Join the Debate: Your Response to Important News of the Day

JOIN THE DEBATE - YOUR RESPONSE TO IMPORTANT NEWS OF THE DAY

Should you have greater access to private health care?

Click here to have your sayIt’s almost 8 a.m. on Vancouver’s Ash Street. As commuters rush to catch the bus at the corner, few notice a big, burly man struggling to lift himself out of a car. With one hand cradling his side and the other grasping the open passenger door, the man, a six-foot-two RCMP officer, slowly pulls himself up. Pain shoots through him.

To those unfamiliar with the Canada Health Act, what the Mountie will do next might appear to be illegal: He is about to enter a private hospital to undergo surgery. And the RCMP is going to pay for it.

The officer has been off duty for four months, but his sore hip has been plaguing him for years. Now he’s hobbling towards the Cambie Surgery Centre, a brash experiment in Canadian health care where, within an hour, he will jump the public queue and undergo surgery. The surgery will not only free him of pain but save his employer, health insurer and Canadian taxpayers tens of thousands of dollars.

If the RCMP had waited for the officer to be treated by medicare, here’s what it would have cost in time and dollars. Wait for an MRI: 19 weeks. Wait for surgery: 18 weeks. Cost to the RCMP and its insurer for long-term disability during the year the officer would be off work: $60,000 or more.

But when the RCMP compared these costs to what Cambie offered, the choice was easy. Wait for an MRI (at another private clinic): one week. Cost of the MRI: $700. Wait for surgery: a few days. Cost of surgery: $4,000. Total cost of private care: $4,700. Total time off the job postoperative: three weeks.

The three-storey Cambie Surgery Centre is a six-year-old facility offering orthopedic, cosmetic, eye and dental surgery. Inside waiting for the Mountie is orthopedic surgeon Dr. Brian Day, the centre’s founder. Day is a man with a big prescription: to save Canadian health care by complementing—not replacing—the public system he supports and in which he continues to practise.

Day’s prescription, however, calls for an ingredient the very mention of which disturbs many Canadians: private, for-profit medical facilities and services, including surgery, a concept that conjures up doomsday scenarios of the end of one-tier, universal-access health care. Those scenarios, Day believes, are based on a misunderstanding of what medicare is. Our system has always had exceptions that allow some people to jump the queue, often on the government’s dime, while others are forced to wait—and suffer.

The RCMP officer is a case in point. He’s allowed into Cambie only because his employer is allowed to use it. The RCMP is exempt from the strictures of the Canada Health Act so it can get officers back to work as fast as possible. It doesn’t matter whether it chooses public or private—whatever is most cost- and time-efficient. The same rules apply to a Workers’ Compensation Board client, members of the Armed Forces or a prisoner in a federal jail.

But the exemptions don’t end there. If the officer were a regular guy from another country, or even another Canadian province or territory, he could book a surgery at Cambie with no problem. But if
he were an ordinary B.C. resident with a bad hip who tried to get treatment, he’d be refused. And if for some reason Day relented and did the surgery, he’d be breaking the law.

“Canadians don’t realize it,” says Day, “but the current health system is actually infringing on their rights.” If he has his way, Cambie and other centres like it will take over all elective surgery, allowing megahospitals to focus on trauma and critical care.

The surprising element of Day’s prescription lies in the funding. He and others like him would deliver the services—but the government would still pay for most of them. Yes, he’d make money for himself and his investors. But in return, he says, the Canadian health-care system would see an infusion of cash that would lead to more up-to-date buildings, equipment and technology, better access and faster service. For the government, it would lead to savings in expenditures because Cambie can operate more efficiently and inexpensively than big, all-purpose hospitals. Indeed, Day claims he can do most surgeries for a little more than half of what it costs public hospitals to do the same procedures.

At 8:05 a.m. the Mountie limps into Cambie’s first-floor waiting room. With its marble floors, leather couches and original works of art, it looks as if it’s ready for an elite clientele. But Day’s typical patients are far from wealthy. Most are unionized employees (sent to Cambie by their workplace medical-insurance providers) and children on social assistance (primarily kids in need of extensive dental work requiring general anesthetic).

Since many of these kids were being bumped by life-threatening cases in the public operating room (OR), the B.C. government now pays Day to do what the hospitals no longer can handle.

After riding the elevator up one floor, the RCMP officer takes a seat outside one of Cambie’s three ORs. A few months earlier, in the same OR, Day had performed surgery on a prisoner whose knee pain was so severe he couldn’t endure the one-year public wait usually associated with the procedure. So the prison sent him to Cambie, paying over $3,000 for the surgery. It brings up the question: How come a criminal can jump the queue while other needy Canadians have to wait?

A day earlier, Day had seen a professional snowboarder from Ontario. He had a torn knee ligament and didn’t want to waste his time off the slopes in Ontario’s medicare queue. So, with help from his sponsors, he raised over $3,000 and came here. The previous week, Day also treated patients from Japan, Australia and Jamaica.

While the Mountie is being prepared for surgery, Lorraine Varner, Cambie’s executive director, is holding a meeting in her office. One of the big items on her plate is overseeing the $4.5 million Cambie expansion next door.

By spring 2003, Cambie will more than double its size to 17,100 square feet, increasing its operating rooms to six, one more than the nearby UBC Hospital. And while UBC has about 200 postoperative and long-term care beds, Cambie will have only 14, because its low-risk, less-invasive surgeries have 95 percent of patients leaving only hours after their operations.

Cambie performs some 3,200 surgeries each year, the average costing about $2,500. A big part of Varner’s job is keeping track of Cambie’s $300,000 monthly operating expenses and making certain that its 182 full- and part-time staff (122 of whom are doctors) function as a team. If Varner worked at a public hospital, she would run only one segment of the business. “Layers and layers of management people in a facility such as this are not required,” she says.

Varner co-ordinates and oversees the daily operation. Right now, one of medicare’s big problems is the nursing shortage: 8.5 percent of nurses call in sick every day, one of the highest rates of absenteeism of any profession. But at Cambie, Varner has had no such problem. After all, she’s got terrific bait: flexibility of shifts, competitive starting salaries (nurses begin at $34 an hour, compared to salaries as low as $27 in the public system) and excellent benefits.

It’s 8:30 a.m. and Day, in emerald scrubs, steps onto a stool beside the operating table to gain height over his patient, who is now dozing under local anesthetic.

The hip arthroscopy the officer is about to undergo is an expensive procedure, primarily due to the cost of equipment. For this operation, Day will use a $12,000 distractor, a ministretcher that will keep the Mountie’s left leg raised at a 45-degree angle from his body so the X-ray probe, part of a $170,000 machine, will have a clear path to the hip’s interior. In addition, Day will use a $20,000 set of surgical instruments, an improvement over the standard $5,000 orthopedic sets that, in his experience, most public hospitals purchase.

Day would like to do this sophisticated version of hip arthroscopy at UBC Hospital, where he practises one day a week. But he can’t, he says, because the facility has no money to purchase the equipment for this and other types of specialty orthopedic procedures—which is why Day will often leave $20,000 worth of instrument sets at UBC. “When I do surgery there,” he says, “I’m using equipment that belongs to Cambie.”

