC Leader Patrick Brown fully supports Windsor’s mega-hospital plan. In his Peoples Guarantee, he pledged to spend an additional $1.9 billion over 10 years on mental health. He promised to “reduce hospital and emergency room wait times.” Importantly, he would “treat doctors with respect by consulting them on future reforms to the health-care system.”
We can only hope that all of these fine words will be translated into concrete action if his party wins the June 7 election.
Clearly we must look for new sources of revenue even if it requires amending federal and provincial health legislation.
The solution is not simply raising taxes, demanding increased federal transfer payments, laying off more nurses, cutting back physician fees or closing more hospital beds or cancelling more days per year of elective surgery operating room time.
Ontario physicians have been attacked by Liberal politicians both federally and provincially. Some 70 per cent of Canadian doctors are incorporated. If federal Finance Minister Bill Morneau’s initial tax reform proposals remain minimally changed, some older physicians may retire prematurely, and some younger, mobile ones may reduce the number of OHIP-insured patients seen per week. Some may even leave for the United States. Physicians remaining in practice will be pressuring their provincial and territorial governments for additional funds to compensate them for the loss of the financial benefits of incorporation.
Ontario doctors have been without a contract for four years. Meanwhile, they have lost $3.5 billion in payments thanks to unilateral cuts by the Ontario Ministry of Health. They have patiently waited for binding arbitration. The above scenarios are particularly likely to occur if next year the Ontario government overturns by subsequent legislation any binding arbitration decision.
Premiers reluctantly agreed to accept a cut in the annual increase in federal transfers from six per cent to 3.5 per cent (plus some targeted funding). Yet not only does Ottawa cover only 22 per cent of public health funding, it has remained inflexible on enforcing certain parts of the Canada Health Act, especially regarding extra-billing and user fees.
In so doing, it is precluding provinces from permitting a limited amount of privatization that could make the health-care system more financially sustainable.
New sources of revenue for health care must be found. Clearly, the Canada Health Act needs to be amended and modernized, beginning with permitting medical tourism. This would entail expanding operating rooms and permitting Americans and other foreign patients to have elective surgery, such as joint replacements, here. This would provide employment for recent Canadian orthopedic graduates unable to obtain hospital privileges or sufficient operating room time, and to nurses and other health professionals. It would provide badly-needed revenue to hospitals and to ministries of health.
Windsor is geographically ideally situated to take advantage of this proposal, especially if and when it opens the mega-hospital in a few years.
Patrick Brown should promise to honour any binding arbitration decisions affecting physicians, and pledge to work with premiers and health ministers across Canada in modernizing and amending the Canada Health Act and provincial legislation so health-care delivery is not only sustainable, but provides employment and fair remuneration to physicians, nurses, and other health professionals.