'Alberta sets the agenda for Canada'
Jean Charest 1996
HEALTH CARE REFORM OR MANAGEMENT REFORM
When we hear about reforming health care in Canada what is the real debate about? Control of hospitals and infrastructure. There is no real challenge to how medicine is taught, or what the aims are of the doctors and their guilds in keeping retrictions on how and who gets taught medicine. As the article by Michael D. Yates points out the crisis in Nursing is not just occuring here, but in the U.S. indeed, Canadian nurses have been cutback by provincial governments for the past decade, they have easily found work in the US, because of the need for front line workers there. So where have the nurses gone here in
In preparing to write this article, I interviewed a Canadian nurse, an activist in her union, with more than thirty years experience. I also read an informative article by Gordon Lafer (“Hospital Speedups and the Fiction of a Nursing Shortage,” Labor Studies Journal 30.1, Spring 2005: 27-46). Lafer tells us that
Nurses may constitute the single most dissatisfied profession in the U.S. . . . When one recent survey asked nurses to describe how they felt at the end of the day, nearly 50 percent reported feeling "exhausted and discouraged." Forty percent felt "powerless to affect change necessary for safe, quality patient care"; 26 percent felt "frightened for [their] patients," and 24 percent felt frightened for themselves. Perhaps most disturbingly, 55 percent of nurses reported that they would not recommend a nursing career to a child or friend. (p. 32)
My Canadian nurse informant gave me chapter-and-verse verification of what Gordon Lafer reports in his article. She reported to me that patient loads (patients are now called "clients") have risen to unconscionable levels. She now works in a long-term patient care facility, where most patients require acute care. Last year there were four Registered Nurses plus some nurses' aides for 32 patients. Today there is one RN for 107 patients. Much of an RN's time is spent filling out forms for funding purposes, and most of the nurses' patient-centered activities are done by less-skilled aides and machines. This means that the nurses' knowledge of their patients, knowledge which can save lives, has been lost. Senior nurses have been laid off or encouraged to take early retirement, and they are either not replaced or replaced with student nurses. This has led to occasional disasters. In the past, student nurses had senior mentors and learned how not to make mistakes. Now they are on their own, and their failure to see warning signs obvious to an experienced nurse costs lives.
Like the colleges, hospitals are top-heavy with highly-paid administrators; when hospitals merge, the number of workers decreases relatively much more than the number of administrators. And as in colleges, administrators are primarily money managers, concerned with the bottom line and not with the health of their "clients."
One final point the Canadian nurse made is that nursing students are now being trained in a system far different than the one in which she was trained. Their expectations are not to become care givers but to become middle managers. So the system creates the people best suited to it. What was will soon be lost forever, unless the nurses' unions and the larger labor movements struggle for change.
Let's Put the Nature of Work on Labor's Agenda: Part Three
by Michael D. Yates
The healthcare reform movement has not addressed the basic fundamental need to completely restructure health care delivery for the good of people and not for profits of the medical establishment and their bueracratic institutions. Medicine, and medical delivery has never been devised by the people who use it or even those who fund it. Medical delivery is part and parcel of the monopoly of the medical establishment, the good old boys who run the Provincial Medical Associaions and the
The Canadian Medical Association while created in
Which physicians from Alberta have become Canadian Medical Association presidents?
Answer: Drs. H.G. Mackid (1911-12), J.S. McEachern (1934-35), A.E. Archer (1942-43), H. Orr (1950), M.A.R. Young (1957-58), R.M. Parsons (1960-61), R.R. Thomson (1966-67), L. Grisdale (1975-76), T.A. MacPherson (1984-85, R.J. Kennedy (1992-93). All were presidents of the Alberta Medical Association beforehand, except for Dr. H.G. Mackid.