Over a year ago, Day had a patient—a B.C. resident he saw through his public practice at UBC

—with a condition similar to the Mountie’s. Since the hospital didn’t have the equipment, Day offered to do the $4,000 procedure at Cambie, but he says B.C. Ministry of Health officials refused. So the patient was sent to a private surgical facility in San Francisco. Total cost, picked up by the B.C. government: $25,000.

By 9:55 a.m. his hip operation successfully completed, the police officer is taken to recovery. In half an hour he’ll awake, groggy, with a small bandage on his hip, and by noon he’ll be ready to go home.

Day rests up for his next surgery, a $2,000 knee-ligament transplant, and over a steaming cup of tea he tells how the Cambie Surgery Centre came to be.

About ten years ago, he says, the OR time of surgeons was significantly reduced as part of the B.C. government’s deficit-cutting measures. Angry, Day and a group of physicians looked into building a 35-bed private surgical facility, but the NDP government—in power at the time—decided the project was too “politically dicey.” Day quietly began planning a smaller venture.

By 1994 Day’s OR hours hadn’t improved. Frustrating him further, he claims, was UBC Hospital’s refusal to invest in the latest technology, which he worried would not allow him to stay at the forefront of his profession.

But, Day says, there was another factor that helped launch Cambie: Due to technological advances and mid-1990s government budget cuts, hospital stays had decreased by about 15 percent, and up to 70 percent of surgery in hospitals was now day surgery.

Deciding it was time to make his move, Day went out and secured 22 investors—14 of whom were doctors—each at $100,000. Next, he convinced a reluctant Royal Bank to give him a loan of $2.6 million. Pulling the remainder from his own pocket, he bought the land and built Cambie for $5 million.

In July 1996 the centre greeted its first patients. Initially business was slow, and for the first two years Cambie was in the red. “We’re now making a profit,” says Day. “And that’s a dirty word in health care.”

As governments struggle with soaring health-care costs, Day maintains, they have to decide what they can and cannot afford. “They’ve got to tell Canadians, ‘Look, we can’t give everything to everyone.’”

Contracting out elective procedures—such as hip and knee surgeries—to private clinics would reduce public waiting lists and prevent thousands of health-care dollars from going to available ORs south of the border. It would also free up public operating rooms and resources for trauma cases. But staunch defenders of the public system argue that once you give up yet another publicly funded service to the private sector, for-profit businesses will want—and take—more.

“One possibility is that we will carve out a U.S.-style private system in which costs, unconstrained by government, will explode,” says Dr. Gordon Guyatt, a spokesman for the Medical Reform Group, an advocacy lobby whose guiding principle is universal access for all. “In this scenario, the public system will become a second tier of care, more underfunded, and will languish.”

Wendy Armstrong, past president of the Alberta branch of the Consumers’ Association of Canada, agrees and adds that two delivery systems will never relieve the waiting list because both are dipping into the same pool of doctors.

The public-versus-private debate isn’t made easier by the fact that rules for what can be done by the private sector and what by the public vary from province to province. For example, private clinics in Alberta can perform complex hip, knee, shoulder and spinal surgeries that are restricted to public hospitals in most other provinces. And in British Columbia, adds Day, “if a child has an amputation for cancer, the operation is covered. But giving that child an artificial limb is not an insured service under medicare. Parents have to pay for that artificial limb. In Manitoba, they don’t.”

Day moves on to discuss the business acumen and money-managing skills of people who run public hospitals. In his experience, hospitals are top-heavy with managers, vice-presidents and presidents of boards who don’t have a proper financial background. Recently, one of Day’s colleagues ranted about one of his hospital committee meetings. “He walked out after an hour and a half, because 20 managers had been discussing what brand of soap to buy,” says Day. “These people are being paid between $80,000 and $150,000 to discuss that. At Cambie, one person makes that decision.”

But the public hospital’s biggest problem, Day believes, is that it can’t see as many patients as there are in line for treatment. “The patient is at the bottom of the pyramid because the patient uses up the budget,” he says. “A place like Cambie is the exact opposite. It works on supply and demand. If there aren’t patients—in other words, customers—revenue stops fuelling the business.”

If Day gets his way, the future will have cash-paying Americans coming north for bargain care. When Canadian surgeons have reached their weekly limit, he asks, why not offer Americans medical aid at a discount while subsidizing our system?

Day reflects on his role as a physician this way: In both his private and public practices, despite all the rules he must adhere to, his patients come first. “My duty really is to advise them of the best thing to do for their health,” he says. “If the best thing is to pay, jump the queue and break the law—it’s not my role to uphold it.”

Should you have greater access to private health care?

Date: March 19, 2004
Name: Ron Koslowsky

Comments:
Absolutely! I thought the day of big government telling people of this world how to think and act went out with the fall of the Berlin Wall.
We spend more per capita on health care than virtually any other country and yet have one of the worst records of service in the industrialized world. People of Canada must begin to realize that the system requires competition, innovation, and that user fees and private involvement does not compromise universal care

Date: September 26, 2003
Name: michael daroczi

Comments:
I was self-employed for 4 years in the 1990's and that was enough to completely turn me off of a publicly funded health care system that does not work. My biggest beef regarding this system, and more so with the politcal and legal vines choking any efficiencies that might exist in it, is that in our free and democratic nation/province I do not have a right to choose. I do not have the right to opt out of OHIP with a full refund of any of my tax dollars(direct and indirect) that are paid into OHIP so that I may direct those(my) dollars to a health insurance plan of my choice. This has been made illegal. This makes me feel very uncomfortable. It reeks of communism or a dictatorship. Something has gone fundamentally wrong. When will the public wake up!

Date: April 14, 2003
Name: Robert Chen

Comments:
I read with interest the article decrying more choice in Candian Health Care (I was in a doctor's office). As an insider to expensive public health care, I have deep concerns about how private institutions may affect the whole.

I am an anaesthetist. Currently we are experiencing a nation-wide manpower shortage that runs in the hundreds. Newly minted anaesthetists are shying away from jobs in university centres hoping to repay their debts more quickly while working in other (potentially) higher paying positions.

To attract staff to a private clinic, I would anticipate that offerings would include better pay, less time worked or improved working conditions than is available in the public system. It would be easy to see how a strained public system, additionally bled of professional staff may not survive.

Robert Chen

Date: April 03, 2003
Name: Debbie Ristimaki

Comments:
In theory (in my eyes at least), the use of the private clinics by those with the means, should free up the public resources for those without the means. Where I see the challenge -is the potential loss of the trained resources from the public to the private sectors. Money talks -and just for those who can pay but it also talks for those receiving. What will be their incentive to remain in the public sector? Without that incentive, who will be there to provide for those without the resources?

Date: February 17, 2003
Name: Brenda Berg

Comments:
Yes, we sure should have access to both.
Old Jean "Crouton" sure does, AND HE USES IT while in florida. Alan Rock jumped the queue for his prostrate.
We already have two-tier healthcare now...those who can afford it DO GO TO THE U.S. for treatment. The rest of us get to DIE waiting for treatment.
THEY should NOT be "MORE EQUAL" than any other person in Canada, but they have either power,money or fame. In today's society that unfortunately DOES make them more equal than the proletariat masses otherwise known as the great unwashed everyday people like you or me.

