Private health not likely in remote areas: CMA

The popular public-private health-care debate is largely irrelevant, according to the Canadian Medical Association.

The popular public-private health-care debate is largely irrelevant, according to the Canadian Medical Association.

“It doesn’t make any difference what happens; there are large areas of this country, both geographically and by specialty, in which private medicine is just not on,” outgoing association president Colin McMillan told about 30 Yukon doctors last Friday at the Yukon Medical Association annual general meeting.

McMillan was responding to queries from former association president Wayne MacNicol about the validity of the public-private debate.

“Up here … the public-private debate doesn’t even exist,” said MacNicol.

With “the private-care practitioners up here and the specialists up here and the general specialists up here, there is not any room for any kind of private system.

“Even with referral of our patients down south, it is actually very marginal that we interact with the private system.

“I wanted to express my concern about the whole tenor of the debate, nationally.

“There are much more important issues for us to be dealing with.”

The debate is, to some degree, a fabrication of the media, replied McMillan.

“It’s unrelenting.

“No matter what you say, they keep coming back to it.”

But the incoming president of the 63,000-member Canadian Medical Association is a well-known advocate of private health-care delivery.

Vancouver-based doctor Brian Day, who owns and operates a private orthopedic clinic called the Cambie Surgery Centre, was named president-elect at a national meeting of the association in Prince Edward Island in August.

He will assume the influential post of national association president for 2007-2008.

At the national meeting Day claimed he has never advocated the privatization of the Canadian health-care system, but does promote private-sector investment.

“My support for universal health is unequivocal,” Day said during an election speech.

“Like most Canadians, and most physicians, I believe there is a place for the private sector and for public-private partnerships.”

Day wasn’t explaining the association’s mandate when he gave his acceptance speech, said McMillan.

“We didn’t perceive the nomination or the election (of Day) as a mandate of medicare or the private-public debate, but clearly that was what the media was interested in,” he said.

However, the day after McMillan spoke, a public health-care advocacy panel told a small group of concerned citizens in Whitehorse that medicare is under siege.

The Conservative government in Ottawa sees health as a commodity to be traded, so Canadians must be vigilant or else their public health care could be dismantled in favour of a for-profit system, Canadian Health Coalition executive director Michael McBane said Saturday in the basement of the Whitehorse United Church.

A push to introduce private health insurance in Quebec could lead to a two-tier health-care delivery system, said McBane.

“Once this two-tier system is in place, our trade agreements open the door to the US health-care market.

“Now, under the trade agreements, health care is protected only if it’s delivered on a non-commercial basis.”

But no one in Canada is considering a US-style option, said McMillan.

“The only option that people are looking into, that I am aware of, is not the United States option, the United States system — or non-system — but other models from other parts of the world where there is some integration of the private-public interface.

“The only discussion I’ve heard so far in that context is where, probably, the public system has the resources, but not the capacity, then people may be prepared to entertain, as they do in many areas of the country now, the introduction of a publicly funded, publicly regulated, private delivery of a basket of services, which may be confined to a relatively small specialty area in large urban centres, and that’s about it.”

Medicare does have problems, noted McMillan.

Waiting lists and access to services remain key challenges, he said.

“Until we have a realistic policy of self-sufficiency for training, educating  and keeping our doctors in the system, we will have these other challenges.”

But there’s no question about the national association’s commitment to public health-care delivery, said McMillan.

“We feel very strongly committed to the public health system, its maintenance and its enhancement.

“We’re prepared to look at options of doing that, but at the end of the day we believe … that our commitment is to our patients and to our population.

“We don’t believe health care is a commodity to be traded on the market.

“We believe that our commitment is based on the medical necessity of the people we serve, individually and collectively, not the size of their wallet.”

With files from Genesee Keevil.