Two areas of the country are experimenting with new approaches to healthcare. Quebec and BC are leading with vision and whether their vision is good or bad depends on who you talk to. But they are allowing evolution to occur within healthcare. One cannot say the same for Ontario, where the status quo is retained at the population's peril where there is an attitude of "short term safety, for long term pain".
Quebec has always been a little heavy handed with its medical practitioners. Probably because it understands many will stay because of language and cultural issues but this is changing. So it is not surprising to see that Queb ec tried to cap specialists wages at about 60% of what their colleagues earn in the rest of the country. "The Special Bill", Bill 27 inspired Quebec specialists to respond and they did, suing the government and encouraging its members to effectively work to rule until the government came back to the table. Time will tell whether Quebec physicians regard their cultural identity as more important than their ability to earn a living on par with other provinces as talks resume.
Quebec is also attempting to respond to growing medical need of its population by opening the doors for more private experimentation which seems to be quietly accepted by much of the population. Even Paul Martin used Montreal-based Medisys, an executive wellness centre, whose CEO is Dr. Sheldon Elman, the former PMs personal physician.
Quebec's Bill 33 was slated to pass this fall. The Bill establishes a role for private healthcare delivery in the public system. It gives doctors permission to run publicly funded, privately owned, for profit medical centres. It will create a wait list management system in public hospitals to determine when overflow patients must be sent to private clinics. It ends the absolute ban on private medical insurance which will allow hip, knee, and cataract procedures. Non-hospital surgical centres (affiliated medical centres) may be allowed to expand into other areas acting as "safety valves". These changes are in direct response to the Chaoulli decision's requirement to improve accessibility to public healthcare.
As always not all doctors (or patients) agree, but something has to be tried and it is possible that by bringing these centres on in a controlled way the fear mongering may be assuaged regarding the "private care boogeyman".
In Victoria BC, a new private health clinic has sprouted up called "Options Health Systems". It opened in November and has been criticized for collecting an annual fee for a range of "executive" style health services. It claims to be the first clinic in Canada to bring affordable "executive" care to average Canadians with a fee-based mix of GP services with complementary medicine and alternative medicine. Service fees are $300 a month for year one then $200 a month each subsequent year. Patients get a minimum half-hour visit with guaranteed same day appointments.
As mentioned previously on this blog, boutique practices are springing up quietly but executive care has been around for years. Why should the elite executive have access to more care than the average senior? Why should a person who chooses not to spend their retirement income on a car, be refused the liberty of spending their money on an annual fee to provide themselves with more time with their physician and more medical attention?
Interesting that Don Copeman, founder of the Copeman Clinic in Vancouver, tried to establish similar clinics in Ontario but was held off by the MOHLTC.
In some parts of the country, patients are allowed to spend their money on healthcare, while in other jurisdictions the same clinic is banned. So much for consistency across Canada.
Quebec and BC may differ in their approaches, but at least they are willing to try new approaches on a small scale and see where it leads. Ontario seems to want to keep plodding, afraid of it's public shadow.
Not a bad plan to evolve and respond to the changing medical climate; just remember what happened to the dinosaurs and how more agile and adaptable organisms managed to survive.
Let's hope Ontario figures it out before its too late.
Speaking of different folks:
As William Hanley puts it from the Financial Post: "They (Boomers) will certainly get their way or make life very uncomfortable for those who stand in their way."
Yes, older people take the time to vote and Boomers have always been demanding.
My prediction for 2007 and beyond: Boomers will insist on having their freedom to be in charge of their healthcare.
My New Year's Resolution: To attempt to understand why some people want to limit the personal freedoms of others.
Looking forward to reading your contributions. New Years Resolutions and Predictions welcome!
Best Wishes to all of you for a Happy 2007!