Date: January 21, 2003
Name: meghan mcaloney

Comments:
I think we should have a choice. nothing that is government runs work efficiently anyways and never will no matter how much money is put into it. In Australia there are both public and private systems and it seems well recepted by the population. If someone wants to pay thousands of dollars instead of waiting for their surgery, then let them and free up the public hospital.

Date: January 17, 2003
Name: William C Rogers

Comments:
Private health care must not be allowed in Canada. It's need is being promoted by the governments because they are in collusion with for profit health care entrepreneurs. If the Canadian heath care system was properly funded we would have the best in the world, for sure. Unfortunatley our federal and provincial governments are wasting so much money on useless programs that they are cutting back where its needed most. Just imagine how the billion dollars wasted on the gun registry would have helped the health care system in Canada.

Date: January 17, 2003
Name: John O. Olson

Comments:
I think the question should be, "Why should we have to choose?" The underlying, misguided, dangerous assumption behind the article (which promotes private-sector surgery clinics) is that the public system -- with equal access to top-quality health care for all Canadians -- cannot be beefed up to enable it to do what I believe it was intended to do in the first place. Page 145: "Why shouldn't all Canadians who need surgery be allowed the same kind of service the RCMP can choose for a Mountie?" EXACTLY!! Via the public health-care system! Let's get Canadian public health care upgraded and back on track before the privatization juggernaut gives us a US-style structure that only the rich can access.

Date: January 12, 2003
Name: Name withheld

Comments:
If private health care was available it could free up more time on the subsidized system. We must care not to jepordize the availabilitty of our current system. Nor should we consider extra billing. but if the wealthy wish to take the burden off our current system it only allows more time for those who can not afford to pay for special services.

Date: January 12, 2003
Name: S. & D. Sheldrake

Comments:
We agree totally with Dr. Day.We wish there were more Clinics like his across this country. We also wish that our politicians would wake up and see the light of day. The private sector is badly needed here and can obviously function far more efficiently than our public system. Profit is not a BAD WORD - we all work for profit.

Date: January 12, 2003
Name: T

Comments:
Although I agree our waitlists are too long, I have serious doubts as to whether privatization is the best solution. It works beautifully in theory but there are a number of potential problems that may come out of it. For starters, what doctor would rather work in a public health care facility if a private one offers higher wages and better benefits? We will lose all of our best doctors immediately to the private clinics who want them on staff. Also, I fail to see how this will alleviate stress on our system because there will still be the same amount of patients and the same amount of doctors. The wait will therefore not be shorter because the decrease of patients needing surgery in public facilities will be met by a decrease of doctors in the public system. This method will simply allow wealthier patients to jump to the front of the line. I agree with the concern from the article that our public system will lag and sputter out in the shadow of privatization. While visiting the states a the year before last, I sprained my wrist. I was in and out of the hospital in 30 minutes, with quick and pleasant service. There were many many beds available and I was taken to X-ray immediately, even being offered a heated blanket to be more comfortable. My mother and I marvelled at this new medical experience, until we recieved the bill in the mail informing us that a simple X-ray and a sling had set us back well over $500. Looking back, I know that I wouldn't have gone at all if I had known the costs. Do we want that to happen in BC? How many people have family or friends who would stay home, possibly risking their health, because they couldn't afford fees like that? Or just as bad, to go to a second rate facility with inexperienced staff because that is all that remains of our medicare system? This is not a decision that can be made without looking at all sides of the situation.

Date: January 11, 2003
Name: Name withheld

Comments:
I agree with Dr. Guyatt and Wendy Armstrong. For profit medicare will lead us to a U.S. style health care where only those who can afford it will receive the best care.Greed will overcome equality and as more private clinics rise up the public system will suffer. Do you think someone on a fixed income or making minimum wage would be able to get the same treatment as the RCMP officer. Of course not. They don't have the money or resourses, so I guess they just have to wait with rest of the people who don't have high paying jobs or company benefits.
The public system is not perfect but it is one of the few areas left where your dignity is not determined on your status in life or how much you earn.

Date: January 09, 2003
Name: Allen Webster

Comments:
I feel that certain circumstances should allow people access to private health care as in the article it would allow people treatment sooner than public heathcare especially when it is life saving and when it will allow people to get back to work sooner than later and it would save not only health plans but it would save the Government thousands in EI benefits as people wouln't be on sick benefits as long.

Date: January 08, 2003
Name: Name withheld

Comments:
I think this article proves that the education system does definitely not tailor to all of a student's needs. I know that as a grade 12 student, most of my academic courses are a) not stimulating enough to hold my attention for 75 minutes (a period waaaay too long for anyone to sit through four times a day), and b) not challenging. Mind you, this is my opinion as an Honours with Distinction student. Other students may disagree with me but from my understanding, this is the general consensus. Your article was, hopefully, a wake up call to all teachers and administrators alike out there to smarten up and start focusing on what the kids need, not what the curriculum states should be done.

Date: January 04, 2003
Name: Elaine Wilson

Comments:
Yes, I'm for private health care. I would feel more confident going to a private than a government run hospital. Also, something has to be done abut the long waiting list.

Date: January 02, 2003
Name: Name withheld

Comments:
Dr. Day is right on the money. The government is all too pleased to spend more money than required. Pay the US to do a job that could be done in Canada for less money in Canadian dollars. What is wrong with this picture??? If the Canadian health care system is already paying clinics in the US for these services why shouldn't doctors be able to offer the same services here in Canada? Even at the same price we would still be saving the exchange rate and according to Dr. Day's information, less money. Logic seems to be in short supply in the goverment these days. The unions are a perfect example of that. I totally agree that doctors and nurses should be well paid for the years of study and skill but do we need to pay the person washing the floor or the person pushing the lunch wagon more per hour than most private sector administration employees make. The unions are killing the country. What happened to if you want to make more money upgrade your skills so you can get a higher paying position. I was horrified this summer during the garbage strike in Toronto to find out that the union garbage collectors made the same or better money than I do in marketing and as a purchasing agent. Perhaps I should have not bothered to get extra education and just concentrated on getting a government union position - good money and better benefits than most people in Canada dream of. Wouldn't the farmers in Canada love to make that kind of money and have those benefits. We will never be able to get a handle on the costs of health care or any other government run institution until employees there are paid real (read non-union)world wages.

Thanks for hearing me out,
Alison

Date: January 01, 2003
Name: Klaas Giesbrecht

Comments:
I think that private health can be good if it is controlled,the health care we like will not be available forever.
Better private clinics assissting now than a one tier system where everyone pays full cost for everything when our care system breaks down.

Date: December 30, 2002
Name: Peter Funk

Comments:
Since a two tier system already exists why not let those who can afford it take the wait time off the regular health care system.