THE SOCIAL HISTORY OF SOCIALIZED MEDICINE IN
The first hospitals in
The public hospital operated until the new
On the south side, the
100 Years of Medicine in Alberta: The Regions First Hospital
Every civic election until the 1960's when an appointed board took over, saw the
The first act of the new Alberta Government was to recognize the monopoly of Doctors as a profession and guild in charge of medicine in the province. It was a recognition of their education, training and professional status. And of course their political power, as many were active in the governments of the day and in the ruling political parties. In civil society they were involved in the police forces, the founding of the
Under the Liberal provincial government 1905-1908, the earliest acts they passed were those recognizing the University of Alberta, the Grand Lodge of Freemasonry, and the formation of the Alberta Medical Association, and the creation of the College of Teachers. Thus the state and civil society became one in
Human progress is our cause, liberty of thought our supreme wish, freedom of conscience our mission, and the guarantee of equal rights to all people everywhere our ultimate goal. -- The Scottish Rite Creed
MACKEY'S FREEMASONRY ENCYCLOPEDIA
Grand Lodge of
Northern Light Lodge was granted a Dispensation in 1864 by Brother A. T. Pierson, then Grand Master in
(
This was followed by another meeting on October 12, 1905, when seventeen lodges were represented by seventy-nine delegates, the Grand Lodge of Alberta was duly organized, and Brother Dr. George MacDonald elected Grand Master and was installed by Grand Master W. G. Scott of the Grand Lodge of Manitoba.
Perfection Lodge in Calgary Perfection Lodge,
The commencement of Dr. Mackid’s practice was significantly augmented by his 1890 appointment as the CPR surgeon for the
Dr. Mackid could rightfully be called the Father of Medicine by Rail in
The senior Mackid led the movement to build hospitals in
It was only the second NWT incorporated and approved hospital and it opened one year after the
Dr. Mackid was appointed coroner for the city of
Pioneer Doctor And Freemason Of The West
Edward Ainslie Braithwaite, M.D., L.M., C.C..
by O.P.Thomas P.D.D.G.M.
When contemplating the history of
He took his discharge from the N.W.M.P. on May 6, 1892, with the rank of Staff Sergeant and came to live in
While he was a contract doctor with the N.W.N.P. from his retirement from active service, he was appointed full Honourary Surgeon in the Royal North West Mounted Police with all the rights of that Office, in September, 1911. He served with the N.W.M.P., the R.N,W.M.P. and the R.C.M.P. for almost forty-eight years, having been awarded the Long Service Medal in 1927. His association with the R.C.M.P. extended for a period of 65 years.
In 1892 he entered into Private Practice in
He had a long distinguished career in Freemasonry. When he arrived in
The Grand Lodge of Alberta, Ancient Free and Accepted Masons was constituted and consecrated on the 12th of October 1905 and was confirmed under an Act of the Province of Alberta passed in the Legislative Assembly in 1908.
At that time, eighteen Lodges withdrew from the jurisdiction of the Grand Lodge of Manitoba, taking with them a combined membership of 1,013. Our daughter Jurisdictions of Saskatchewan and Alberta both of whom are interested in the early development of this Grand Lodge, have each in this Jubilee year [1925] a membership and Lodge Roll in excess of the mother Grand Lodge, the figures in each case being:Grand Lodge of Alberta as at 27th December, 1924, had 130 Lodges with a membership of 12,329.
137767 08-17-91 History of Grand Lodge of Alberta
HEALTH CARE IN
1905 Alberta's Medical Profession Act passes after Alberta becomes a province.
1906 The College of Physicians and Surgeons of Alberta (CPSA) is formed in
1907 -1908 When the Calgary General Hospital encountered serious financial difficulties in 1907, Dr. Mackid organized a prepaid medical and hospital plan with all the CPR employees at 50 cents per employee, per month in 1908. It covered 3,000-5,000 CPR employees. Although the deductions or amounts varied over the succeeding decades, the plan was continued until MSI took over the contracts in the early 1950’s.
1910-19 At the request of the AMA, CPSA contributes funds to establish a provincial sanatorium for tuberculosis treatment.
The public health nursing service is established to carry out preventive health care and public health education at the urging of physicians, concerned with insufficient numbers of physicians in
1920-29 AMA recommends physician appointment to the Workmen's Compensation Board (WCB).
CPSA retains licensing and discipline functions and takes over the "business" side -- dues, representing the profession in relation to legislation. The AMA becomes responsible for education and public relations.
A grant to Dr. J.B. Collip's studies helps lead to insulin discovery.
CPSA and CMA sponsor health services investigation.
