Medical reform, not privatization

Commission Castonguay

The Canadian Medical Association says it wants to protect patients, and to do so it is asking the federal government to loosen the Canada Health Act, legislation which ensures universal access to health care for all Canadians based on medical necessity.
The CMA wants doctors to be allowed to work in the public and private systems, a practice the act prohibits. Physicians already have the choice to work privately by opting out of the Canada Health Act, and the great majority have chosen not to do so.
Nurses reject CMA's recipe and say it is a privatization gimmick. In an open letter to Prime Minister Stephen Harper, the Registered Nurses' Association of Ontario urged the PM to restate, in no uncertain terms, that physicians will not be allowed to practise simultaneously in both the private and public health-care systems.
A wealth of evidence shows that allowing physicians to practise in both public and private systems decreases access to health care, costs taxpayers more, and results in lower quality of care - including higher rates of complications and deaths. A parallel private system siphons health-care professionals and drains resources out of the public system.
Countries with parallel private hospitals have larger and longer waiting lists in their public hospitals. A parallel private system allows for-profit clinics and the physicians who work in them to benefit from people's vulnerability in times of illness. These clinics cherry-pick patients who are healthier, younger or have conditions that are cheaper to treat, leaving more complicated cases to a public system with fewer health-care professionals.
Moreover, whenever patients in a for-profit clinic suffer complications, they are sent to the public system.
We must stay the course to continue to strengthen public medicare by increasing funding for human health resources, allowing all professionals to practise to the full extent of their abilities; develop a solid system of primary and community care; utilize our diagnostic equipment round the clock; increase our efficiency by dedicating staff to specialized procedures; move patients in and out of our hospitals in a timely fashion - without delaying or cancelling their procedures - and provide them with adequate community supports. This is the nursing prescription for strengthening medicare.
Even in Alberta, former health minister Iris Evans described the province's reduction in wait times for hip and knee replacement as a public system triumph. Alberta went from an average wait of 47 weeks to 4.7 weeks. The recipe for success was based on not-for-profit solutions: establishing specialized teams of surgeons, nurses, and physical therapists who moved patients quickly through the system; performing surgeries according to well-managed waiting lists based on medical priorities; and providing nursing and other resources for patient education to assist people in managing their diabetes or losing weight before surgery.
Let us be very clear: Nurses want change, but not privatization. We want to move from the rhetoric that has characterized the private-public debate to find real solutions to strengthen medicare - a system that will keep Canadians healthier and that will be there for them when they are ill, serving them better and faster, regardless of the size of their wallets.
Nurses are united in our intent to protect the public by strengthening and expanding medicare, and we will expose those who would profit from the destruction of medicare. The facts are clear: publicly funded and not-for-profit delivery results in lower wait times, lower costs and better health outcomes. Let us focus on the facts and together we will continue to strengthen medicare for all.
The CMA is again squandering an opportunity to show Canadians it is committed to our universal, publicly funded health-care system.
We call on our physician colleagues to avoid the mistakes of the past, such as the Saskatchewan doctors' strike of 1962 that tried to stop the implementation of Saskatchewan's Medical Care Act - the precursor to medicare.
While allowing doctors to work in both the public and private systems might benefit individual doctors, strengthening the for-profit motive will fray our social fabric and jeopardize quality health care.

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