Date: December 29, 2002
Name: Noalur Rahim

Comments:
Well the right to choose is great, but at what cost? Firstly, its the same number of doctors and other medical professionals taking care. So there actually will be no significant difference when the mass is considered. I have great faith in our fine doctors. However, they are humans too. Once they feel the taste of added money (I donot oppose they have more OT hours or somehow paid more) in the private practise, they may start to neglect their public practise. This has happened in many countries. On the other hand, if the private sector can invest a certain amount of money to procure modern equipment, then I refuse to beleive that the government cannot. After all, Canada is amongst the hightest tax paying countries in the world.

I hope we do not loose our great health care system to a bunch of money hunting politicians. We should try to improve on what we have, not convert it for the worse. Certain public sectors, specially health-care and education should not be compromised to fianancial gains or losses.

Date: December 29, 2002
Name: Herbert Jordan

Comments:
Public Health Care is obviouusly not sustainable in its present form. Has Roy Romanov or any other politician conferred with Dr. Day? If not,why not?

Certainly all citizens of Canada should be given the opportunity to avail themselves of services similar to those offered by Cambie Surgery Centre.

It is a violation of our human rights not to have this access.

Date: December 23, 2002
Name: DON ALKINS

Comments:
REGARDING THE ABOVE ARTICLE,THE GOV'T/POPULACE STANCE DEFYS LOGIC.THE MADE IN CANADA BLENDED SYSTEM WOULD KEEP FUNDS IN THE COUNTRY,ALLOW THOSE WITH THE FINANCES TO GET PROCEDURES DONE LOCALLY AND QUICKLY FREEING UP THEIR SPACE IN LINE FOR THOSE USING THE PUBLIC SYSTEM.WE SEEM TO HAVE A SOCIALIST MENTALITY THAT SAYS THAT NO ONE SHOULD MAKE A PROFIT FROM A PUBLICLY FUNDED SYSTEM WHILE THOUSANDS DO JUST THAT DUE TO INEFFICIENCY,FEATHER BEDDING AND OUTRIGHT THEFT

Date: December 17, 2002
Name: Denyse Kutlesa

Comments:
Our health care system at one time was the best in the world. I often wonder if we let the politics ruin it. We have excellent Doctors that are caring and want to help in every possible way. I say let them start more clinics that are private. I see no reason to stop them....but must still follow safe and healthy practices.

Date: December 16, 2002
Name: Ron Richardson

Comments:
Universality? What universality? If it is legal and accepted that there are some in this country that are permitted and do jump the queue for medical care, it would seeem that universality is quite the myth.
On top of that, I can only have the services that big brother, the government, says I can have, where and when they say I can have it. Again, is this what is meant by universality? I hope not.
And as the article points out, an expensive comittee of eight spent hours trying to decide on what soap and other cleaning materials to purchase, and from where. Private industry does this minor function much more efficiently, as well as pretty well everything else they do.
The government sould not be in a business that they write the rules for. We need more business in government, and less government in business...

Date: December 15, 2002
Name: martha Griffith

Comments:
Hi,
I can not understand the socialistic thinking of the public. When one has private and socialistic health care- one can go up the waiting list faster. why shouldn't people that are willing and able to pay for their own medical care- pay!Don't get me wrong- I wouldn't have the means to pay- but I see things that way.Socialisim just breeds jealousy and greed! We should all have the choice of private enterprise and - or- socialist thinking and doing.The medical system is in such dire straights now- can't wait any longer to do something to put it back into the power of the people and not let the unions take a strangle hold on it.Thelast batch of money that went into the system- paid for the hier wages of the nurses and doctors. there is something wrong here- who is running the country- the unions or the ones voted into power? Our medical fees go up and up- and we get very little for it! I just had a knee transplant in May- waited 18 months for it- no complaining- just wanted people to know that they had better stop complaing if they do not want private and public system. Further more- I think we should all have a bill sent to us- stating what the costs of operations are.I know it would cost more administration- but there are ways of cutting back on things like that- using both sides of paper and not having two or more people doing the same thing etc.You would be surprised how few people know the cost of an operation.They think a bed in the hospital only costs about 5 dollars a day- operations a couple of hundred- educate the people! Enough for now.
Thanks for letting me vent! Martha Griffith.

Date: December 14, 2002
Name: Dennis Richer

Comments:
Why shouldn't there be a top heavy public system for our health care? Our federal government has been doing that for decades and yet we allow them to keep coming back to continue the waste of money to accomplish nothing for the taxpayer ,only for their friends.
The underlying problem of healthcare is of the same ideas of bureaucracy "Care not for the work of your position, hire someone to do it for you".
Today's healthcare allows some Doctors to get rich by treating the symptoms,not the actual problem.Why? The drug companies can give them free trips under the guise of a training session or other perks to numerous to be listed here.
The private "Business" of healthcare can work but,only if guidelines are established to protect the end user of the system and not allow the private sector to attain monoply status.

Date: December 13, 2002
Name: Name withheld

Comments:
I am in favor of for profit medical centers. I would also like to see a user fee at doctors offices and hospitals. These two facilities are over run with new Canadians thrilled with the novelty of "free" healthcare.

Date: December 12, 2002
Name: Dennis McCallum

Comments:
We definately should have the right to more choice in how our health care is delivered to us, but what really upsets me is I have to wait for 5 months to see an orthopedic surgeon for an assessment of problems with my knee that has me in constant pain. The 2 tier system that some people are worried about is already a 4 tier system with prisoners, atheletes, wealfare recpients, and federal government employees at the top of the heap. It is really irksome that a prisoner can jump in front of others whose knees are every bit as sore as his. Maybe the way to get prompt access to the system is to get arrested

Date: December 12, 2002
Name: B.D.

Comments:
I strongly believe that we should have access to private clinics. Two of my friends have gone to the U.S. in recent years. One had skin cancer and didn't want to wait for treatment here. The other spent almost $100,000 on two knee replacements because he didn't want to wait. That money could have stayed in Canada had they the option to stay at home and receive treatment.

Most of us live in close proximity to the U.S. border and will go there if we can afford to do so. Why should we have to leave our country to get this treatment?

I have sent this same info to the federal Minister of Health but received no answer.

Date: December 11, 2002
Name: Helen Balzer

Comments:
I was disturbed by the fact that I'm paying my taxes so that prisoners can have better access to health services than I do. I would be willing to pay to jump the queues and get much needed medical attention in a timely fashion. At any rate, it would be nice to have the option.

It's ridiculous that the BC government will pay thousands of tax payer dollars to send people to the US for surgeries that could've been done at a private clinic here in Canada. No wonder we're having economic difficulties!

Date: December 10, 2002
Name: Ron Quick

Comments:
My impression was that most people wished to have good health. Thank you Dr. Day for dealing with frustration in such a constructive manner.

Date: December 09, 2002
Name: Allen Funk

Comments:
It has been proven that certain specialized proceedures can be handled very efficiently in a stand-alone profit driven enterprise. If a given percentage of hospital costs (example 80%)of a proceedure could be made 'contract' eligible would we not all learn as to what works and what doesn't?
The simple premise is: Do not spend $5000. where $4000. will do. Especially when facilities and staff are overloaded and excellence is strained.

