It's time to proletarianize these petit-bourgeoisie self employed businessmen, and put them on salaries in community based medical clinics. Which would include pharmacists, and other complimentary workers like nurse practitioners.
This is not as far fetched as it may seem. Without such a radical grassroots reform expect the CMA businessmen to continue to lobby for contracting out and user fees as their ideals of Medicare reform.
Medical user-fee motion vote narrowly fails
doctors narrowly defeated a controversial user-fee motion at the annual Canadian Medical Association meeting.
The motion, which proposed that patients should help fund their care with "co-payments and health savings accounts," drew support from 48 per cent of voting doctors. Fifty per cent were opposed and two per cent abstained.
"Co-payments" mean patients would pay a fee when they see their doctors or obtain hospital services. "Health savings accounts" would act like registered retirement savings plans, enabling people to stash savings in tax-sheltered accounts, to be spent on medical items like home care, long-term care and prescription drugs.
"My support for universal health care is unequivocal, but I believe the [Canada Health] Act must be revised, reformed and updated," said Day, a founder and owner of the private Cambie Surgery Centre in Vancouver.
He said there could be a role for private health care in our public system.
"I realize it will surprise some of you that I raise this topic," he said. "Let's be clear. Canadians should have the right to private medical insurance when timely access is not available in the public system.
"Contracting out public health services to the private sector to reduce wait lists is not a new idea and does not spell the end of universality."
The entire health-care system has to be examined with two aims in mind: To offer excellent health care as it is provided now, but using different professionals at a much lower cost.
Let's start with the drug companies. They spend tens of millions on research and promotion and bring out new drugs at an inflated price that are only marginally, if at all, better than the drugs being used. It is estimated that only about one in 20 drugs released for use is of major importance. The government should appoint pharmacists to check these new drugs against what is in use for a particular patient to see if the higher price is reflected in a healthier patient.
All the work done by doctors, dentists, pharmacists, nurses and optometrists must be examined to see if their jobs can be inter-changed at a lower cost. As an example, the Ontario government will soon license dental hygienists to practise independent of dentists. This could change the way basic preventive oral care is offered in Ontario, surely at a lower cost.
In the North, where doctors are scarce, nurse-practitioners do the job of the GPs very successfully.
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