Canadian Health Care System

Fed Up, Doctors Across Canada Go On Strike

Canada's universal health-care system -- which features price controls and health care rationing by waiting --- is generating a wave of strikes. Physicians complain they are overworked and underpaid.

  • Doctors in British Columbia staged a Friday through Sunday work stoppage this past week to protest a $90 million gap between the government's cap on their income and the actual value of the services they say they provide.

  • Last week, doctors in 60 rural Alberta communities -- almost 80 percent of the province's 500 rural doctors -- closed their offices for one day to pressure the government for more money, since they are only being offered $6 an hour for being on call after normal working hours.

  • In Quebec, many health-care practices were closed last Thursday and Friday, and the province's nurses have announced they will refuse to work overtime this summer -- complaining that due to shortages, they are burned out.

  • According to British Columbia's medical association, the wait for coronary bypass surgery is now 30 weeks -- and patients are dying because of the delay.

Canada's physicians are leaving for the U.S., where doctors make an average of two to three times more than those in Canada. The country lost 513 doctors in 1996 -- but that was only one-quarter of all the health-care workers who leave for the U.S. every year.

Source: Editorial, "Doctors Who Go On Strike," Wall Street Journal, June 17, 1998.

Socialized Medicine Canada-Style: Nobody Likes It

To hold down skyrocketing costs and still comply with mandates of the Canadian Health Care Act -- which requires universal health coverage from the government -- the province of Ontario passed a so-called Savings and Restructuring Act earlier this year. It attempts to attack the problem of out-of-control costs by rationing and price controls.

  • Over the past five years, increases in Ontario's mandated physicians' fees have been restricted to less than 1 percent a year.

  • Doctors have been required to return to the government one-third of their gross income over $251,000 Canadian (US$183,700) , two-thirds of their gross income over C$276,000, and three-fourths of their gross income over C$30l,000.

  • Their net income after expenses, but before taxes, is 40 percent to 50 percent less than their gross income.

  • In spite of these measures, physicians' total billings are increasing by 13 percent a year.

In June 1995, after four years of socialist rule -- during which the provincial government's debt load doubled -- Ontarians elected a conservative government which drastically reduced spending. In January, Ontario passed the Savings and Restructuring Act.

Although aimed at cutting costs it has had these results:

  • Ontario physicians have become civil servants -- although without pensions or unemployment insurance.

  • The minister of health can now unilaterally close hospitals, set physicians' fees, tell them where they can work, what services they can provide -- and remove at will their right to practice in the province.

  • Government inspectors can seize medical records without reason, warrant or patient consent as well as review doctors' billing patterns and rescind payment after the fact for services deemed to have been "unnecessary."

Physicians in the province are reported to be outraged by the new law.

  • In 1994, even before the act was passed, 350 physicians left Ontario -- with two-thirds of them coming to the U. S.

  • In 1995, 30 of the 95 graduates in family medicine of the University of Toronto moved to the U. S.

  • A survey of the 1996 graduates showed that 80 of the class of 95 would emigrate if the Savings and Restructuring Act were passed.

Among the other results of Canada's system of socialized medicine: the government has been "delisting" previously covered services and rationing of care to the elderly is widely practiced.

Experts say that of all current reform proposals, only medical insurance accounts will return decision-making to patients and their doctors.

Source: Dr. Jerafle C. Arnett Jr. (West Virginia practicing physician), "Ontario's Health Care: A Pox on Doctors and Patients," Wall Street Journal, July 12, 1996.

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