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Two-Tiered Health Care for Canadians

Two-Tiered Health Care for Canada will not Work

Health care is destined to use up the majority of tax dollars in this country, more than education and more than infrastructure. Since Federal and Provincial governments cannot see a solution it is inevitable that eventually a two-tiered health system will be introduced to Canadians.

On the surface it may seem like a workable solution to endless waits at emergency and even longer wait times for elective surgery. Just pay for the services you need and you can get them immediately.

You may have to wait anywhere from 2 months to a year for an MRI (magnetic resonance imaging) test or you can have one tomorrow in Buffalo at your convenience for $450. Under two-tired health care you would still pay the money but have the MRI nearby and at your convenience.

If our physicians are allowed to opt out of the plan completely then a large portion of people who make a reasonable living will have the option of spending $100 dollars to see a very good physician and maybe 5 or 10 thousand dollars to have some knee surgery done immediately. The situation should work because even though you may have to take out a loan for surgery you should be able to deduct the medical expense from your taxes at the end of the year. Almost everyone who has a job will be happy except for the millions of poor people, pensioners, people with disabilities and people with large families who just cannot afford to lay out the money.

These people will get a double whammy because the majority of excellent physicians will opt into the cash plan leaving the mediocre and less talented ones behind to take care of the poor masses.

Think of the law profession for a moment. You have your brilliant talented lawyers fighting huge cases and earning extremely high salaries. They graduated at the top of their class. They were the most excellent students and they became the most excellent lawyers. Those at the middle or at the bottom wind up pleading out petty criminals in criminal court or representing small claims against insurance companies.

When I had my pharmacy it was an independent operation. I could not afford to give my pharmacists a dental plan, drug plan or pension like Shoppers Drug Mart or PharmaPlus. The pharmacists available for me to hire were the rejects of the large organizations, many of who could not even communicate in the English language let alone have the ability to prepare a mixture from scratch.

The same thing would happen with our physicians and surgeons.  One of the arguments in favour of a two-tiered health system is that with people paying directly for services the wait times for the rest of the people will be reduced because those with money would no longer be in the queue. The only problem is that the physicians and surgeons that will still work for the government and serve the masses will be the bottom of the barrel, those who graduated near the bottom of their class not the top.

But let us suppose that a different solution is worked out. Our governments let all the doctors stay in the plan but allow them to charge extra for patients to move up the line. Patients would pay the difference between what OHIP pays the physician and what the physician charges you. It will only work for non-emergency elective conditions because most physicians feel duty-bound to take care of the health of the patient first and worry about the money later. The patients that are in most dire need will be treated more quickly.  If this system actually did work, the health budget should be reduced by almost 50 percent but the reality is the health budget will not be reduced by a solitary nickel. It is the way governments budget.

Let us suppose you make an agreement with social services of Hamilton to open a woman’s shelter. You prepare a plan that estimates costs of $100 thousand dollars annually. However in the first year you only spend $90 thousand. Do you give back the left over money because if you do you will only get $90 thousand next year? The government agency that gave you the money will thank you for your honesty but tell you to keep the $10 thousand and ask for another $100 thousand the following year. That is how government budgeting works. The same thing would happen with health care. The federal and provincial governments would still collect all the taxes and distribute the money just as before but at least for a few years there would not be any spending increases.

This happens because we do not appoint health ministers from the medical professions. Our Federal Minister of Health is Leona Aglukkaq a graduate of Artic College in Inuvik with a diploma in journalism. Our provincial Health Minister is Deb Matthews, a PhD. Graduate of Western University in London with a degree in Social Demography (how different cultures live and assimilate together). Both of these women have been involved in politics their whole lives. Neither has any knowledge of the medical system or medical care but they understand budgets, funding and the way tax dollars are spent. When will we ever learn to keep politicians away from our health care system?

What if Health Canada were run by a physician or surgeon? A physician or surgeon would understand the need for free-standing clinics for elective surgery; a physician or surgeon would be diligent about the misappropriation of hospital funds and the huge sums spent on administration; a physician or surgeon would not be so quick to list drugs that cost $50 thousand dollars a month that would maybe extend the life of a cancer patient for 3 to 6 weeks. A physician or surgeon might put the quality of life and health care over and above the need to be reelected.

At the present time our health system in Canada treats every person equally and covers us from cradle to grave. This is the same system that is used in Britain, France, Germany, Sweden, Norway, Japan and almost every civilized country in this world. If we allow ourselves to fall into a two-tiered system we become just like our American neighbours.  Everybody for themselves. Why should my tax dollars pay for some poor person’s operation when I work so hard to earn my money? The United States is an entrepreneurial nation that works on greed.

Canada is a great country that treats all of its citizens equally. I hope that we never allow ourselves to fall into a two-tiered system in which not only do the rich get richer but they also get the best health care.


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