THE BLOG

Muddled Medical Thinking and a Meddlesome Alberta Doctor

12/03/2013 04:00 EST | Updated 01/29/2014 05:59 EST

One irony of Canadian life is that the most economically free province in the country, Alberta, often has government policy that is the most hostile to private health care. Another irony, this time right across Canada, is that one can spend any amount of money on a basic necessity of life such as food. But when Canadians want to use their own money to purchase medical treatment to improve, prolong, or even save that same life, they are legally prevented from doing so.

These two ironies came together recently when the Alberta College of Physicians and Surgeons Registrar, Dr. Trevor Theman, moved to eliminate Alberta's two notable exceptions to restrictions on private health care: private MRI and CT scans and partially privately funded primary care clinics.

Dr. Theman is trying to change the College's policies to halt partially privately funded primary care clinics in Alberta. He has also madeclear his views on private diagnostic scans and called for their ban. His initiative has the potential to harm Albertan's well-being; it has no clear upside other than perhaps the satisfaction of imposing an ideology on those who cannot hold the good doctor to account.

Dr. Theman claims this is all being done to defend the noble principle of Medicare, that access to necessary care is not based on ability to influence or pay. To understate it, Dr. Theman's position is short-sighted.

Stopping people from choosing an alternative to government-funded care clearly makes them worse off. Just as bad, it doesn't actually make those who stick with the public system better off either: shackling patients to a single, uncontested standard of care results in a lower standard of care for everyone. Letting some patients opt out of the public scan queue should reduce pressure on that system and benefit those who remain in it. Yes, some doctors may opt for private patients or partially-privately billed practices rather than fully government-funded ones. But they already have the choice to leave Medicare entirely (for opted-out practice) or move elsewhere in Canada where they can provide these services.

Another irony: Dr. Theman's initiative would have no impact on wealthy Albertans who could simply hop on a plane to Vancouver, Montreal, or the United States for their private primary care and private MRI or CT scans. But it would impact Albertans who might cobble together money for more comprehensive or timely care but cannot also afford to travel to Vancouver or Phoenix to get it.

And one last irony: Part of the problem here is the physician shortage created by governments in the first place when they restricted domestic physician training in the 1990s.

As a reminder of how sub-par the Canadian health care system is, the Commonwealth Fund just released an international survey of patients that again pointed to the reality that Canadians face some of the longest waits in the developed world for access to care. Perhaps not surprisingly then, a 2007 Medical Post survey of doctors found that 26 per cent of them said they've had a patient on a waiting list die.

If the concern is that Albertans without sufficient means might wait too long for care, we should work towards providing universal access without long queues for treatment as is done in Belgium, France, Germany, Japan, Luxembourg, the Netherlands, and Switzerland.

Funny thing about such European (and Japanese) countries: people there have the same choices with health care as they do with food: they also have better universal health care systems because the governments don't insure, own and run everything.

The proposals coming from the Registrar of Alberta's College of Physicians and Surgeons put ideology before patient health. They reflect the short-sighted thinking of those who feel the only acceptable way to spend money on health care is through higher taxes, and through inefficient bureaucratic and politically-driven service delivery. All that has done is squelch any potential growth in medical professionals and their services. That has harmed patients and--as noted by the Supreme Court of Canada back in 2005--caused some to perish. Medicare needs to be fixed alright, and the first step is to not further punish Albertans who, by their actions, have sent a powerful signal that Medicare isn't working for them.