Date: December 09, 2002
Name: John D Lovering

Comments:
I have heard of increased waiting periods in Great Britain. Those with more money already have better skills at receiving better treatment. What guarantee do the poor have that the existing services will not be scaled back once the middle and upper classes are more content? If the very rich have to line up than the whole system is more liable to improve.

Date: December 09, 2002
Name: Name withheld

Comments:
Dr Day is totally accurate in his understanding and his approach to this very expensive problem. Somehow we need to get the politics out of the medical system and return to a time where common sense prevails.

Date: December 09, 2002
Name: Doug Griffin

Comments:
Sorry, I do not buy the arguments of Karen van Kampen of the National Post ("Shouldn't We Have the Right to Choose") in favour of for-profit health care, in your December 2002 issue. Ms. van Kampen's main point is that the public system is so badly managed that patients are willing to shell out for private care that is quick, available and efficient. But who are the smart, hardworking people are who are managing these elective surgery centres so efficiently? Why, - they’re the very same folks who are making such a mess of the public system. Hmmm. Well now. Does that not make you wonder?

Date: December 09, 2002
Name: Wayne Andre

Comments:
Health care is a closed equation. X patients times y treatments equals z costs. Change any variable and at least one of the other variables must change. Dr. Day is skimming. He will become very wealthy, but he is not responsible for for the full care of his patients. He will cherry pick the easiest and most profitable patients and if any complications arise, he will quickly turn the problem over to public health care.

As taxpayers, we will be reqired to maintain a fully functioning hospital that will be able to respond to the very worst case scenario. This will not be a concern to Dr. Day, but it will continue to be a great cost to the taxpayer. We would not save money using Dr. Day's plan, but more people would be treated. Going back to the original statement, if more money is put in, either more patients are treated or they have more treatments. Dr. Day's plan only works if he is able to be more cost efficient than the public system.

Dr. Day, to my understanding, is paid from the public purse in one form or another. If we are spending the extra money, I would prefer that he work within the system. Health is our most important (and largest) expenditure, and I would not have it any other way. If we do not have health, we have nothing. If we do not have an educated work force, we will not be able to pay for our health care. Everything else is secondary.

This is not to suggest that we just throw more money into the furnace and hope for the best. Funding must be directed and excesses must be found and eliminated.

One final thought, the biggest difference between private and public health care is that private health care has no problem turning someone away from their door if they cannot pay or they would not be cost efficient. A sorry way to make a profit.

Wayne Andre

Date: December 09, 2002
Name: Garry GRAHAM

Comments:
IF I WAS IN NEED OF A OPERATION IWOULD LIKE THE OPTION OF GOING TO A PRIVATE CLINIC

Date: December 06, 2002
Name: Beth Denman

Comments:
Yes. Our governments can not seem to fix the problem of our health care systems no matter how much of the taxpayers money they inject in to it. Why should RCMP and WCB get preferental treatment? As for two tiered. The politicians are two tiered themselves. On one tier saying what the constituents would like to hear and the other tier doing what they bloody well feel like doing anyway.
Free up the congestion at the hospitals and have more surgery clinics.

Date: December 05, 2002
Name: Name withheld

Comments:
If taxpayers are funding American institutions by sending Canadians south for procedures that are not available or not timely in Canada, then we must allow local physicians to set up clinics and hospitals that will perform the service while keeping the tax dollars at home. In the usual "this is my rice bowl" controversy between the medical bureaucracy and the government bureaucracy, the patient once again loses out. Health care that is not compassionate, timely or modern is not what Mr. Douglas envisioned.

Date: December 05, 2002
Name: Name withheld

Comments:
As a veterinarian I find it very ironic that we have to wait weeks or months to get the same health care that pets can have now. If a client calls with a sick pet I see that pet today. If blood tests need to be done we can have results in as little as an hour if done in-house or as much as 24-48 hours if we have to send it to an outside lab. If the pet needs surgery we do it right away (although elective procedures may need to wait a week). If the pet needs to see a specialist they may have to wait a week or two (possibly 3).
On the other hand, if I need to see my doctor I might be able to get in in a week. Simple blood tests take at least a week to get results for but sometimes it takes 2 or 3weeks. If I need to see a specialist or have surgery I can wait for months or more than a year. There is a chance I could die in that time but if I do at least the next person in line moves up a space - if he lives long enough.
It also seems ironic that while most people demand immediate care for their pets, they are content to wait in line for their own health care. It seems that many Canadians believe that we all deserve to have the same health care regardless of how crappy it is. I think that if I want to pay for prompt private care then that should be my right. And I should think that if I do that then they other people left in line should be saying "Great! Now I'm that much closer to the front of MY line!" instead of "No fair! He should have to wait way back here with the rest of us!"
And that's assuming I pay for it myself. If it costs less in a private clinic then why not send everyone to the private clinic so we can all save our tax dollars (or the government can squander it on something else). The Romanow report said that we need to dump more money into healthcare but wasn't there also a recent report that showed that Canadians spend more per capita on health care than most other developed countries and get much less for that money? There has to be a better way and we already know that private clinics fit the bill.

Date: December 05, 2002
Name: R. Bronnimann

Comments:
dear reader's digest, thank-you for this excellent article! i was born and raised in europe. the fee for - mandatory - basic healthcare-insurance is higher there than here in BC, but it covers the insured for a much wider range of services. anyone can opt for a better coverage,for which they pay higher than basic fees per month. all services are being delivered in hospitals and clinics all over the country;the only difference in treatment is that basic-care patients have to share a room with several other patients during recovery; patients that pay higher fees get to share a room with one other patient, still higher and you are by yourself. and it works, all side by side; hopefully happily ever after...

Date: December 04, 2002
Name: Martha Dueck

Comments:
Yes, we definitely need more access to private health care. It is a shame that a BC resident had to have a procedure done in the USA for $25,000 when Day could have done it for $4,000. Why does the government want to spend more money on health care then they have to? Instead of spending so much money on the top-heavy management which is needed to run a public hospital, a private hopital can invest the money in better equipment, pay their nurses better wages and provide Canadian citizens with health care since we are already paying for it. The way it is now you can hardly call it "health care". If we could even get people south of the border to come here for medical aid, that would be quite a change. I don't understand why people are so opposed to private hospitals when it is so clear to see that they can be run so much more efficiently? How many people have died or almost died waiting for surgery? We had to take two of our children to USA for a treatment which was not available in Canada. Why is the Canadian system so far behind?

Date: December 01, 2002
Name: Peter J. Funk

Comments:
Dr. Day's article confirms what many of us seniors have seen and know. This is especially true of federal and provincial corporations, however, this can also be applied to some of the large private corporations. It is an injustice not to allow the citzens of B.C. to choose where they want to spend their money or where to we want to be treated. I congratulate Dr. Brian Day for his foresight in establishing the Cambie Surgery Centre and wish that others would be able to make use of such a facility. It is obvious in the examples quoted in the Dec. Readers Digest article that common sense is not part of the decision making process in our hospital administration, nor their spending of our money.
I encourage the editors of Readers Digest to expose more of the flaws of our current medical/health system. With the kind of problems that we have no amount of money is going to solve them. One annoyed British Columbian.

