HomeMy WebLinkAboutClinton News-Record, 1986-04-23, Page 5CLINTON NEWS -RECORD, WEDNESDAY, APRIL.23, 1986—Page 5
Extra billing issue is about nothing but.. about everything...
4 in the provincial parliament. This Act Does anyone in this society really provide
• from
pagemakes it a serious offence for any doctor to "health care"? Well, if anyone does, I think
fearless thinking if any society is to survive. charge a fee above the benefits detailed in it's the farmers. A moment's reflection and
"Extra billing" is life the Emperor's new the OHIP schedule. That is, it allows a set of a little common sense will lead you to the
clothes. It doesn't really exist, except in peo- government- bureaucrats to set doctor's conclusion that food is the single most im-
ple's imaginations. The phrase "extra bill- fees. If passed, as I pointed out before, it portant factor in health care. Probably
ing" was thought up by the provincial pollti- will, by precedent, allow the bureaucrats to clothing and housing come next. Physicians
cians to describe the practice of some doc- set your wages or salary.or fees - that's what and surgeons probably come' a little way
tors in requesting full payment for their fees the fuss is about. You see, although at pre down the line. Are we then to have a society
( instead of the 70 percent or less of those sent 90 percent of doctors are "opted in' for where the government bureaucrats come
fees that the government health insurance the sake of their patients, they have always along to the farmers and say "you are the
plan pays in patient's benefits). For many had the right to "opt out" if things became most important people there are as regards
years, nine out of 10 doctors in Ontario have too bad. This proposed Act denies them that the health care of the community. We are
° accepted that 70 percent of their fees as full right and, by precedent, denies you that going to reduce your prices and wages by 30
payment. They have done this out of decen- right, possibly some time in the future. It is percent, because otherwise people can't af-
cy and respect for their patients, and to complete totalitarianism. ford you, and you are denying accessibility
avoid any financial barriers in providing to health care. And every time you disagree
medical treatment. These are' the "opted I hope all this isn't boring you, but I am with us, you will be fined $10,000." Do you
in" doctors. One out of every ten doctors in going on at some length because the prin- want to live in a society like that?
Ontario considers that his or her fees should ciples at stake here are so vital to every per- Perhaps the silliest aspect of this debate
be paid in full, and presently bill their pa- son in this province. It is also important P P
tients for the difference between the in- because I believe .all is not well with the that I have seen are the so-called "surveys"
4.1 surance plan benefits and the Ontario practice of medicine in Ontario at this time. carried out by the government and by
Medical Association schedule of fees. Thesevarious newspapers. In these "surveys"
thout" doctors. Could I give you a couple of examples ? people are asked whether they would like to
are
this practice of billing for the balance Let's look at a fairly typical operation that see "extra billing" by doctors banned. Not
• surprisingly, most of them say yes. Do the
people carrying out these "surveys" not
realize that if one were to ask the general
public whether they would like to pay only 70
percent of their lawyer's fees, their
mechanic's fees or their administrator's
fees, they would also say yes? People who
carry out these "surveys" reallyshould en-
sure that their brains are in gear before they
engage their pens.
Who is telling you all this anyway? Well, I
am a general surgeon and I bring to the
community . in which I practise (Huron
County) about 20 years of surgical ex-
perience together with five surgical
fellowships from four advanced western
countries, quite apart from post -graduate
qualifications in radiology, obstetrics and
gynecology. I work 80 to 90 hours each week
and provide, free of charge a virtually 24
( usually 30 percent is what the government we do in our local hospitals. Suppose we
has termed "extra billing". It is a deceitful have an old lady who falls and fractures her
and untruthful phrase because there is hip; this will render her immobile and cause
nothing "extra" about it. Everyone else in her death unless an operation is performed
this society, including you, dear reader, gets to cure this injury. For some types of frac-
approximately 100 percent of their wages or tures, we do a partial replacement of the hip
prices or salaries. Therefore it would be called a hemiarthroplasty. It is a several
logical to say that everyone is "extra bill- hour operation and one has to be a surgical
ing", unless they accept 70 percent of their specialist before performing it - that means
income as full final payment. That's why you are not going to be doing this sort of
"extra billing" doesn't exist; like the thing much below the age of 35. The fee for
`Emperor's clothes, it is a gimmick thought this procedure in the United States is ap-
up by deceitful politicians for their own proximately $1200 or about $2000 Canadian.
