Cherry picking the wealthiest patients

I was reading about Canada’s pharmacare (out of curiosity) because I was keen to check out the principles behind funding a vast expense. Behind one proponent of pharmacare was Monica Dutta who made extremely nuanced and balanced statements about it. I stumbled on one of her write ups and I could easily see why it was relevant as the healthcare should diffuse to everyone. The industrialisation and corporatisation of healthcare means that the benefits don’t really percolate to the vulnerable unless we prop them up securities system. However, the financial incentives to milk the system are huge and therefore, these systems run into trouble over the long term.

The problem in context:

A Charter challenge is underway at the Supreme Court of BC, championed by Dr. Brian Day, owner of the Cambie Surgical Centre. Day is arguing that the laws currently prohibiting doctors in Canada from practicing in the public and private health sectors simultaneously should be struck down, along with the prohibition on the extra billing of patients for services already covered by the provincial health plan.

From Day’s perspective, such restrictions prohibit patients from seeking the best care possible, thereby violating the Charter of Rights and Freedoms. But critics arguethe case is more about doctors’ potential to earn more money than patient choice or quality care.

I am not aware of the nuances of the debate (it was in 2016) and I have seen no update. I couldn’t find any more relevant discussions in this regard, but what Monica writes further merits scrutiny on the funding of healthcare.

The German health care system is also a public/private mix, but patients have to choose one or the other. Germans with public health insurance – about 90 per cent of the population — wait three times longer for some care than those with private insurance. More importantly, the private insurance sold in Germany is for those wealthy enough to leave the public system entirely. They can never come back, no matter how expensive their care becomes.

Some believe the UK’s National Health Service (NHS) is a comparable system to Canada’s. It’s not. NHS doctors are salaried employees of the government who must work a 40-hour work week with additional evening and weekend call hours before they are allowed to see private pay patients on top of their public practice.

What is important is the sub-context. As healthcare organisations are increasingly turning towards the “artificial intelligence”, the idea of a replacement of a doctor may become real. I am not pandering half truths or lies or speculations here, but inherently, the regulatory agencies are not geared towards a nuanced understanding of technology. Therefore, it should be apparent that medical practitioners should guard their own turf, embracing the technologies and adapting them to their own workflows.

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