Date: December 01, 2002
Name: Name withheld

Comments:
If a family member needed a CAT scan or an MRI I would not hesitate to go to Buffalo or Detroit to have it done rather than waiting 10 months as is current. This is a two tier system like it or not. England, New Zealand, and Australia all have the private sector. Why not her?

Date: December 01, 2002
Name: Drew Bryant

Comments:
After almost 40 years of watching the situation develop I have come to what I feel is a most logical conclusion . . . it's true that privatization would lead to the unequal distribution of health care, but our current (undemocratic and socialized) system leads only to the equal distribution of NO health care. Public medicare has never been more than a politically driven scare-mongering tactic over the future possibilities of each individual voter's health needs. The truth is that privatized health care would give us ALL more abundant medical options at the most affordable market prices.

Date: November 30, 2002
Name: Name withheld

Comments:
People who say that we shouldn't touch our cherished medicare system because for-profit or privatization aren't the "Canadian way" infuriate. Should we not focus on what is BEST for Canadians and what is going to be the most efficient system, rather than holding on to something only because what it symbolically represents? I'm sure if you were suffering terribly and had to wait months for treatment, symbolism and the "Canadian way" would be the least of your concerns.

Date: November 30, 2002
Name: joan boesterd

Comments:
no . i dont think private health care is the way to go.it should be a option only if you want to pay your own way.the us has private health care as the only option and only the peolpe with money can aford a medical plan .there are over 18 million people in the U.S. that don't have medical care plans .there health care is a money making busness,so no money you fall into the bottom line no surgerys for you because you don't have the money .here in canada everyone has medical and every one gets surgerys if needed.

Date: November 29, 2002
Name: Name withheld

Comments:
I agree 100% with Dr. Day. The public system is so polluted with waste and abuse it cannot survive. Any institution run by the government is doomed for failure because of apathy. The public system, as Dr. Day said, is so "top heavy" with overpaid lazy union-minded employees that choke the system. No amount of money can save it, it'll just cost the average tax payer more (and we are alrady the highest taxed country in the world). A public system on the otherhand has to survive on its own, and no doubt, they account for their dollars far better than any public system. If I want certain medical treatment, and feel I want to pay for it, then that's my business and NOT the governments. As far as I'm concerned, the governemt has too much say in how we average Canadians live. Ottawa itself could do away with several civil servants as that's where it is the most "top-heavy" and the most wasteful.

Date: November 29, 2002
Name: Paul E. Perry

Comments:
You can't say George Orwell didn't warn us: "All pigs are equal, but some are more equal than others". The only way I could accept Roy Romanow's report is if all pigs were truly equal, that is, no exemptions for anyone....the groups Brian Day mentions, and also politicians, senior bureaucrats and physicians themselves, who routinely skip the waiting list. That, of course, "ain't about to happen", so Day's thesis makes enormous sense. Let's confirm the existence of two-tier medicare and make it work,
rather than accepting the bleak vision of socialist medicine assumed by Orwell in "1984".
Romanow's report is Oz; Romanow the wizard, who turns out to be an unpretentious man bedazzled by the emotional rhetoric of his mentor, Tommy Douglas, the man responsible for the first strike by doctors in Canada's history. The vision is not reality and comes nowhere close to solving the real problems of medicare.

Date: November 29, 2002
Name: Dan Tye

Comments:
One of the many problems I feel that we have is that we limit the amount of money Dr's can make. For instance, we have a Doctor here that does eye correction surgery. He is forced to close his practise in October because he cannot bill the system any further.

What about his patients that are still waiting? Why should we limit the total amount being billed. I agree in principal of having set amounts per transaction, but not in total. Are we worried that someone might make more than the next guy? Why? We do these things then wonder why there is a Doctor shortage in Canada.

Date: November 29, 2002
Name:

Comments:
Yes, there should be greater access to private health care. Waiting lists for hip and knee replacements now number in the thousands and a 1-2 yr. wait, sometimes 6 months to even consult a surgeon. In B.C. other wait lists are long.
Something must be done to reduce these long wait lists and private health care would reduce the suffering of many people. Surely, Medicare and/or MSP can still pay the cost of surgery - because its private it doesn't mean it has to come from an individual.

Date: November 28, 2002
Name: Denis Tusar

Comments:
Because the cash-strapped public health care system cannot afford world-wide state of the art technology, Canadians are being denied access to the best diagnostic imaging technology for the early detection of cancer, its recurrence and spread, PET (Positron Emission Tomography) scans are publicly available in all the G7 countries except Canada. There are 1000 scanners in the world, 600 of them in the US. Canada has less than 10, all of which are used for research except for the scanner at the PETSCAN Centre in Vancouver. This is a private patient pay facility because PET scans are not covered by any provincial health insurance program in Canada. In fact, Ontario is proposing to embark on a study of PET’s usefulness – a study Australia began to do in 1990 and finished recently. Australia’s health insurance system now covers PET scans.

When capital funds were more available Canadian provinces were quick to cover CT and MRI scans which are good for some things, but not as good as PET scans for many diagnoses. Now the rules are different and it is not as if PET scans are not safe and cost effective – millions can be saved in avoiding futile hit and miss lung and breast surgery alone.

An ideal fit for the private sector is the category of new diagnostic technology. The private sector foots the bill for the capital cost of setting up and equipping the Centre (the equipment costs millions) and the public sector pays for scans through provincial insurance coverage. There are many examples of this type of collaboration, such as private medical laboratories. Privately provided, publicly funded diagnostic services should offend no one.

Date: November 28, 2002
Name: Name withheld

Comments:
If I wanted to live in a country with crap for health care I would move to the States!! I have had some positive and some negative experiences with our current health care system but it still is better then the states or even third world countries!! When myself or my family have really needed it the health care has been there and realiable.

Like I said if you thinks it stinks here then go to the states and pay all your money there.

Date: November 27, 2002
Name: Name withheld

Comments:
Absolutely, its the only way any form of health
care can survive. In the end everyone is a winner. The govt.saves money- the waiting lists would get
shorter and everyone would receive the services they need much sooner. Otherwise we are stuck with a mediocre system with outdated equipment and extremely long waits for lifesaving treatment.

Date: November 27, 2002
Name: Name withheld

Comments:
Any system that allows money to determine who gets treated first is NOT part of the Canadian Way.

Date: November 27, 2002
Name: Dr G E Stiles

Comments:
Doctors like Brian Day make me ill. They pretend they are saviours of Canadian health care. I would suggest their motive is quite different. GREED!! The doctors most in fovour of a second tier are most often the same one who will PROFIT most, notably orthopedic surgeons and radiologists. You will seldom hear the same refrain from those of us who treat critical illness such as cardiovascular disease and cancer. I am by no means left wing but I indeed find medicine for profit offensive.

