Saturday, November 25, 2006

Privatizing Health Care

Canada's first private ER to begin service So what will our Federal Health Minister do about this. Probably about as much as the last one did. Nada, nothing, ok well maybe send a letter to the Premier of B.C. full of thunder and bluster. Buts thats it.

Welcome to two tier health care. Wait we already have two tier privatized health care in Canada.
Its called Lasik laser eye surgery. And it is not without risks. Though you wouldn't know it from the TV ads you see. And it is draining the healthcare system of Opthamologists and optometrists who are now going into private practice.

Eye disease prompts Toronto cataract surgery centre to close
TASS has affected about 137 eye centres across North America in the past 18 months. It is often difficult to determine the source.

Unreported laser surgery risks.

Have you been for laser eye surgery yet? It's the latest and greatest for people who don't mind flexing the plastic to get rid of glasses, especially aging boomers who want to look a whole lot younger. A huge industry has developed in just a few years. Over a million Americans and up to 100,000 Canadians underwent laser surgery last year.

Harmless? Not according to the Food and Drug Administration in the US. Definitely not for risk-takers, they say. The carefree growth of the industry ended last spring when investigators began to report that up to 50% of laser surgery patients experience abnormalities of night vision. Soon horror stories began to hit the press. Like most quick fixes, laser surgery isn't necessarily either. Caveat emptor. Buyer beware.
Dr. Gordon Guyatt, a co-founder of the progressive-minded Medical Reform Group, says there's another risk that doesn't get as much reporting. Ultimately what may be more of a threat is what the laser surgery industry does to public health care in Canada. If fees are high enough for private eye surgery, doctors - trained at public expense - will opt for doing these surgeries instead of the publicly funded work they would otherwise do, producing "fewer ophthalmologists to perform emergency procedures, as well as longer waiting lists," according to last year's Ontario Medical Review. Your aging parents - like a close neighbour of mine - must wait a year for cataract removal so someone younger and wealthier can buy elective laser surgery.

Early 1960s

Lasers are first used in surgery.


Russian ophthalmologist Svyatoslav Fyodorov establishes The Moscow Eye Microsurgery Centre. Dr. Fyodorov announces a surgical cure for myopia -- the radial keratotomy ("RK"). The procedure involves reshaping the eye through cuts around the periphery of the cornea, which results in its flattening. At its peak, Dr. Fyodorov's clinics turn out a surgically corrected eye every 19 seconds through a special assembly line process.

Late 1970s

IBM develops heatless laser etching with the excimer laser.


The National Eye Institute issues a public warning about RK, calling it "experimental."

Early 1980's

The U.S. military conducts studies into improving the vision of military troops through RK. Ultimately, the Department of Defense bans RK as a procedure.


Dr. Stephen Trokel, an ophthalmologist and physicist, publishes landmark article following years of experiments using the excimer laser on corneal tissue. Article marks the beginning of the laser refractive surgery era.


Ophthalmologist Marguerite McDonald performs the first photorefractive keratectomy ("PRK") in a human patient.


Lucio Buratto of Milan, Italy, uses the excimer laser to remove tissue from the underside of a cap cut from the cornea. American ophthalmologists Stephen Slade and Steve Brint travel to Italy to observe Buratto's technique.


Drs. Brint and Slade perform the first laser assisted in-situ keratomileusis ("LASIK") in the U.S.


1.35 million LASIK procedures performed, a 40 percent increase over the previous year.


U.S. Department of Defense actively promotes laser eye surgery for military combat personnel.

2010 Goal of refractive surgeons to have 90 percent of patients who need vision correction to achieve 20/10 vision, through newest laser techniques.




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