gain. The maximum allowable benefit under the
The distinction between the Ontario OHIP plan is $346.30. Well, you might say,
Medical Association (OMA) schedule of fees, that's not at all bad. But that is not net in -
and the Ontario Health Insurance Plan come; expenses for the average physician
(OHIP) schedule of benefits is crucial to in Ontario are about 50 percent of income.
understanding this debate. I am appalled at Allowing therefore 50 percent expenses and
the carelessness of the media constantly 50 percent tax, that particular "fee"
referring to the "OHIP schedule of fees". translates into about $90 in real income.
There is no such thing. Well, you might say, that is still not bad. But
OHIP is a government monopoly scheme, remember that that includes all the pre -
brought into existence I believe mainly as a operative care, several hours operation and
gimmick to voters with the promise of two months care after the operation. And in
universal free medical care. It was created that "fee" there is not allowance for paid
by legislating out of existence any com- holidays, there are no fringe benefits of any
peting insurance company (to the best of my sort and there is no pension, indexed or
knowledge the only place in the western otherwise. Are you surprised that each year
•world where this totalitarianism has occur- many highly skilled specialists leave this
red). Like any insurance plan, it provides country? Is this "increasing your ac -
benefits to its subscribers. It can no more cessibility to health care"? Do you care?
set fees than the Workmen's Compensation Let's look at another possible scenario if
Board can set wages. If you disagree with the proposed Act becomes law. Supposing,
this, stop to think what would happen if after this Act is passed, I am called up in the
some set of government officials were to ar- middle of the night to see an aged gentleman
bitrarily determine your wage, with no with a bladder obstruction. That too, is ex -
possibility of negotiation and no possibility tremely disabling and life threatening. Let's
of strike action. What would you think about suppose that, I treat him appropriately by
that? carrying, out a dilatation ,of the bladder
You may consider that the OMA schedule outlet. Let's suppose that when he has
of fees is high. Yet it is one of the lowest of recovered I discuss this with him and we
all the fee schedules in Canada. Its fees are come to a mutually acceptable fee for this
between one-fifth and one-tenth of fees procedure - say $10. For this I would end up
d theUnited St t d itsfees are
hour on-call service. I do not send bills to my
patients, even for items not covered by their
insurance scheme such as travel time and
certificates. I spend, free of charge, hun-
dreds of hours on committees, nursing
education and other public services. For all
of this, I expect neither adulation nor riches.
I do expect, however, some glimmer of
political awareness and common sense from
the general public, and some sense of
responsibility from the media.
The other day one of the weekend papers
carried a very large photograph of an angry
lady who was "outraged by her doctor's ex-
tra billing". It turned out that her doctor's
fee for a particular service was $50 and her
insurance plan had only covered $30. The in-
teresting thing is that she was not outraged
at her lawyer's fees, her accountant's fees
or any other fees. She was not even outraged
at her government insurance plan which
failed to meet her medical expenses. In-
stead she was outraged at her doctor who
presumably had given excellent service.
charge in a es an ee Such is the power of government brain -
generally lower than those charged in in jail (or be fined $10,000 which I obviously
most sacred cows, OHIP, (the vote -getter),
turns out to have all four feet made of clay
and is in imminent danger of collapsing, the
simplest and cheapest thing for the govern-
ment to do is find a scapegoat,
This is ail age-old political technique,
usually used by politicians whose moral
code belongs in the sewers. The Nazis did
this quite well for a time in Europe in the
1930's and early 40's by blaming all the pro-
blems of the National Socialist Republic on
the Jews. It is not difficult to pick on a hard-
working, relatively prosperous and easily
identifiable section of the community, be it
Jews or doctors, and, through one's virtual-
ly complete control of the media, brainwash
the public into believing that all it's pro-
blems are due to that particular group.
