Quality of care

All Islanders entitled to medical care on par with anyone else in province

BY DAVID BULGER

For most of my adult life, I have defended our Canadian medical care system. Indeed, I have had some heated moments with “rabid anti-socialist Americans” on the subject. I have admitted the problems, in particular some wait times, but I was always quick to point out that I had chosen my family physician, and when I had a major medical condition, the time from diagnosis to surgery had been less than three weeks.

I have recently learned that my “glasses” were decidedly “rose-coloured.”

I have now spent some considerable time on the infamous “patient registry” and have just discovered that “physician independence” is permitted to trump fairness and justice in the system by providing for outright line-jumping. Clearly this must be stopped. However, in addition to this injustice, it is also the case that our system does not deliver the same quality of care to those without a family physician as it does to those who have one.

A modest example. I take maintenance doses of two medications which were originally prescribed for me 20 years ago and continued to be prescribed for me in one year quantities right up to the point where I no longer had a doc.

Now I have to regularly drag my sorry self to clinics every two months to obtain the necessary prescriptions. This is clearly second-class care, and this small example does not even begin to touch on things like the lack of regular physical examinations and blood tests.

If we accept that fact that there are almost certainly going to be persons without personal physicians — always — then that very fact has to be addressed, not as an anomaly, but as much a part of the norm as personal medical care. While medicine itself is well beyond the ken of the average person, common sense ought to dictate ways of dealing justly with individuals who do not have a family doctor.

Those individuals still require, and are entitled to, medical care on a par with anyone else in the province, and if that care is going to be supplied by clinics, then the practice of the clinics will have to match that of individual physicians.

Or the care is not equal. And our system, in terms of the comprehensiveness and universality mandated by the Canada Health Act, in terms of the equality imposed on government by the Charter, and, finally, by virtue of the sheer fact that those who lack a family physician are still taxpayers, requires an equality of care.

We largely surrender the right to choose a physician freely – though this is clearly a defect–in return for the guarantee that we will not be treated worse than our neighbour when it comes to health care.

If we cannot deliver the same quality of health care to all taxpayers, then we may as well fold our tents and move to the American “free market” system, with all of its inequities and deficiencies.

And of course, our system will no longer be defensible.

David M. Bulger of Cornwall is Adjunct Professor (retired), UPEI