Equality and Universality

That's a barrier to parents being able to get their children vaccinated, to parents being able to get their baby's well-baby checks done. It is highly important care that is paid for by our tax dollars. To require people to pay again for it is really inappropriate and unethical.... It is an insult to all of us who are paying taxes for equitable access to medically necessary health care. Dr. Danielle Martin, Canadian Doctors for Medicare

At one time in the not-too-distant past, there was no universality of medical care in Canada, much less the Province of Ontario. You had the wherewithal to pay a doctor's fees and a hospital stay or you did not. That was the bad old days. Now universality is guaranteed to Canadians through the funding of universal medicare that is paid for through federal tax dollars, doled out to the provinces.

In the not-so-distant past nuclear families did not exist. But extended families living in close proximity did. Where older family members who had experienced health problems, medical emergencies and the manner in which to react as a new mother to the demands of caring for a new baby advanced a helping hand or two, gave advice and encouragement.

Help was available from that source where it now no longer is.

A pediatrician in private practise who bills OHIP the normal fees for patients, also charges families a $1,000-plus "membership fee" which guarantees nervous parents that she will be available to them virtually around-the-clock. For that annual fee they can also be assured that through her version of (illegal) private health care, there is an informed, professional staff also on call to assist.

Dr. Karen Dockrill takes her profession seriously. She involves herself deeply with her patients' needs, and through her they are exposed to additional, allied health care professionals to aid them in their all-consuming and worrying work as new parents. She is accessible, personally, by telephone, and her patients claim her calm advice has stopped them from accessing hospital emergency units on occasion.

The confidence, practical advice and professional services they receive through their membership in Dr. Dockrill's Mom and Baby Depot located in Whitby, east of Toronto, has meant money well spent to these patients. The College of Physicians and Surgeons of Ontario has laid disciplinary charges against Dr. Dockrill, and she has been warned she will have her license revoked should she refuse to stop charging extra fees.

Without those extra fees at her disposal, Dr. Dockrill will no longer be able to operate her clinic in the same way; discharging some of her office staff, and removing some of the intensive services she had previously offered. There are far more physicians charging mandatory additional fees to their patients in exchange for specialized services, than Dr. Dockrill alone.

She feels she is being made an example of, as a warning to all those others who have chosen to offer exemplary professional service beyond that given by most doctors on a tight schedule, living within OHIP rules and obeying the law by not imposing additional charges on their patients. Somehow, it doesn't seem quite as out of whack when voluntary fees are suggested for certain services.

But the "block fees" levied by some private clinics does create a two-tier system of medical care. Those who can afford the freight and who will not deny themselves the opportunity to be entitled to special care beyond the normal call of professional duty can take advantage of the significant add-ons. Obviously, a huge number of other people would find the mandatory "block fees" beyond their capacity to pay.

The existence of these clinics who charge for services beyond what medicare normally funds is not quite fair, argue its critics, and they're obviously right. On the other hand, we also have universal education, where taxes fund the primary and secondary education system. Despite which, increasingly, materials once considered the school boards' responsibility to supply to students as part of their normal tuition is now charged to parents.

Moreover, when a family has more than a single child enrolled in the school system and must pay for an ongoing array of school equipment, in addition to which there are trips and special events which children are encouraged to attend, but which must be paid for by the families themselves this creates a hardship for some families.

Those families who cannot afford to pay additional fees for their children see their children receiving not equality of exposure to opportunities and treatment, but becoming victims of a two-tier education system.

What is wrong for one social benefit to be wrenched away from universality toward specialized treatment for those who can pay doubly, is wrong for any other social benefit, equally.