Steamed

A radio interview with Dr. Chaoulli, a Québécois entrepreneur/physician in Montreal, yesterday on the CBC's (Canadian Broadcasting Corporation) As It Happens really got me steamed. Dr. Chaoulli is opening a new private health care business that is basically an agency to match up paying customers with private health care in the province of Quebec. He says they have members for whom they will find ways to match them up with specialists who will either see them on top of their regular medicare practice at an expedited pace for a fee+medicare payment or with specialists who run private clinics.

The part that I found very interesting about his interview was his claim that this would be good for the public health care system. How, you may ask? Well, Chaoulli claims that this is not a case of skipping the queue but merely a way to facilitate practitioners moonlighting on top of their regular medicare clientèle to both expedite the care of the paying and to shorten the wait times for others who are waiting in the public system. I have a few problems with this argument. First, there is a shortage of specialists in this country and most specialists are working as many hours as they can in a safe manner. By moonlighting on top of their regular hours in the public health care system they may be 1) putting patients at risk because they are working too much or 2) cutting back on the hours they are working in the public system to accommodate the higher paying 'medicare plus' or private patients. And, since when is getting care faster than everyone else not skipping the queue? There are a finite number of hours of doctors time in a situation like ours where there aren't enough doctors to go around, so by paying more to see a doctor earlier you are skipping the cue and bumping someone out of a spot - not freeing up the time of a doctor to treat more patients in the public system since you are essentially using the SAME resource, not a different one from a different pool.

Furthermore, Dr. Chaoulli also claims that his organization is a 'watchdog' of the public health care system. He states that patients don't know enough about hospitals' track records with hospital acquired infections and other problems before they choose to go to that hospital for an operation. A patient who pays can have the hospital they go to hand picked to ensure that it is the best public hospital around. So, essentially what he's saying is that rich people deserve good clean hospitals and to know everything about the hospital they are going into for an operation and poor people do not. I think this reasoning is deplorable. Perhaps if he wanted to be a real 'watchdog' of the public health care system he would allow his information about hospital safety to be shared amongst all people so that individuals and groups in society can lobby the government for better and safer hospitals with better infection control policies.

Dr. Chaoulli tried to make it sound like he was doing all of Canadian society a favor by opening up his service but I just don't buy it. You're doing the general public a disservice by taking doctors' time away from the public system and by keeping information about public safety hazards to yourself. You, Dr., are greedy.