1940-49 AMA supports prepaid medical care or health insurance. Extensive development by the profession is followed by government-created Medical Services (
80% physicians responding to AMA-conducted referendum favor prepaid medical care.
MEDICAL FAQS ABOUT
When was the first medical school west of
Answer: At the
What doctor in
Answer: Dr. A.R. Munroe of
By whom and when was the first free VD clinic started in
Answer: By Dr. H. Orr, in
When was the first free polio rehabilitation program established in
Answer: In
When was the first free cancer services program established in
Answer: In
What five medical schools in
Answer:
When and where was the first continuous voluntary prepaid medical insurance program - open to all members of the community - established and operated?
Answer: In Cardston in March 1932. Drs. J.K. Mulloy and M. Brayton were the physicians. The Trustees were Messrs. N.E. Tanner, E.W. Hinman and D.O. Wight. It was replicated with modifications in Lamont by Drs. Archer et al in 1933 under the "Di Bochza" program. The Alberta Government supported and agreed to subsidize a prepayment insurance program in 1935 and again in 1942. The former died because the
What was the largest hospital ever built at one time in
Answer:
What was the largest hospital ever destroyed at one time?
Answer:
100 Years of Medicine in Alberta: Medical History On The Prairies
Frontiers of Medicine: A History of Medical Education and Research at the University of Alberta. Publisher: University of Alberta Press. Place of Publication:
A History of Medical Education and Research at the
In 1913, Dr. Henry Marshall Tory established the
CHAPTER I
The Early Years 1913-1921IN 1912, a group of twenty-five science students at the fledgling University of Alberta signed a petition requesting the Senate to institute a faculty of medicine. Henry Marshall Tory, president of the university, presented the petition to the Senate at its meeting in April of that year and gave it his complete support. Medical practitioners arriving in the rapidly developing West, he said, preferred to settle in the larger urban centres, and those settlers who lived in small communities and rural areas had little access to a physician. If the farming families in the outlying districts were to receive adequate medical care, then it was necessary to train doctors in
CHAPTER 2
The Years of Struggle
The twenties and the thirties
THE YEARS immediately following the war were exciting ones for the young school, even though fraught with tension, problems and concern about its future. There were high points: the Class A rating, the opening of the Medical Building, an endowment of half a million dollars from the Rockefeller Foundation, the extension of the programme to a full-degree course, and the pride and excitement of having one of its own faculty members involved with the dramatic discovery of insulin.
Several major events took place during this postwar period to solidify and strengthen the role of the Faculty of Medicine within the framework of the
All these developments will be explored in this chapter, but first they have to be set within the framework of the political and economic situation in
Review Essay Aspects of Canadian Medical Education*
Teachers of Medicine presents local material on a topic
that deserves more attention than it has received, namely the growth
of internship and residency training in
internships emerged in Canadian hospitals, the authors report what
took place in each hospital in their city. They attribute the introduction
of internships in
America) to the impetus given by the
establishing standards of hospital accreditation after World War I. The
implication is that community hospitals received accreditation and
cheap labor while the interns obtained clinical experience with minimal
systematic education. Internships came slowly to
a provincial ruling, in 1930, that every community hospital should
have house staff in proportion to the bed size of the hospital. In 1934,
the
interns because the medical staff was not "organized well enough to
mount a satisfactory experience for novice doctors. The next year the
General did not have a viable internship program until the 1950s.
Before the medical school developed in the 1960s it was not always
easy for
l
flourished under the aegis of the Royal College of Physicians and
Surgeons of Canada, full internship and residency programs sprang
up in the
specialties is described briefly. The most innovative residency was that
in family medicine started by Dr. John Corley before the medical school
was in operation. His program had an important influence on what
happened across the country as this new specialty emerged. The
involvement of the
laissez-faire approach to one of conformity with increasingly strict
national standards. What happened in
scene across the country.
Once
Socialized Medicine originated in
And what was good for
But Douglas developed this system into
Alberta maintained its private public insurance program while Tommy Douglas developed the first single payer social model in North America. The model was originally developed in the United States and lobbied for there by the labour movement.
