Professional Opinions

The universality application of Canada's medicare is an important principle to uphold.  Yet, on the other hand, there are those who espouse that the universal program will only be enhanced if some element of private enterprise were introduced and melded to it.  In fact, under law, a Quebec challenge was upheld by a majority opinion of the Supreme Court of Canada. 

And while that decision applied only to Quebec, three of the seven judges found that current laws making it illegal to introduce a private element violated section seven of the Canadian Charter of Rights and Freedoms.

Universality's defenders contend that private enterprise supporting the public system would inevitably weaken the public system by withdrawing the services of some health professionals and luring them into private clinics for which people will pay additional costs apart from public subscriptions to be entitled to special care.  And the principle of equal quality of care for all Canadians would be breached.

On the other hand, there already exist private health clinics offering services to Canadians, covered under medicare, and sometimes charging additional rates over what medicare will pay for.  Like, for example the Shouldice Hospital in Toronto, other private health clinics in Montreal and in Vancouver, and no one is any the poorer for their presence, medically speaking; on the contrary.

On the other hand there is something to be said for those who can afford it, freeing up public access to publicly-funded facilities and care by opting to pay additional costs for personal and swifter service.  Wait times would be decreased as those who could afford it would go elsewhere, paying extra to receive the services they wish.

It may not seem fair to many, but the inescapable fact of life is that though the current system is all about level playing fields, life itself with its division between haves and have-nots is not a level playing field.

On the other hand, people don't necessarily have to be wealthy to decide on their own initiative that it is to their benefit to pay more for a service that more personally suits their needs.  And in the case of pediatrician Dr. Karen Dockrill, who charged her patients to pay additional annual fees of between $500 to $2,500 for more personalized care, her initiative and her patients' satisfaction did not appear to be excessive.

In return for that relatively modest additional sum they were assured of a range of services not normally covered by medicare.  Inclusive of around-the-clock telephone access to medical advise.  And assistance and advise with breastfeeding, and appointments with dietitians.  These patients were more confident in their ability to cope with their children's needs as a result of more intensive interaction with their primary caregiver for their children.

These are people who felt that they needed that extra help, and who didn't mind paying the extra fees.  There are other people who feel additional assistance is not required and wouldn't dream, even if they could afford it, of paying for extras such as Dr. Dockrill offered her patients.  She was valued by them as an expert who was concerned about the well-being of their families.  She offered extended, additional care.  And wasn't getting rich on it.

But the College of Physicians and Surgeons of Ontario concluded that she was guilty of unprofessional conduct, and was disciplined for charging patient fees for her Whitby, Ontario clinic.  She has had to wrap up her clinic.  The College suspended her for a month, and she had to attend an ethics course and submit to inspections.

To be perfectly fair, it's hard not to feel that she has been hard done by, through the current system.  On the other hand, she knew what she was up against.  The result of which shouldn't quite have surprised her to the extent that it obviously did.  The upshot is unfortunate, that Canada will be losing the services of a skilled health worker as she moves her practise to the United States.

The Ontario Medical Association is on record as supporting the college rules on block fees, while the Ontario Coalition of Specialists and Family Physicians thinks otherwise, decrying her treatment as unjust.

"The college just wiped her off the map.  I think it went too far.  They seem to be the henchman for the government, to keep an archaic, monopolized health care system going", commented Dr. Doug Mark, president of the coalition.