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“We're not lying: it's more profitable in the private sector. The public, we see that… I don't want to say it harshly… but it's almost voluntary. It's less efficient, it's less productive, we're stuck working on call, going home on Evenings, and work on weekends. It's like our good deed we're doing there. »
Many readers incorrectly swallow their coffee while reading This quote is in Journalism, last week. It was the letter from orthopedic surgeon David Blanchett, the owner of a private practice, who is threatening to give up his job at the hospital forever if the government prevents him from moving between the public and private sectors as he pleases.
The Minister of Health is actually considering taking various measures to reduce the phenomenon of dual medicine in Quebec, or at least slow it down, according to information revealed by our parliamentary correspondent Tommy Chouinard.
Quote from Drs Blanchett is a shocker, it's true. For the public, an orthopedic surgeon earns an average of $514,266 per year.
Photo by Alain Roberge, Press Archive
Drs David Blanchett, in 2014
“I think there are a lot of people who would like to volunteer for that salary,” joked…Drs Blanchett himself, was painfully aware that he had expressed himself poorly. “That's not what I meant at all. I wanted to talk about less efficient conditions.” [au public] Difficulty in accessing operating rooms. You really chose the wrong term. »
I would like to believe. I do not want to burden the doctor who undoubtedly expressed loudly and in an embarrassed manner what some of his colleagues were quietly thinking. However, it's not Drs Blanchett, the problem.
Nor is it the fact that an increasing number of doctors are doing the same by privately withdrawing from work before returning to work later. Not only that, though.
The fundamental problem is a universal and free health system that is slowly disintegrating, before our eyes, with no one doing anything about it – or very little.
Tommy Chouinard sent me a sample of the angry e-mails he received and they reassured me a little: Not everyone has lost the ability to be scandalized.
Fifteen years ago, all of Quebec would have ripped its shirt off in the face of such comments. The universal health system, the collective pride, was a sacred beast that should not be touched under any circumstances. Private care was taboo. Not anymore.
In Quebec, private medicine has been gradually downplayed and normalized. Celebrate, even. And with good reason, some will say: In the hospital, patients with Ds Blanchett must wait three years for a procedure that requires hospitalization. In private practice, “there's really no waiting list,” says the orthopedic surgeon. The patient can choose the date of the operation.
For a patient doomed to suffer from pain for three years, the choice can quickly become clear. All he has to do is replace his Sun card with his credit card.
For the same treatment, often provided by the same doctor, you now have a choice: pay a large sum or wait months, or even years. This is precisely the two-tier medicine that Quebec has rejected, in the interests of fairness. We have long refused to allow commercial logic to creep into our health system.
What happened ? Quebec has become Canada's champion for private health care. Clinics that charge fees for services covered by the Régie de l'assurance santé du Québec (RAMQ) are widespread.
For $5,000 per year, you are entitled to comprehensive services: family doctor, health examinations and follow-up. You can also pay a la carte: $250 per consultation, $25,000 for a hip replacement…there's something for everyone.
The exodus towards the private sector is gaining momentum. There have never been so many “non-participating” doctors in the RAMQ. In January, Quebec had 720 doctors, most of whom were family doctors. By comparison, all other Canadian provinces have… a dozen, according to one An alarming investigation conducted last year by Globe and Mail.
In 2003, Ontario banned its doctors from joining the public plan. And in Alberta, supposedly an entrepreneurial paradise, patients who want to get treatment more quickly have to turn to the United States or… Quebec.
How did Quebec get there? If you had to blame just one doctor, it would probably be Dr.s Jacques Cholley, that Frenchman from Quebec who waged an epic battle — including a hunger strike — in favor of health care privatization.
In 2005, the Supreme Court agreed that: Quebecers who have been on waiting lists for several months should have the right to obtain private insurance for care covered by the public plan.
The Choli ruling, which applies only to Quebec, had limited legal effect. But it opened a loophole. Since this ruling, the privatization of health care has gained increasing social acceptance in the province.
Keep in mind that this didn't really improve the state of our network.
Even today, Drs Blanchett defends what Dr. defendeds Chawli before the Supreme Court: The delay for the public is inhumane. Among his patients waiting for surgery are workers suffering from forced unemployment. There are elderly people who risk losing their homes and ending up in CHSLDs because they are no longer able to move around on their own.
There is a lot of tragedy caused by these damned waiting lists.
The health system is failing everywhere. If too many people go to the private sector, it is because the public is unable to treat them within a reasonable time frame. Who can blame them?
Private medicine is a “valve” of the public system, its advocates tell us. It has the huge advantage of reducing waiting lists. Then, for surgeons, it is better to work in the private sector rather than sit and wait to work in the public sector. The health network is in such poor condition that surgeons cannot access operating rooms, which are often closed due to a shortage of nurses and respiratory specialists.
This is all true. But it's also a vicious cycle.
If there is such a shortage of workers in the network, it is partly because many health workers choose to migrate to the private sector, where they do not have to carry a network that lacks everything.
However, the more dilapidated the network is, the more workers will move to the private sector, and the more dilapidated the network becomes…
It is true that in the short term, the private sector can be a valve for the public. But in the long run it won't save him. If we continue to allow it to grow, it could kill it.
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