The Doctors Is Not In
In the last month, I have been sick. It’s a cold. It’s a cold that won’t go away. I am exhausted, but that’s my thing. My partner was worried for me, so she encouraged me to have this cold checked out. I went to a clinic on the way home. It was full and not accepting walk-ins. We went home wherein my cough was really bad. I heeded the call to go and try another clinic. It was closed at 6PM because of a shortage of doctors. It had a nice sign that pointed it out. I hit a third clinic: also closed. Like the others, it had a nice sign. Translation: VIHA cannot guarantee doctors in clinics, but they can mass produce little signs with red letter warning away the sick.
A general practitioner of medicine (a GP) has a key role in our preventative care. Minor issues can be headed off. Minor issues can create side effects that cause a decline in a patient’s quality of life.
In BC, we pay medical premiums. They are mandatory. We also pay taxes to cover medical services. The Federal government kicks the BC health care system money. There is lots of money coming into this system and sick people cannot get care. From one perspective, this is fine: if the administration is intact, then the system works. That’s the mantra of government. There are departments that hum along and deliver very little in the way of services. The health care system is broken. Here are some thoughts for how to fix the broken system:
GPs Don’t Have Limits
After med school, graduates want to become specialists. The work is more interesting. The specialization allows focus. Specialization means the mundane comes out of the formula. Specialists earn more. There has to be a way to change this formula.
Specialists bill the government for the services they deliver to patients. The specialists should have an annual billing cap-- something big so that most specialists are not impacted. For example, let them only bill $200k per year. When it comes to general practitioners, don’t impose a limit. Let them bill as much as they want. If the income is less lucrative for specialists, physicians may be more prone to stay in a general practice.
Specialists Don’t Need GPs
Take GPs out of the mix. To see a specialist, a GP has to refer you. If GPs are impossible to lock down-- if you can’t get a GP or you can’t get an appointment-- then you cannot get to a specialist. Why? Why do you need to have a GP say, “sure” before a specialist can see you? If the workload of GPs diminishes, they can see more patients. The health care costs drop.
Let Me Take Drugs
I am on two prescription medications. When they run out, I should be allowed to get more. Just that simple. A doctor said I should take a given medication, I should be allowed to get more of the same. Why does my $300 trip to the pharmacy have to be preceded by a $100 visit that the government pays for? I really think physicians get things wrong with enough frequency, that they are not the ideal gatekeepers that we make them out to be. It’s my body. I should be allowed to buy the right or the wrong drugs.
Give The Job To Immigrants
There are a number of immigrants and refugees coming to Canada. Some of them are physicians and nurses. They cannot work in their field because they need to upgrade and certify to work in our jurisdictions. Why not have the government offer to pay a modest salary and the expenses associated with upgrading, in exchange for a promise to work as a GP for five years?
Nothing gets the attention of government like having to testify, lose and hand over cash. If the citizens of BC sued to get services for their premiums, or sued to get their premiums back, service levels could change.
There are ways to change this system for the better.
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