Cana­dian Medi­care is not so­cial­ized medicine

Prairie Post (West Edition) - - Opinion - BY NOOR BRAR

What’s the one thing many of us Cana­di­ans take pride in about our coun­try?

Pub­lic health­care.

Canada is among the nu­mer­ous coun­tries that have pub­lic health­care, but even our sys­tem has room for im­prove­ment. Pro­gress­ing to­wards so­cial­ized medicine could re­sult in a medi­care sys­tem that of­fers bet­ter-qual­ity care through in­creased physi­cian-pa­tient time, re­duces di­ag­nos­tic er­rors, and pos­sesses pas­sion­ate health­care physi­cians.

At one point or an­other, we’ve been, or been with, some­one who praises the Cana­dian medi­care sys­tem due to its uni­ver­sal, pub­lic in­sur­ance for all of Canada’s res­i­dents.

There are var­i­ous pos­i­tive as­pects to our sys­tem, and I’m sure we are all thank­ful we don’t have to pay large sums of money in or­der to re­ceive med­i­cal care. Ad­di­tion­ally, the state of our south­ern neigh­bours health­care sys­tem only re­in­forces the no­tion that our’s is su­pe­rior.

How­ever, a pub­lic health­care sys­tem is not a per­fect health­care sys­tem.

Many in­di­vid­u­als term Cana­dian medi­care as “so­cial­ized medicine,” but that is an in­cor­rect def­i­ni­tion. Dr. George D. Lund­berg, the ed­i­tor-at-large for Med­scape, de­fines so­cial­ized medicine as “a health­care sys­tem in which the gov­ern­ment owns and op­er­ates health­care fa­cil­i­ties and em­ploys health­care pro­fes­sion­als, thus also pay­ing for health­care ser­vices.”

Cana­dian medi­care is sim­i­lar to so­cial­ized medicine, but there is one ma­jor dis­crep­ancy: health­care pro­fes­sion­als in Canada are self-em­ployed in­di­vid­u­als, rather than gov­ern­ment em­ploy­ees.

This grants them the flex­i­bil­ity to de­ter­mine their hours, num­ber of pa­tients seen, and work lo­ca­tion, as well as the re­spon­si­bil­ity of pay­ing their em­ploy­ees. Con­trar­ily, a gov­ern­ment-em­ployed physi­cian would have re­stricted con­trol over these fac­tors.

Since Cana­dian health­care pro­fes­sion­als are un­able to di­rectly charge their pa­tients for the ser­vices they pro­vide, they are paid through the fee-for-ser­vice pay­ment model. Physi­cians bill their pro­vin­cial gov­ern­ment for the ser­vices they pro­vide to pa­tients. As a re­sult, Cana­dian medi­care is sim­ply in­di­vid­ual pri­vate providers billing the gov­ern­ment for pub­licly funded ser­vices, which is con­trary to the struc­ture of so­cial­ized medicine.

The pri­mary is­sue with the fee-for-ser­vice method is that it mo­ti­vates doc­tors to see as many pa­tients pos­si­ble within a work­ing day. Physi­cians are able to bill the gov­ern­ment for each pa­tient they see, so by pro­vid­ing care for more pa­tients, they will earn a higher in­come. Some prov­inces, such as BC, have a daily pa­tient cap that lim­its how many peo­ple a doc­tor can see in a day, but this could still mo­ti­vate physi­cians to meet the limit in or­der to ob­tain max­i­mum in­come. A higher num­ber of pa­tients per doc­tor means less time per pa­tient.

Ac­cord­ing to the Cana­dian Med­i­cal As­so­ci­a­tion, the av­er­age hours worked by a physi­cian per week, ex­clud­ing on-call, was 33 hours. In BC, the daily pa­tient cap is 50, so if a doc­tor was see­ing 50 pa­tients per day, about eight min­utes is ded­i­cated to each pa­tient. Nu­mer­ous peo­ple would agree that af­ter the time spent wait­ing to re­ceive med­i­cal care, eight min­utes is not suf­fi­cient enough.

In­creased physi­cian-pa­tient time could de­crease num­ber of med­i­cal er­rors made.

A tele­phone-sur­vey study done in Al­berta re­ported that 37.3% of re­spon­dents claimed that they or a fam­ily mem­ber had en­coun­tered med­i­cal er­ror while re­ceiv­ing health­care. About 94% of them agreed that one way this could have been pre­vented was if doc­tors spent more time with their pa­tients, and this is highly pos­si­ble. Er­rors could be re­duced if Canada adopted so­cial­ized medicine; doc­tors would not be in­cen­tivized to see a high num­ber of pa­tients be­cause they’d paid on a salary ba­sis, and as a re­sult, would have the op­por­tu­nity to spend more time with each pa­tient.

Money-ori­ented in­di­vid­u­als tend to pur­sue hig­h­earn­ing ca­reers, such as medicine, de­spite not hav­ing much in­ter­est in the field.

Not all physi­cians are in the med­i­cal field sim­ply for the sake of re­ceiv­ing high pay, but peo­ple aim­ing for fi­nan­cially-strong ca­reers may turn to­wards jobs in medicine, law, and busi­ness. If Cana­dian medi­care evolved into so­cial­ized medicine, physi­cians salaries may be re­duced and re­sult in a lower in­come. How­ever, this could en­sure that those en­ter­ing the med­i­cal field are do­ing so be­cause they are pas­sion­ate about medicine, and this could po­ten­tially in­crease the qual­ity of Cana­dian health­care.

Un­for­tu­nately, Cana­dian medi­care is not so­cial­ized medicine.

Noor Crar is a stu­dent from Bri­tish Columbia

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