Friday, August 06, 2010

CMA returns to advocating for public health instead of private profits

They're still buying into nonsense framing about unsustainability but this years public statement is a welcome return to fighting for patients instead of insurance companies and private clinic entrepreneurs.

Also frustrating is the CMA’s assertion that the public health-care system is unsustainable. This is a Chicken Little claim that has been repeated so many times it risks becoming self-fulfilling. The truth is that Canada’s health-care system is less expensive than those of several other wealthy nations. In fact, we spend less public money on the health-care system as a whole than most comparable countries. We are richer than we ever have been. If our government can afford $16 billion for fighter jets, it can certainly afford to pay for a reasonably decent and humane health-care system.

But perhaps even more importantly, the debate over sustainability is a false one. We are going to pay for health care, whether we pay individually or through our taxes. If governments download costs onto citizens in order to make the public system more “sustainable,” we will end up paying more for the same services out of pocket or via private insurance. A few wealthier Canadians would then have better access than the rest of us, and we would be right back where we were before the passage of the Canada Health Act.

What isn’t sustainable is the status quo because Canadians deserve a health-care system that continually gets better. Like everyone who works in the system, doctors are not exempt from the need to change. While doctors play a crucial role in the health-care system, the CMA’s report falls short of recognizing the extent to which we also contribute to our system’s challenges — by ordering too many expensive tests, prescribing medications unnecessarily, contributing to the lack of coordination in the system, and sometimes failing to embrace necessary change when it puts our power or our established ways of doing things at risk.

The CMA’s apparent shift away from privatization, and toward a more constructive dialogue with Canadians about how to improve medicare, will be welcomed by many physicians and our patients. Now that the CMA has recognized that the principles and values of the Canada Health Act provide the most efficient framework for delivering accessible and quality health care, on to the hard work of improving medicare!

Dr. Danielle Martin is chair of Canadian Doctors for Medicare, and Dr. Irfan Dhalla serves on the board of directors.

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