alex@xios.UUCP (Alex B Laney) (07/12/86)
I HOPE EVERYONE REALIZES THIS ISSUE COULD BE DISCUSSED FOR YEARS!! In article <1936@utai.UUCP> perelgut@utai.UUCP (Stephen Perelgut) writes: > >Second, the government is NOT the people. The government is elected by the >people to represent the people. This is not an Athenian democracy. > The above is a pedantic comment. You know what I mean. I believe that the government is the only body that can represent the people in negotiations over the public health system. >And I think you are not thinking clearly if you believe every doctor that leaves >the province over Bill 94 is a money-grubber. Most are highly-trained >professionals with a real talent for what they do. All the cases in the papers >have performed services for free when the patient couldn't pay. But their >expertise is worth more than some kid fresh outa medical school. > Did I say that I thought every doctor who leaves is a money-grubbing S.O.B.? If a doctor leaves to go elsewhere over the extra-billing issue alone, then that action does seems a little drastic over a principle, however. All parties have been willing to discuss what the OMA says is at stake to them -- professional freedom. A say in the running of the system that they work for. I don't believe that that has been compromised by Bill 94 specifically. I would have to read the Bill. I think the issue of professional freedom is a bit of a smoke-screen. The system has had OHIP for roughly 30 years now. Some doctors have been using the legality of extra-billing to dodge OHIP. Doctors put up a similar stink when OHIP came in. The decision was made a long time ago to have public Medicare. If because of the Bill, then doctors will stop giving 'free' services, then that is a drastic reaction. I don't think doctors in the past gave 'free' services because they could get the cash out of someone else. They could have kept the extra bucks. They did the favours because they wanted to help the people who needed extra help. If extra-billing is the difference between a successful doctor and a successful doctor who pitches in with some of his own time, then I don't see it. Are we talking about a shortage of doctors compared to the case load out there? Probably. The doctor who stops giving free services because of the Bill, is stopping either to publicise his opposition, or because of an emotional feeling. There are definite cases where the Bill is going to hurt patients. The Kingston cancer clinic, for example. The problem there is that the rate allowed by OHIP is too low. That is acknowledged by the doctors there as the reason it's closing once the ban comes into effect. However, I don't think these examples are justification for a general strike and the rhetoric I have heard from doctors about how awful this bill is. If the doctors could have publicised how they are greatly hurt by this, then I could say yes, the OHIP rates are low, and the doctors needed to extra-bill. Instead I have heard that a tiny fraction of doctors extra-bill. The system doesn't seem far off. I think a ban on extra-billing in a public Health system is inevitable, but the system has to be responsive. >You don't have to support the doctors, but you should think things through >carefully before you post. And vice versa. P.S. I didn't make up the part about my doctor not willing to spend any time with verbal consultations over the phone, as someone has said. But really the point was that I have found that doctors in private practice try to take the least time with you to solve anything. And I don't mean they are trying to be efficient on the side of the patient! Maybe I should find a doctor that is more laid-back! P.P.S. I think it is interesting that Medicare was brought in to guarantee access to hospitals, and that it is in the public good. Now, when we make a move to strengthen Medicare, it is the wrong thing to do. -- - + - + - Alex Laney, Xios Systems Corp, 105-1600 Carling Av, Ottawa (613)725-5411x402 utzoo - > !dciem allegra!ihnp4!utcsri -- > nrcaer!xios!lib!alex ucbvax!hplabs -- / > !seismo!hadron!netex!prcrs/ decvax --
dave@lsuc.UUCP (David Sherman) (07/13/86)
