Cancelled fee was silo thinking

Re Slogans won’t fix health care, Editorial, May 19

I fully agree with your view that “health care is a field of incredible silos.”

Across Ontario, chronic patients remain in what should be acute hospital beds.

In cities such as Ottawa, emergency departments sometimes run out of beds and nurses are often unavailable to take over the care of patients newly arriving by ambulance.

This results is an overall shortage of ambulances throughout the city.

All three major parties agree that more chronic care beds must be built.

Former Canadian Medical Association president Dr. Chris Simpson has advocated a “National Seniors’ Strategy” to acknowledge that, with an aging population, most older persons have multiple chronic diseases.

Yet ironically, several years ago, the Liberal government unilaterally cancelled the E078 premium fee for doctors. For 10 years, this fee had increased followup visits by 50 per cent for general internists, cardiologists, gastroenterologists and nephrologists.

It covered about 30 chronic diseases, such as diabetes mellitus, congestive heart failure and dementia. It afforded additional time for a more complete history and physical exam, and a discussion of drug interactions and side effects, as well as dietary restrictions.

It likely prevented many patients from developing complications and, in desperation, swamping emergency departments.

Cancellation of this fee by then health minister Eric Hoskins made no sense, and is totally counterproductive to the seniors’ strategy — an excellent example of “silo thinking.”