1947
Under Tommy Douglas (regarded as the founder of
The
While Douglas is often described as the "father of Medicare" in
The dispute between the
Once again proving that user pay philosophy of the right wing remains intact here. Whether Socreds or Conservatives, they grudgingly accepted a national Medicare program, but they still insisted on the
Led by Tommy Douglas’ Co-operative Commonwealth Federation government (the precursor to the modern New Democratic Party),
During the 1950s, two parallel developments in health insurance occurred in
Prime Minister Louis St-Laurent was hesitant to extend federal involvement in health care B in part, due to resistance on jurisdictional grounds by Quebec, but also from many other provinces, including Ontario's Progressive Conservative Premier Leslie Frost, who sought federal funds to help pay for provincial hospital plans. Despite the misgivings of insurers and medical lobby groups, the House of Commons unanimously passed the Hospital Insurance and Diagnostic Services Act in 1957. The federal government would now share in the costs of provincial hospital insurance and diagnostic services. The program came into effect on July 1, 1958, and by the end of 1961, every province in
Once again,
Exhibit - Public Health Insurance Throught History - 1987-2002
The Plan essentially served as an extension of
Continual innovation has marked the history of Alberta Blue Cross since 1948. With the introduction of Medicare in the late 1960s, Albertans no longer needed basic hospital coverage, but they wanted other, supplementary, coverage.
Since the early 1970s, Alberta Blue Cross has administered Alberta Government-sponsored supplementary health benefit programs. These important programs for =seniors and Albertans who did not have coverage available through an employer.
To meet customer demands in the '70s and '80s, Alberta Blue Cross added coverage for dental care, vision care, outside
By the 1990s, less than one per cent of Alberta Blue Cross business related to hospital claims. Changes in
HEALTH CARE IN CANADA
The single payer Canadian Health System is the result of a protracted battle in the post war years between business groups and the medical profession on one side and the people on the other. The people won a resounding victory. The health system is consequently highly valued and attempts to meddle with it are politically sensitive. Canadians are well aware of the situation south of the border.
While private care was not prohibited and continued in a small number of areas all Canadians had equitable access to services paid for by taxes.
The Birth of Medicare CBC ARCHIVES
Phoney Health Care Reform:
The Neo Liberal Agenda of Outsourcing and Privatization
THE DIFFERENTIAL IMPACT OF HEALTH CARE PRIVATIZATION ON WOMEN IN ALBERTA
Privatization of The Canadian Health Care System
Not Yet and Hopefully Never
by Donna Wilson, RN, PhD
Associate Professor, Faculty of Nursing,
University of Alberta, Edmonton, Alberta T6G 2G3
donna.wilson@ualberta.ca
Alberta under the Social Credit party of Ernest Manning, fought to maintain the two tier private insurance program against Tommy Douglas's single payer form of medicare, even after the Federal Government accepted it as the national program. During the reign of the Progressive Conservatives of Peter Lougheed an unprecidented expansion of the public service as well as a construction boom in hospital and long term care facilities occurred. It reflected the wealth of the oil boom of the seventies in the province and the political accumen of the Lougheed gang in getting rural and seniors votes.
With the oil crisis in 1984 and the crash in the market the Getty Government faced a crisis in building and staffing infrastructure. Further attempts at diversification by the government led to many startling business failures. The government became scandal ridden. In came Ralph Klein and the Calgary/Southern Alberta right wing, with their neo-liberal agenda and Alberta became a laboratory for privatization and market models of public service delivery.
The Klein government closed and blew up hospitals, transformed rural hospitals into long term care facilities, privatized laundry services in Edmonton and Calgary Hospitals (giving the contract to Tory insiders), reduced funding for univeristies resulting in a decline in training of nurses and doctors, laid off hospital staff, and of course froze wages and benefits forcing those not laid off to look for work elsewhere. They also consolidated the hospitals into districts, removed control from boards and appointed their own lackies to the new District Boards.
What the Lougheed government had built the Klein government renovated, causing long serious and long term damage. Currently the lack of doctors and nurses in this province and across the country is a result of the decisions of 1995. In that year the Federal Government under Fianace Minister Paul Martin also adopted the neo-liberal model and reduced transfer payments to the provinces to reduce its debt. The federal government also embraced the Reinventing government model prevalent in the U.S. which promoted the contracting out of government services and the development of Private Public Partnerships (P3's).
