Gerald Tevaarwerk
As a physician, I am glad to see that the residents of Lake Cowichan are meeting to find answers to their doctor shortage.
However, the Vancouver Island Health Authority is not responsible for the shortage, nor is it in a position to fix it. Rather, the problem lies with the fact that we have half the number of physicians per capita compared to the countries that lead the world in the provision of medical care, such as the Netherlands, Denmark and other European countries with social-democratic political systems similar to ours.
The amount of money spent by those countries on medical care — which invariably includes all drug costs and basic dental and eye care — is similar to that spent in Canada, either in absolute dollars or as a percentage of gross domestic product. Physician remuneration is also similar to that in Canada.
Where they do differ is in their decision-making regarding the need for health-care services. Whereas ours and others like the National Health Service in Britain are politically led, the systems that score highest are led by an independent group of professionals assisted by interested citizens. The result is that decisions are not influenced by political considerations concerned about re-election and obtaining funds for running for election from sources that might benefit from the subsequent political decision-making.
One result is that in our system, physicians have been degraded to “health-care workers,” instead of recognizing them as the devoted, vocational professionals they are. Telling in that respect is the fact that for non-procedural tasks, physicians are now, in essence, paid 29 cents for what earned them a dollar 30 years ago.
Guess what the result of that has been?
The way forward is to make our health-care system independent of elected politicians, much like the Bank of Canada and our judiciary, allowing it to make decisions based on needs, including an adequate number of physicians, the single most important variable in determining the quality, cost-effectiveness and accessibility of medical care.
Gerald Tevaarwerk is a consultant specialist physician, a member of the executive and past-president of the Victoria Medical Society.
