When the Americans started saying all sorts of nasty things about Canada’s health-care system this summer, Canadians became defensive.
But our knee-jerk reactions were sometimes without reason, said Anne Doig, president of the Canadian Medical Association.
“The funny thing about the US/Canadian (health care) debate is that we’re both lousy,” said Doig.
“Here’s two countries that don’t stand up well on the international scene throwing tomatoes at each other across the 49th parallel, and for what?”
Both countries are defending a system that they think is superior, but in comparison to what is happening elsewhere, “they’re not all that good,” she said.
Doig is in Whitehorse this weekend to speak at the Yukon Medical Association’s annual general meeting.
Since being elected as president of the medical association in August, Doig hasn’t held back in her criticisms of Canada’s health-care system.
In her inauguration speech Doig said Canada’s health-care system is “imploding” and that it’s “more precarious than perhaps Canadians realize.” The comments lit up the blogosphere and were used as ammunition by those south of the border lobbying against nationalized health care.
The provocative statement was meant to point out that there are large cracks in the system holding doctors back from looking after patients in the best way they can, she said.
Waiting too long to see a specialist and not getting the right diagnostic tests at the appropriate time are unacceptable, she said.
“We joke in our community that some women have to book their ultrasounds before they even know they’re pregnant.”
Doig has been outspoken about other health issues, too. In October, she addressed the House of Commons in Ottawa to say that communication between the government and health-care providers could have been vastly improved during the lead-up to the H1N1 pandemic.
“In hindsight we could have had a more co-ordinated national response,” she said.
But what Doig has become best known for is her unflinching ability to pick apart Canada’s health-care system.
It isn’t necessarily beyond repair, it just needs to be working a lot better than it is now, she believes.
Doig is third in a line of association presidents who have openly stated there is a role for private health care in Canada.
Bloated health-care budgets, long lineups and hallway medicine are all proof that Canada could be doing things better.
“The public has to have a debate about what comprehensive care is,” she said.
“Let’s quit throwing around words like ‘private’ and ‘public’- it stifles the debate and only serves to frighten people.”
But public health care is a sacred cow in Canada and few people are prepared to see the system, which took Tommy Douglas so long to implement, threatened.
Doig’s own roots are entwined with those of the national health care debate in the 60’s.
Her father, also a doctor, fled Britain in 1958 because the government-run National Health Service was meddling in patient-care. But it would be just his luck that the province he moved to, Saskatchewan, would become the birthplace of medicare four years later.
He would eventually become involved in talks about how medicare was to be introduced in Canada.
Doig was a young girl at the time. The experience taught her that “the hammer of government affordability (can’t be used) to tell a patient what kind of treatment that person needs.”
It also made her appreciate the security Canada’s health-care system offers. This may be lost on Canadians younger than 40, who have never taken money out their wallet to pay for health care, she said.
But because there is a perception our system is “free,” people inevitably take advantage of it, she added.
This means that Canadians must ultimately choose between higher taxes to pay for the spiralling costs of health care, which will only escalate when the “silver tsunami” of baby-boomers reach old age, or look at alternatives to fund our system, she said.
“Part of what scares people about private (health care) is that they immediately think it’s for profit and they see it as an opportunity for doctors to line their pockets.”
Not-for-profit crown corporations could be set up to compete with the existing system, she suggested. Some private elements already exist in Canada whether people realize it or not, she said.
Doig points to the Worker’s Compensation Board, which gives claimants preferential service over regular patients to speed workers back to their jobs.
And some provinces, such as Ontario and British Columbia, charge their residents health premiums based on income.
Last year the Yukon government considered introducing health premiums to the territory to pay down health-care costs, but the suggestion was met with a great deal of resistance.
However, premiums place the cost of health care more squarely on the shoulders of taxpayers, making people less likely to abuse the system, said Doig.
When Saskatchewan chose to get rid of health premiums in the ‘60s, it “crippled” the province, said Doig.
But health care is region-specific, Doig concedes. And up north, the biggest challenge people face is recruiting and retaining general surgeons and practitioners.
“Students in medical school are taught that if you don’t specialize then you’re nothing,” said Doig.
At the end of the day, what is most important is that Canada actually begins to have an open discussion about its health-care system without fear of recrimination from those who cling to the ideals of medicare, she said.
“There is a lot of good in having a system that is publicly funded and publicly administered,” she said.
“We just need to make it work better.”
Anne Doig will address the Yukon Medical Association Friday, 3:30 p.m. at the High Country Inn. The talk is open to the public.
Contact Vivian Belik at