The result of this move to the right provincially and Federally left public health care seriously undermined, as the right hoped in order to 'level the playing field' in order to introduce a market driven model of for profit health delivery in Alberta. The old hospitals in Calgary that weren't blown up were sold at fire sale prices to private medical companies, which again had ties to the Tory government.
Health boards were stocked with former Tory ministers. And new delivery models of health care became the reform agenda of the government, including its disatorous attempt to intorduce fullscale privatization with Bill 11. Mass protests stalled the bill but the Federal Government was in no position to oppose it since it had abdicated its fiscal responsibilty for health care with its cuts.
For the last decade the Klein government has driven the agenda of Health Care Reform in Canada, and its model is that of private public insurance (MSI) combined with public funding for private service delivery.
In the past two years the Klein government and its supporters on the right ( The Fraser Institute and Preston Manning and Mike Harris) has realized its reliance on the American model is a political deadend in Canada. So now they are looking to Europe for P3 models to emulate.
But the fact remains it was their very attack on the public funding and delivery of medical services that created the problem in the first place. While claiming to have to spend billions in providing public health care, the reason is that they are rebuilding a social infrastructure that they blew up during the Klein Revolution and the Martin Budget of 1995.
The money is not the problem, as America's increasing costs for medicine prove, it is the failure of the government to develop a wide based public healthcare system that includes coverage for pharmaceuticals, dentistry, alternative delivery, etc. that is resulting in increased costs. Like the reform of public education and other so called reforms of the right these are not driven by cost considerations but by the ideology of privatization at all costs.
Real Health Care Reform: The Proletarianization of Medicine
Much to learn from cost-efficient HMOs
Andrew Coyne
Health care is a classic case of ''producer capture'': a system run more in the interests of providers than of patients or taxpayers. Competition is limited by the various professional cartels within the medical industry, through ''recommended'' fee schedules, restrictions on the numbers of new doctors, a licensed monopoly in broad areas of medical practice, and prohibitions on advertising so strict as to make even the use of bold type in the Yellow Pages an offence.
The object of reform should not, however, merely be to break the doctors' cartel. It is not doctors' incomes, first, that are at issue, since they are but a fraction of the total health bill. Nor is competition much use so long as consumers have vastly less knowledge than their physicians about the care they need. Who is the patient to object if the doctor recommends an expensive course of treatment, especially in an emergency? ALTERNATIVE MODEL
Most doctors are paid on a fee-for-service basis, which makes the pound of cure more interesting than the ounce of prevention. Yet it is not enough, either, simply to proletarianize the physicians. Putting doctors on salary would remove any direct incentive to waste. But it would not encourage them to seek out the lowest- cost treatment, when the costs of expensive new procedures, so entrancing to the profession, can be passed on without question to the public insurer.
Coyne as usual throws a red herring in which is the cost of treatment which is set by either specialists wages, or by high cost pharmacutecal costs. Drug costs skyrocketed because Coynes pals in the Mulroney government allowed drug companies a twenty year patent monopoly on their drugs thwarting a free market in generic based drugs.
However the proletarianization of medicine is exactly what we need. And it would work and be the most radical real reform we could do to socialized medicine in Canada. One that the great Canadian Communist Doctor Norman Bethune advocated back during the Spanish Civil War and one he attempted to implement in revolutionary China with Mao during the war against Japan.
Bethune himself clashed with the English Ruling Class Masonic Monopoly that controled medicine in Canada. He developed open heart surgery during WWI when the medical establishment shyed away from it. He developed transfusion units and the modern MASH units in the Spanish Civil War. His proletarian approach to medicine, was frowned upon by the parlour phsycians that controled medicine in Canada.
Had we had open training for medical professionals instead of the current guild monopoly by the doctors associations we would not have been in the crisis we are for a shortage in medical staff:
| Canadian Press |
Monday, August 15, 2005
"Right now, things in medicine in Canada are not particularly rosy," said Dr. Albert Schumacher, the association's out-going president.
"We're confronted with very significant wait times which, in some instances, are unfortunately increasing every day . . . for core procedures - hips, knees, hearts, cataracts."
