🚀 go-pugleaf

In article <336@unbc.edu>,
	lyndon@unbc.edu (Lyndon Nerenberg) writes:

> 
> Boy, you sure know how to fire up an ex-Albertan :-)  The gov't has no
> business selling car insurance. Car insurance, like a car, is a luxury
> item, and should be dealt with by private industry. Medical care is not.
> Most of your arguments *seem* (I don't want to put words in your mouth here)
> to reflect an attitude that medical care is a business venture. I maintain
> that it isn't, and therefore should not be operated as such.
> 
   I certainly wasn't trying to convey that impression. The point I was trying
to make was that we roll over and accept increases in insurance rates, which
coming from a crown corporation which has a monopoly on [at least certain
parts of] the service is very much like a tax increase as far as I'm concerned,
yet we seem to find the idea of paying extra taxes ( or medical insurance
premiums ) for something as crucial as health care to be unacceptable. For 
many British Columbians a car is not a luxury ( at least no more than a 
home or clothing are )

   I think we have to separate the provision of medical care from the funding
of medical care. I believe a doctor has a right to treat his practice
like a business - in all financial and legal senses it is one. This doesn't
mean he doesn't have ethical and moral responsibilities which go beyond a
simple profit motive, but it does mean that he has a right to get paid for
the services he delivers. On the other hand I believe the goverment has a
responsibility to see that every resident of the province has access to
affordable health care. They have chosen to do this by offering a highly
subsidised medical insurance plan. What I see them doing now is gutting
this plan by making it so unattractive to the service providers that they
feel continuing to participate in it is an untenable business position. 

  I am under the impression that the fees BC doctors receive are 
comparable to what doctors in other provinces get, and are low 
compared to the U.S. If this is the case then I can certainly understand 
their anger at the government unilaterally setting a cap on their revenue
(ie they don't appear to be arguing about how much they get paid for unit 
of service, but they are complaining about the government limiting the 
number of units of service they are allowed to deliver). I believe most
doctors who don't opt out will treat as many patients this year with the
cap in effect as they did before it was implemented - and that one of the
factors behind this is an ethical obligation to properly tend to the people
who have entrusted their health to them. The government seems to be 
taking advantage of this attitude with their fee cap. In any field covered 
by a trade union the service providers ( employees ) would demand premium 
pay ( overtime ) if called upon to deliver more than a predefined amount of 
service, yet we expect the doctors to take a reduction in unit value for 
doing the same thing.

  If the government feels the doctors are delivering unnecessary services
then they should be open about declaring which services these are and
refuse to pay for them. If on the other hand the services are
required by the client then the government has a moral duty to pay the
doctor for providing them. 

-- 
========================================================================
Malcolm Dunnett    Malaspina College         Email: dunnett@mala.bc.ca
Computer Services  Nanaimo, B.C. CANADA        Tel: (604)755-8738