Dr G.E.Stiles
Vascular, thoracic surgeon

Date: November 27, 2002
Name: Name withheld

Comments:
There has ALWAYS been a two tiered medical system in BC. It is used by the lawyers & ICBC during litigation.
You can get an appt with any specialist through your lawyer or ICBC's adjusters.
If you ask through your doc, it takes MONTHS, up to years to get an appt.
The provincial newspapers have reported how political members get to "jump the queue" for themselves and their family members.
I myself have over $50,000 in medical receipts for massage, chiropractic, physio, naturopathic, MRI's (done in Bellingham), acupuncture, chinese medicine, homeopathic, psychological treatment for post traumatic stress, allergy treatment etc etc etc.
Don't delude yourself. There has always been a multi-tiered system for health here.
Also, I find it very interesting that since the MSP doesn't cover eye exams anymore, the fee has jumped from $25 paid by the govt to $75 paid for by the client.
Isn't THAT interesting???

Date: November 27, 2002
Name: Shaunene Neilson

Comments:
The simple answer to me is YES.

I speak from the patient perspective and as an employee of a private diagnostic centre.

Over the past year I have had to go through several medical procedures and have more often than not been shocked and dismayed at the age of the equipment being used in various facilities and the delay time to get into see these health care professionals. Now thankfully my health problems have not been life threatening but it has been frustrating and drawn out because the substandard equipment used was not able to accurately diagnose my problem(s) and therefore caused me to go through several more procedures to arrive at the same endpoint that would have been arrived earlier had the equipment been up to date.

People say that it would be the death of public health care to allow private facilities. I do not believe this, the Norwegian model is an example of a system that can incorporate both private and public systems for the better good of the patient. It would allow our system to change from an illness care back to a health care system. We already have private health care, just look at the list of what we have to pay for:
Optometry, Dentistry, Chiropractic, Massage Therapy, Physiotherapy, Podiatry

All these not covered, at least in BC, by public health care. In BC there are private MRI’s, CT’s and the Vancouver PETSCAN Centre, who I work for. These centres are here because there is a need; patients are tired of being given a number and told to wait. I work with Cancer patients and the time from initial symptoms to actual diagnosis can be excruciatingly long for a number of reasons such as waitlists and the technology not being available in the public system, period. If, in the case of our Centre, we were not here these patients would not get a service that the rest of the world deems essential to staging and managing their disease.

Our system is broken and in need of repair, increasing my taxes is not the way. We all know that money will either not be used for Medicare or if given to provinces will be used not for opening beds or improving technology but to play catch up in administrative areas. If I have to pay more money I would rather pay for state of the art technology and immediate health care as opposed to increased taxes. We need to find a happy medium of both public and private health care and we need to do it sooner rather than later.

I am not wealthy but I can guarantee you that if I do get a diagnosis of cancer I am not going to wait for the public system to catch up to my disease and I resent the government and various self interest groups attempting to take away my freedom of choice in determining how I acquire my medical care.

Shaunene Neilson

Date: November 27, 2002
Name: diane feeny

Comments:
I believe under the charter of rights we are allowed the right to equality in Canada. We are
tax payers. Each individual is different in thier
status, and maybe this is the attention this needs. I believe each individual has thier rights and opportunities, regarding health care and if
they seek attention under emergencies in a death
or not death situation, they should have that attention to thier needs. Thanking you, Diane F.

Date: November 26, 2002
Name: Alec Cook

Comments:
7 years ago I was advised to have my hip replaced by a specialist at a Calgary Hospital where I was referred to by my local doctor. Because I was only 53 at the time I set out to do everything possible to defer the operation until I was older. The pain is now to the point where I loose sleep & have difficulty walking. With pills I could possibly delay the operation longer but I am concerned that when it is finally necessary I will have to wait a year or more. 3 months to see the specialist & 9 month before the operation can take place. Because of this waiting time I must ask for the operation even though I might be able to last longer without it. I would conclude that the groups who make the decisions that create the line ups have not had to bear any great pain any lengh of time.

Date: November 26, 2002
Name: Gary Wilkinson

Comments:
Hi Private health care may sound appealing now but one of the first thing's to happen is the Governments start to underfund the public system and more and more is picked up by the Private pretty soon the services just are not avalable in the Public system. In the mean time fees keep going up and up and soon you can't afford to go to the Private care and there is either a really poor Public system or non at all. Margret Thatcher did this in Britan years ago and they still do not have it fixed.Also in the USA there are about 36 million people that don't have access to health care at all so I think we should all be carefull what we wish for.

Date: November 26, 2002
Name: Name withheld

Comments:
Definitely! Here in Saskatchewan we have unimagineable waiting lists along with nurses and health care professionals overworked,going on strike and/or moving elsewhere. If I have the ways and means to provide my family or myself with the quickest resolution to a health problem I should be able to do so.

Date: November 26, 2002
Name: Name withheld

Comments:
I am very much afraid that choice would further enhance the two tier medical system we already have. IF you can pay, you get treated now. IF you can't, you wait for an opening . If you can pay, you see a specialist in his/her office for treatment; if you can't, you go to a clinic. This is not the answer. This kind of system should not be allowed to go one even now- there should be equal access for everyone. I believe in equality for everyone despite ability to pay.

Date: November 26, 2002
Name: William D. Pooles

Comments:
We should have two tier health care were we can opt for a private facility if we so wish. We live in socialistic Manitoba where the government is using health care funds to buy out private providers. We had one clinic start up with up to date equipment, but the government would not let him have patients stay one night and so closed down this facilty. Having used American health care we found that there was no waiting lines and the treatment was excellent. Regretfully, Canadians are slowly being robbed of there freedom to choose.

Date: November 26, 2002
Name: Ernie Brauen

Comments:
No one, Police officer, military person, politician, or other criminal has more right to health care services than I or my family.
I served 28 years in the military to maintain the freedoms of Canadians, and this is just one of many ways that we are losing them. I also agree wholeheartedly that a country that jails farmers for selling their own grain, (or hogs or chickens)is not free. God help us all!

Date: November 26, 2002
Name: Name withheld

Comments:
the best solution to shorten waiting lists is to do as dr. brian day suggests and put all canadians in the same category as the rcmp in having private health care as an option.
our only other choice when our painful waits get longer and longer is to mortgage our homes and go to the usa for rapid attention.

Date: November 25, 2002
Name: Name withheld

Comments:
The main argument for not allowing private health care seems to be "it must be equal for everyone"; however, this article, and others, clearly shows that equality does not exist. I am in favor of privatizing hospitals and other facilities because I believe governments should govern, not run businesses.

Date: November 25, 2002
Name: Don Willis

Comments:
Eighty percent of medicare dollars is spent on salaries to medical and administrative staff. Until there is competition introduced in
the provision of medical procedures, the unions which represent government medical empoloyees will escalate costs beyond what taxpayers can afford. Witness last years union demands in B.C. by Nurses and Doctors. They based their demands on what the U.S. is paying medical staff without regard to the value of the Canadian dollar as opposed to the U.S. dollar. Private surgery clinics can counter the union demads. What is wrong with opening up medicare to competition if the private clinics can perform the procedures at less or slightly more (with provision for a reasonable profit), than government facilities as long as the amount paid for procedures is based on a scale negotiated by the private clinics and the government. The objective is to provide timely medical care at affordable cost. Dr. Day has proven that this can be done.