In article <293@xios.UUCP> alex@xios.UUCP (Alex B Laney) writes: > I don't believe that that has been compromised by Bill 94 >specifically. I would have to read the Bill. The Health Care Accessibility Act, known before its enactment as Bill 94, is one of the shortest pieces of legislation I've ever seen. I don't have it in front of me, but it only has one section other than definitions and penalties. That section says something like "A doctor shall not charge or accept a fee which is greater than that provided for by the Plan." (That's not quite right, but it's close. The key operative words are definitely "charge" and "accept". I looked it up some months ago to find out whether its form of drafting would preclude our making genuinely independent and voluntary contractual arrangements with our doctor for a higher fee. It does.) Incidentally, continuing to refer to it by its bill number introduces a certain ambiguity (which of course is cleared up by the context, usually. It was Bill 94 of the 1985 session of the Legislature. If the Legislature is equally active in 1986, then sometime this November or so we'll see another Bill 94 which likely will have nothing whatsoever to do with doctors (possibly an amendment to the Pregnant Mares Urine Act or the Lightning Rods Act). Dave Sherman (non-practising lawyer) The Law Society of Upper Canada Toronto -- { ihnp4!utzoo seismo!mnetor utzoo hcr decvax!utcsri } !lsuc!dave
jimomura@lsuc.UUCP (07/15/86)
In article <293@xios.UUCP> alex@xios.UUCP (Alex B Laney) writes: >I HOPE EVERYONE REALIZES THIS ISSUE COULD BE DISCUSSED FOR YEARS!! Yes, we realize it. Do you realize that most Netters weren't born yesterday? > >All parties have been willing to discuss what the OMA says is at stake >they work for. I don't believe that that has been compromised by Bill 94 >specifically. I would have to read the Bill. I think the issue of >professional freedom is a bit of a smoke-screen. The system has had OHIP >for roughly 30 years now. Some doctors have been using the legality of >extra-billing to dodge OHIP. Doctors put up a similar stink when OHIP >came in. The decision was made a long time ago to have public Medicare. >If because of the Bill, then doctors will stop giving 'free' services, then >that is a drastic reaction. I don't think doctors in the past gave 'free' >services because they could get the cash out of someone else. They could >have kept the extra bucks. They did the favours because they wanted to help >the people who needed extra help. If extra-billing is the difference >between a successful doctor and a successful doctor who pitches in with >some of his own time, then I don't see it. Are we talking about a shortage >of doctors compared to the case load out there? Probably. The doctor who >stops giving free services because of the Bill, is stopping either to >publicise his opposition, or because of an emotional feeling. > >There are definite cases where the Bill is going to hurt patients. >The Kingston cancer clinic, for example. The problem there is that >the rate allowed by OHIP is too low. That is acknowledged by the doctors there >as the reason it's closing once the ban comes into effect. However, I don't >think these examples are justification for a general strike and the >rhetoric I have heard from doctors about how awful this bill is. > >If the doctors could have publicised how they are greatly hurt by this, then >I could say yes, the OHIP rates are low, and the doctors needed to extra-bill. >Instead I have heard that a tiny fraction of doctors extra-bill. The system >doesn't seem far off. I think a ban on extra-billing in a public Health >system is inevitable, but the system has to be responsive. > > >P.S. > > I didn't make up the part about my doctor not willing to spend any time >with verbal consultations over the phone, as someone has said. But really the >point was that I have found that doctors in private practice try to take the >least time with you to solve anything. And I don't mean they are trying to be >efficient on the side of the patient! Maybe I should find a doctor that is >more laid-back! > >P.P.S. > > I think it is interesting that Medicare was brought in to guarantee access >to hospitals, and that it is in the public good. Now, when we make a move >to strengthen Medicare, it is the wrong thing to do. > >-- Bill 94 didn't "strengthen" Medicare as it existed in Ontario for the past N years, it changed it fundamentally. The initial premise which was accepted by the people of Ontario was that extra billing would be an integral part of our system. It's like saying that changing our method of government from representative multi partied democracy to representative single partied democracy would be strengthening our system of government. It doesn't. It's fundamentally a new thing. Whether it is better or worse is a different matter. Cheers! -- Jim O. -- James Omura, Barrister & Solicitor, Toronto ihnp4!utzoo!lsuc!jimomura Byte Information eXchange: jimomura (416) 652-3880