Foreign trained doctors ?   Why not look at foreign health care
systems !

The Health Care crisis in Canada gives new meaning to Shakespeare's
strutting and freeting our hours upon the stage.   The  present
Ontario Minister of Health Minister George Smitherman announced he
will, over the summer,  work with the "College of Physicians" to
introduce a bill on allowing "foreign trained"  doctors to be ‘fast-
tracked' into Canada.   The inability of patients to have a family
doctor has and will create serious complications to patients, which in
turn creates a greater demand on the services required of the health
system, not only jeopardizing the patients health, but also putting a
great deal of stress on doctors, nurses and other care givers.    No
one is willing to grab the proverbial 'bull' and deal with it; let me
explain.

One of the most important lessons I learned was as a volunteer
director at Bay Credit Union.  It was a lesson on ‘paradigm paralysis"
or in more relevant terms .the inability to think outside the box.
Canada's Health Care system needs some new creative input, input we
can receive from other countries.  I say this because according the
Watson/Wyatt report of 2000, Canada's health care system was ranked
superior to that of the USA.  The USA was ranked 36th, Canada's system
was ranked 30th, behind Columbia while France and Italy were ranked in
the top two.  If the current Minister of Health is looking to ‘import'
foreign trained doctors, perhaps we should be looking at foreign
countries for different models that are known to work.

To the matter of the College of Physicians and Surgeons, let me give
some observations based on an incident that happened in 1989.    This
involved  a ‘Foreign trained" Canadian citizen who was hoping to
return to Canada and set up an office with his wife and start a
family.   When the possibility was mentioned to another doctor, it was
clear that there was a great deal of resistence to having another
‘competitor' set up office in the city.  This Canadian Doctor, foreign
trained  is now practicing in Italy.

The Minister should not be surprised that "The College" is burdened by
a payment system that does not  guarantee an income to its doctor.

Our current publically funded health system pays most doctors ‘a
measely fee' (yes that is my opinion) per visit, that creates an
inverse relationship between your health and your doctors income; that
is a major systemic flaw.  The end result is that most doctors have no
guaranteed salary or income, which creates a field of competition
that, according to simple economics' rewards the suppliers of services
if there is a shortage.

If we go back to the top two countries in the world, France has a
system whereby patients pay their doctors first, and then get
reimbursed from the government.  This adds an element of
accountability and ‘fee's would be more reasonable to both patient and
doctor..

Italy on the other hand pays its doctors a flat fee per patient per
year, that results in a guaranteed salary per year per patient.  Italy
boast having the highest ration of doctors per patient.  The payment
also indirectly creates a financial incentive that rewards good
doctoring, good treatments and prevention.   Tragically the payment
system in Canada, a fee per visit, does exactly the opposite, while
encouraging a shortage in doctors.  How what system would you
prefer ?.

This information was provided some 10 years ago to the former Minister
of Health for Ontario, the Honourable Tony Clement, who is now the
Federal Minister of Health and he and the current Minister of Health
seem unable to look beyond  the ‘borders' of the health care systems
in Canada to appreciate that we have in this world other Health Care
Models with proven track records that are more efficient and
effective.

So why with the obvious comparative rankings does Canada in its
discussions on health care systems always focus on the American
system, and not the systems  used in  France and Italy, who are
considered the top two in the world ?

Caesar J. B. Squitti

Wrighter:  Thunder Bay, Online
http://www.thunderbayonline.com