Date: November 25, 2002
Name: Richard Elliott

Comments:
Thank you Dr. Day.

The medical system is at present a publicly funded two tier system not a publicly funded single tier system

Tier One consists of privileged groups. Examples are groups such as the RCMP (as mentioned by Dr. Day); groups with authority and power (do you really think that a Prime Minister, or his family or his friends, would have to wait 6 months for an MRI?); and groups in the medical system (do you really think that a GP, or his family or his friends, would have to wait 12 hours in the ER?).

Tier Two consists of the rest of us.

I would like to see a fair, reasonably regulated public system and a fair, reasonably regulated private system. This approach would begin to even off the inequities that occur in our present publicly funded two tier system.

Date: November 25, 2002
Name: Pat Grier

Comments:
I've had chronic problems through much of my life.

I've seen long waits, doubts, unrealized hopes, and deep disappointments, repeatedly.

Specialists have a very narrow set of qualifications that will cause them to act. And no time for patients that don't meet their narrow abilities.

A media that places great emphasis on the little that can be done.

Few, lucky people fall into those categories.

Also lack of understanding in my peers who have no experience, but will eventually.

Most efforts to diagnose or treat are hit and miss, (remove and replace in todays disposible society), which is a terrible roller coster for the patient.

We've emphasised successes and ignored the poor parts of medical services.

Perhaps an aging society will smooth out a few of the hills and valleys in the medical care.

But it also leaves the doors open for supplement quacks to waste peoples money.

Thats my $100.00 bucks worth

Date: November 25, 2002
Name: Lorne St. Clair

Comments:
In regards to more access to private health care, I feel that due to the long waiting list in the public system, that if a person can afford to take advantage of the private system, they should be able to do that to alleviate the suffering that we have to go through while waiting for our name to come up. Dr. Day's points are well taken in regard to the fact that a private clinic can operate more efficiently then the public hospitals. At the present time I am trying to get an appointment with an orthopedic surgeon and I can't get an appointment until sometime in 2003.
I believe that the changes that Alberta is suggesting in their health care system will be much better for people that require elective surgery.

Date: November 24, 2002
Name: Alex D. Smith

Comments:
I agree with all the points that Dr. Day covered in his article of Readers Digest December issue.
I believe our current health care is top heavy in management which is very expensive. I think that there is a lot of vested interest in our public system and they would rather stick with the status quo rather then see health care go in a new direction.Union members dont want to lose their bloated salaries. I take my hat off to Dr. Day.

Date: November 24, 2002
Name: Gloria Emery

Comments:
I think that the private clinic for day surgery is a good thing and that all Canadians should have access to them. It would eliminate the line up to the hospitals and reduce our overall medical costs. The doctors are going to make this money no matter which way it is done, why not be sensible and efficient. Why should an out of province person, a prisoner or a government employee have access to this clinic and the Canadian taxpaper who pays for these services, not have the same privleges. It is about time got over the fear of people making money on medical procedures and improve our health care system by allowing private day surgery for all Canadians paid by the medical plan. Allow the clinics to be owned by Canadians investors only, to keep out the profiteers from other countries.

Date: November 24, 2002
Name: Name withheld

Comments:
I definitely think a person should be allowed to have private health care. There is so much abuse in the Health Care System...there is no way it can continue...A elderly couple told me their eye doctor said they both had cataracts and they should be removed...I advised them to get a second opinion...Guess What??? they never had any cataracts..This is just a small example...

Date: November 24, 2002
Name: Edna Craig

Comments:
I am against two tier medicine that is funded by the health care system taking funds from that system. However, there are people already being funded for health care by the government who are not part of the system: i.e. military, RCMP, prisoners, welfare recipients in some cases. If these people could be treated in private care facilities, then space in the public system could be made available for the rest of us. This makes sense to me and does not suggest that having money of your own guarantees you space. Why should people be sent to American facilities with payment by our health care system when these services could be available in Canada? Why should public facilities be hamstrung by the administrative layer to the extent that they currently are?
It is time we got past the rhetoric and looked for sensible answers.

Date: November 23, 2002
Name: Donn Watt

Comments:
RE: "Shouldn't We Have The Right to Choose"?
Yes! I agree wholeheartedly with Mr Day's position. Canadians are being denied their rights to quick and effective health care. Some patients, such as the ones mentioned in this article (many of whom are in public service jobs incidentally) jump the queues that the rest of us must wait in. Patients are suffering and dying unnecessarily because of long waits for access to the public system. Why? Because too many of us hate the fact that investors could profit from treating me. Frankly I don't care so long as my care meets government standards (easily measured) and doesn't cost the taxpayer more. As the article points out, Mr. Day's private clinic can perform these surgeries for "a little more than half what it costs the public hospitals to perform the same procedures". I want the right to choose where I get my medical care, just as I choose my dentist, optometrist, and many other health service providers. Please, will those like Roy Romano please take off your blinders?

Date: November 23, 2002
Name:

Comments:
I do not agree that this is the answer ..the rich get richer and the poor get poorer.. and a lot of time these are left out ..not everyone will be able to afford health care services...this way but when emergencies arrive they should come first...

Date: November 22, 2002
Name: Tom Miller

Comments:
I see no reason in the world why we should not have more clinics such as Dr. Days in Vancouver. Anyone should have the choice of waiting for a publicly funded hospital to perform surgery or pay a small fee in a private one. The provincial health plans would then be required to pay the bill. Anyone who remembers the days in Canada before the advent of public health insurance would agree though, that we must never again get ourselves into a system where we have to pay our own hospital bills. It would ruin most families.

Date: November 22, 2002
Name: keith brown

Comments:
after reading the artical on Dr.Day ,i could not agree more.all the more power to him and the likes of him.we hear all too often of stories about how they send people out of the country at a great deal of expence,because they don't want to set a precedent at home.then it ends up cost 3 or 4 times more to have the operation done when the money could be better spent at home and the money stays here.why are we so afraid that some one is going to get ahead of us in the line,when they more than likely need it worse than they do.Keep up the good work Dr. and full steam ahead.

Date: November 21, 2002
Name: Robert Myers

Comments:
Re article by Karen van Kampen; After a great deal of rhetoric, extolling thje questionable benefits of private health care, one fact emerges. Dr. Brian Day will become very wealthy along with his investors. If Day gets his way, and elective surgeries were contracted out to private clinics, such as Cambie, he would become very wealthy on top of his present wealth. In spite of what Day says, private clinics will see the death of the publically funded health care system and universal access. I understand very well the profit motive, and I am not against it, having been General Manager of a plant in Toronto. We competed against other like companies, but health care is quite a bit different. A recent study of UD hospitals exemplifies this. The study measured the death rate in all hospitals. It was found that the death rate was much higher in for profit operated hospitals than it was in those hospitals operated by not for profit organizations. One could conclude, that hospital administrators, when faced with a choice between patient care and achieving a profit for investors, opted for profit. I'm very afraid that the publically funded system of univeral health care will vanish to be replaced with corporately run facilities. If you have the money, you will be treated.