Monday, June 20, 2005

Abbott faces quick test from clinics pushing two-tier care

VICTORIA - A posh Vancouver clinic that promises better health care - for a steep annual price - is going to be one of the first tests for new Health Minister George Abbott. .
The Copeman Healthcare Centre is pushing the boundaries for two-tier care, promising an elegant waiting room, Internet access and most importantly "unparalleled levels of patient care."
The centre, set to open this fall, sounds great. But to get the benefits, you'll have to come up with a $1,700 initiation fee, and $2,300 a year. (Tax-deductible, of course.)
It may well be worth it, for those with the money.
But their gain comes at the expense of the rest of British Columbians.
The clinic is selling is access to better health care. Salaried doctors will see a dozen patients a day, instead of the typical 30 or 40. They will work on keeping clients healthy and do lots of testing to allow early diagnosis of problems.
But there is - or should be - a problem. The intent of the Canada Health Act is to prevent some people from slipping doctors, or hospitals, a big tip to make sure they get faster, better care. So far, Canadians have agreed that health care should be delivered on the basis of need, not on who can write the biggest cheque.
That principle has been steadily eroded, in B.C., and across Canada. Both NDP and Liberal governments in this province have turned a blind eye to the increasing number of private surgical clinics. The clinics offer paying customers - like Environment Minister Barry Penner - a chance to jump the queue and get speedier treatment, for a hefty price.
The Copeman clinic is a bid to take two-tier care to the next level, offering better basic health care for people with money, while still collecting from the Medical Services Plan at the same time.
Abbott will have to decide whether the clinic is legal, and two-tier health care is in the best interest of British Columbians.
Ministry staff met clinic owner Dan Copeman last week, but so far the government has taken no position on the private care centre.
That's surprising.
The clinic, and others like it, will actually ensure British Columbians who can't pay will get poorer treatment than they do today. (Effectively increasing the market for private clinics.)
Look at just one aspect, the effect on the doctor shortage in B.C.
The clinic wants to hire 12 doctors from within the province by the time it starts operations. Right now those doctors are practicing somewhere, and typically providing care to about 15,000 British Columbians.
But the clinic promises doctors will see one-quarter the number of patients.
Not only will the 15,000 patients lose their doctors, but the overall capacity of the system will be reduced, in order to improve the care for a small number paying a premium for better care. Some 200,000 people in the province can't find a family doctor today, and BCMA head Dr. Michael Golbey says the clinic will make the problem worse.
And there is the basic underlying principle.
So far, Canadians have agreed that equal access to health care is part of a fair society. We've said that if two children are sick, they both deserve the same treatment. Having parents with less money shouldn't mean a greater risk of sickness and death, or second-class medical treatment.
The clinic violates that basic principle. If parents register, their children are also covered. They receive the same promise of superior treatment.
The track record of B.C. governments is not good in this area.
Private surgical clinics opened under the NDP, and grew to more than two dozen under the Liberals. They provide faster treatment for thousands of people who can pay to jump the queue, while waits in the public system have risen.
The government has taken no action.
British Columbians will find out quickly if Abbott is prepared to act, where his predecessors waffled.
Footnote: Private clinics are proving that people are willing to pay more money for better health care. In this case, they are paying directly. But their willingness could equally extend to higher taxes  -- if they were convinced the money would result in benefits to them. (The clinics will automatically push up overall health care costs.)

1 comment:

Blue Cross of California said...

Two tier health care can be a great aspect to many individuals. I hope it can help improve the health care system.