An even bigger issue from the profession's standpoint, for both the short and long term, is the shortage of health-care professionals - the main reason behind the long wait lists, Schumacher said.
"We need to move our country to a goal of self-sufficiency in the supply of doctors, nurses and other health-care professionals. We've been too long plundering from other countries that can ill-afford to lose people."
The system is struggling to recover from deficit cuts by governments in the 1990s.
Nurses were laid off. And funding cuts filtered down to universities, which in turn cut medical enrolments, said Schumacher.
Canada now ranks lowest among industrialized nations in the world in terms of its self-sufficiency in supplying health professionals, said the general practitioner from Windsor, Ont.
Even though medical schools are scrambling to increase enrolments again, it will only take the country to 80 per cent self-sufficiency, he added.
Financial Survey: Young doctors face a steep climb
Says a line in the union song Solidarity Forever, in order to do so we need to look at making medicine truly socialized. That would mean breaking the monopoly of the College of Physicians and Surgeons, and the Canadian Medical Association. When Alberta first became a province, the British/American medical interests founded the University of Alberta and the College of Physians and Surgeons, making their establishment the first acts of the provincial legislature. This guarnteed their guild monopoly that has existed for 100 years.
It is time that we remodled social medicine not to be the prevue of the elite but be proletarianized, reducing the restrictions and monopoly on who can become doctors, paying them a salary, and creating community medical clinics where a series of on salary services are provided, including psychiatric, specialists, dentists, etc.
Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): Mr. Speaker, I listened with a great deal of interest to the presentations of the two hon. members who just spoke. I think we can agree that currently in
We also know that the majority of these doctors are private entrepreneurs. They are paid a fee for service, and if they do not work, they are not remunerated. If they do work, they are. It is up to them to take care of their own fringe benefits.
My colleague is simply suggesting that we stop this type of practice in
[English]
Mr. Dick Proctor: Mr. Speaker, I certainly think people who work in the profession feel that if we had doctors paid on a salaried basis, it would help matters. I worked in the department of health in the
I am pleased to say that I belong to the
When Mr. Romanow was the premier of the
I have less concern overall about the doctors on a fee for service basis than I have on private MRIs. Inevitably, built into those private MRIs will have to be a profit motive. That is our concern. We want to limit and reduce the for profit delivery rather than see it escalate in the years to come.
Mrs. Lynne Yelich (Blackstrap, CPC): Mr. Speaker, I really have to wonder if the two members who spoke before are really from
I can tell about a person who went in for a knee operation. He was quite healthy and was told to have both knees operated on at the same time. He had both done at the same time and never came out of the hospital. I can tell about a person who had to go back into the hospital to have a limb re-broken. What about the workmen's compensation patients who go to
That is why nobody wants to participate in this debate. It is sickening.
Mr. Dick Proctor: Mr. Speaker, one hardly knows where to start on that. I would just repeat what I said a minute ago. When provinces are carrying 84¢ of the dollar and the federal government is only putting in 16¢, it is very difficult for provinces like
Section B: Vital Statistics and Health
R.D. Fraser, Queen's University
Statistics in the tables of Section B are in two divisions. Series Bl-81 contain data on vital statistics and series B82-543 on health. Data on social welfare, formerly contained in this section, are presented separately in Section C.
The principal sources for vital statistics (series B1-81) are: Statistics Canada, Vital Statistics, 1921 to 1970, (Ottawa, Queen's Printer); Statistics Canada, Vital Statistics, vol. I, Births; vol. II, Marriages and Divorces; vol. III, Deaths; all three volumes published annually since 1971 (Ottawa, Queen's Printer). Additional sources on historical series are given in the first edition of Historical Statistics of Canada, p. 30.
The principal sources for health (series B82-543) are: Department of National Health and Welfare, Canada Health Manpower Inventory, annual (Ottawa, Department of National Health and Welfare); Statistics Canada, Hospital Statistics, vols. I-VII, (Ottawa, Queen's Printer); Statistics Canada, Mental Health Statistics, vols. I-III, annual (Ottawa, Queen's Printer); Department of National Health and Welfare, National Health Expenditures in Canada, 1960-1973, updated every two years (Ottawa, Department of National Health and Welfare).
