Two-Tier or Not Two-Tier? That is the Health Care Question!
January 16, 2009
On September 22, 2008, Calgary acquired the dubious honour of being the place where two-tiered health care began in Alberta. The Copeman Healthcare Centre opened, guaranteeing healthcare services to those willing to pay an annual fee. The Copeman clinic charges its clients a fee of $3,900 in the first year and $2,900 annually after that for its "elite program" where a team of health professionals assess patients and create a preventative health plan. The clinic also has family doctors to help patients with all their medical needs. The physicians bill government for any medically-necessary treatments.
Alberta’s Friends of Medicare allege that the clinic's annual fees are infringing on the Canada Health Act and provincial laws, which prohibit charging patients for medically necessary procedures. Dave Eggen, the organization’s executive director, says "They're putting up a $4,000 barrier to access the health-care professionals who are working there. It's an access problem. It goes against the spirit and the letter of the Canada Health Act."
An angry woman at a demonstration outside the Clinic said she was protesting because the private facility recruited her doctor of 16 years, leaving her without a family physician.
"It sucks," she said. "I can't afford the $4,000, and there are no family doctors in Calgary."
The CEO of this company says he loves the public health-care system. Of course he does -- the company is paid for medical services by the government, in addition to the $1.5 million per year it will receive from the 500 clients invited to receive this preferred status.
If this business is established, we could see a rush of other doctors charging their patients an annual fee for the privilege of having them as their family doctors. Those who cannot afford this fee will face even longer wait times, while the rich jump the queue.
Health Minister Ron Liepert says he will not interfere with this business coming to Alberta, since the B.C. government found it to be within the provisions of the Canada Health Act.
The Calgary location represents the first expansion for the British Columbia company, which hopes to establish clinics across the country. In 2005, Don Copeman opened Copeman Healthcare Centre in Vancouver, generating headlines across the country -- and vocal opposition to the clinic.
Last year, the B.C. Medical Services Commission completed its audit of the Vancouver facility and concluded there is no problem with its services, finding no evidence of extra billing or enhanced services related to the fees.
"Don't do it!" That was the advice Frank Dobson, a UK Labour MP and secretary of state for health under Tony Blair, brought to B.C. politicians and policy makers about the prospect of adding more private enterprise elements to B.C.’s provincial health system. Dobson, in B.C. to speak at a conference said that the changes made to the UK's National Health Service under prime ministers Margaret Thatcher and Tony Blair had consistently run up costs and diminished service satisfaction for patients in Britain.
Prior to the introduction of market elements into the UK's health care system, administrative costs in the National Health Service averaged around 4 per cent of the budget. Now the cost of paper work and record keeping is between 12 and 15 per cent within the "reformed" health system.
In Sweden, the government tried turning its supposedly inefficient socialized Medicare system over to the private sector, hoping to reap great benefits for all. Privately owned hospitals and for-profit clinics were instituted to garner cost reductions and efficiencies. This experiment with privatization failed and in January 2006, new national legislation closed the door against any further privatization of public hospitals and sharply limited the room for private enterprise in delivering health care across the country.
In July 2004, the World Health Organization issued a major study concerning the implications of private health-care funding in Western Europe. The report concludes "Evidence shows that private sources of health care funding are often regressive and present financial barriers to access. They contribute little to efforts to contain costs and may actually encourage cost inflation."
Alberta is short of over 1000 doctors. Shifting our current complement of doctors from general access to preferred access clinics will not improve overall health care in Alberta. It will, though, allow the wealthy to jump the queue waiting for the services of a physician and enable businesses to profit without adding much value. More doctors, nurses and other medical personnel need to be trained so that everyone would have equal access to efficient, effective health care. Then there would be no incentive or need for two-tiered health care in Alberta.
Len Skowronski