Dear editor:

There has been considerable recent correspondence in The Lake Report regarding our health care system.

Let me deal first with letter writer Richard Wright’s concern when his brother-in-law was charged for an iron infusion, “Liberals, NDP need to act to stop privatized health care,” (March 16).

A number of medical items are deemed “uninsured services” by the provincial government, e.g. if a physician has to send a letter to an insurance company on behalf of a patient.

It is incumbent on the physician to make it clear in advance what services are not covered.

The Ontario Medical Association has provided to physicians a list of charges that it feels are appropriate for such services.

If a patient feels they have been charged for a service that should have been covered by OHIP, they should call the College of Physicians and Surgeons of Ontario and explain the circumstances.

If the college feels this was inappropriate, the patient should lodge a complaint. The college is then obliged to investigate.

Believe me, no physician wants to get a letter from the college – “Dear Dr.: A complaint has been made …”

The thorny issue of private health care is more complicated.

Brian Crow put it well in his March 23 letter, (“We already have a long list of private health care providers,“) by pointing out that virtually all medical services outside hospitals are in the private domain.

Physicians are self-employed, for-profit contractors. They pay for their staff, equipment and rent (to for-profit corporations that own the office building).

The fee for providing each service to the patient is set by the government. The “profit,” when all these expenses are paid, is the physician’s remuneration.

All too often the administrative and financial burden of running an office with no ability to take a holiday (unpaid) is too much and family doctors simply quit.

Many opt to join a walk-in clinic or go on an emergency room rotation at the local hospital where the overhead is much lower and when your shift is over you’re free.

The government did have plans to create family health teams where nurse practitioners, dietitians, physiotherapists and mental health counsellors were provided to groups of family doctors to help spread the burden.

But this has now been abandoned in many areas, which is a scandal.

Private hospitals providing services such as hip and knee surgery simply siphon off staff from regular hospitals, leaving them with the “difficult stuff” – cancer care, ER and ICU staffing.

Of course, God forbid, if you should have a heart attack or other serious complication after the hip operation in the private facility you’ll end up in the ER at your local hospital putting even more burden on its resources.

It would be far cheaper to increase funding to hospitals to allow their operating rooms to run seven days a week to decrease waiting times but I suspect staffing may be an issue, as it will be in private facilities.

As for nurses becoming millionaires in these clinics – not likely. If they want to maximize their profits, the clinics will try to pay the nurses a pittance.

We always seem to forget about the law of unintended consequences.

Dr. Richard James
NOTL