ON docs can now join the rest of
their practices. Here's how to get in on the tax savings
Hospitalists look after your inpatients when you can't.
Who are these docs-for-hire?
A doc and his community take on the physician shortage and build themselves a clinic
Even the right wing so called Free Market Think Tank the AIMS institute recognizes that the doctors historic monopoly in Canada needs to be busted up in order to truly have medicare reform. The proletarianization of modern medicine is their reccomendation through the use of Nurse Practicioners. But of courtse their whole point is not to create a socialized community clinic model of delivery but a MacDonalds style franchise of private sector delivery of services......
DOCTORS HAVE TO
November 2002
AIMS Health Care Reform
Background Paper #6
Atlantic Institute for Market Studies
The Atlantic Institute for Market Studies (AIMS) is an independent, non-partisan, social and economic policy
think tank based in
debate about the realistic options available to build our economy.
AIMS was incorporated as a non-profit corporation under Part II of the Canada Corporations Act, and was
The American evidence indicates that, over a certain range of services, nurse practitioners (NPs) can
deliver a comparable quality of care and are cheaper to train than MDs. However, the cost of educating
The ultimate determinant of how much a provider earns is the value of the services they provide. If NP
an MD providing the same service. This is what has happened in the
of NPs acknowledge that they have lost their cost advantage over MDs. According to one salary
A second factor at play is equal pay for work of equal value. If NP services are of comparable quality to
Regardless of what it costs to train an NP, it will cost the system as much to have those primary care
preventive dental tasks. While the dentist could do cleanings, his time is undoubtedly better spent at
them. As a result, the typical general practice dentist’s time is probably more efficiently allocated than
The real solution to Medicare reform lies neither with the return of the old MSI model as the Alberta government is currently promoting as its third way,
Firm chosen to do private health insurance review, nor the bandaid solutions offered by reforms to the Canada Health Act. Real reform would be to create community health clinics based on the Boyle McCauley Model below.
This model was also developed in Saskatchewan but once the Canada Health Act was passed the community health clinic model was shelved in favour of doctors as private businessmen on the government payroll, the billing process.
We need to put doctors on salary, widening the abilities of nurse practioners to be GP's, especially in remote communities, we need to break their haughty power and monopoly. End their control over university medical departments with their outmoded archaic practices of training Doctors over seven or eight years, but only those students who have a high GPA.
Open it up to a four year GP course drop the GPA requirements, and make it an apprenceship system where you begin as a Nurse Practioner, move to a GP then specialize. We need to end the hazing process where by new interns spend thirty six hour shifts in Hospital emergency rooms.
We need to combine in health clinics doctors, NP's, massage therapists, chiropractors and natropaths as well as pharmacists and dentists.
Dentistry is not covered by the Canada Health Act, and again is a monopoly controlled by those who certify and approve those who can become dentists. Boyle McCauley includes dentists in its clinic in the inner city.
And we need to insure that all university trained doctors and dentists serve a two year indentured service on salary in rural and northern communities, and inner cities as their social service to the community. This would then lessen the crisis these communities face in having medical services delivered.
To break the medical monopoly would be to expand social medicine to community colleges and technical schools with two year, three year and four year programs, with universities training specialists.
About the Boyle McCauley Health Centre
The Boyle McCauley Health Centre has been serving the population of the inner city for over twenty years and is constantly growing and changing.
The community-owned Boyle McCauley Health Centre responds to the unique needs of
Our Vision
We are recognized as a model of excellence and innovation in providing accessible primary health care and health promotion services in
BHMC Background Information
The Boyle McCauley Health Centre and Society: the BMHC is a non-profit, charitable organization, run by the Board of Directors of the BMHC Society. The Board members are elected at the Annual General Meeting of the Society for a two-year term and can serve a total of three consecutive terms. The Board of Directors is responsible for hiring the Executive Director. The Executive Director is responsible for hiring all staff and for the overall day-to-day running of the Health Centre.
The Health cCentre is funded on a global basis by the Capital Health Authority and by charitable donations. Staff physicians are remunerated at a flat rate and do not bill Alberta Health Care or any other agency for the services they provide at the Health Centre.