Witness the "outraged" lady in the weekend
newspaper.
I think there may be a second,
psychological, reason for the government's
paranoid hysterics. I think they are jealous
of the medical profession's tradition, it's
knowledge, and it's dignity. Many politi-
cians seem to lack all these things. I am told
that at one time there were certain ignorant
and primitive savages in Africa who used to
kill lions. They then used to eat the lions in
the mistaken belief that somehow they
would acquire the lion's courage and
strength. I sometimes wonder if, in the
same way, certain politicians hope that by
devouring the noble lion of the medical pro-
fession, they will somehow inherit it's vir-
tues. They will not. They will remain exact-
ly as they were before - primitive and
ignorant.
The tragedy of ali this is that in the for-
thcoming fight, someone may well be hurt.
It will not be the politicians. If you dislike
them, you can vote the opposite party into
power, and they will all simply change seats
at Queens Park. If you really dislike them
you can not vote for them' at all; I don't think
washing of certain individuals. Such is the
practice in Britain. cduld not afford). Do you know why? power of the press.
privateBecause the maximum allowable "benefit" You might wonder, as I wonder, why the
Do you know what percentage of doctor's under the OHIP plan for this procedure is provincial government would want to in -
bills in Ontario cost the patient anything at , $8.40. If you were in my shoes, would you troduce the Health Care Accessibility Act
all? Six percent. That means that 94 percent want .to practise medicine in Ontario under at this�w e,,,:with 's.iprecedeilt-settinge
of doctor's bills cost the patients nothing at ?t
these circumstances . totalitarianism • and government control,-
all. "So what's all the fuss about?" you In the new language of Doublespeak, I am and it's vicious and': almost hysterical
might say, and I would agree with you. The called bythegovernment, a "health care
fuss is about the- fact that the provincial threats against the medical profession.
government is using that six percent of professional". I don't provide health care. I What sort of brain would think up this par -
balance billing to vilify the entire medical diagnose and treat disease. But by using the titular piece of legislation? I think there are
profession and allege that they are "denying former title, the government can imply that two possible explanations.
accessibility to health care". The provin- any disagreement with the government on The major explanation is that, as I have
cial government has therefore introduced my part can be translated into "denying ac- already demonstrated, things are not well
an act. The Health Care Accessibility Act, cessibility to health care". Did you ever with the practice of medicine in Ontario, at
which is presently undergoing its readings hear such nonsense? this time. When one of the government's
Professional deve
All teachers in the Huron -Perth R.C.
System will be meeting on Monday, May 5,
at St. Aloysius School and Central United
Church Hall, Stratford for the last three pro-
fessional development days this years
devoted to the topic of writing.
During the morning, teachers will meet in
division groups to discuss the task related to
conferencing (or responding to students'
writing) which were assigned at the
previous P.D. day.
Keynote speaker, June Gravelle, a
language consultant with the Dufferin-Peel
R.C.S.S. Board, will introduce the topic of
the evaluation of student writing in her ad-
dress at the end of the morning.
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lopment days devoted to writing
Teachers will return to their division
groups for the first part of the afternoon in
order to discuss the details of evaluating or
analyzing'student writing at their particular
grade levels. Workshop leaders will .be
Gabrielle O'Reilly (primary), a consultant
with the Waterloo Separate Board; Sharon
Abbey (junior), language consultant with
the Perth County Board; and Gary Leduc
(intermediate), language consultant with
the Waterloo Separate Board.
At the summary session, teachers will be
informed as to the procedure for transferr-
ing of samples of student writing at the end
of the school year. Writing has been
facilitated this year by the introduction of
writing folders intended to provide a record
of the student's writing growth throughout
his schooling,from Kindergarten to Grade 9.
Levy up 9.79% ...
that will particularly worry them, because
they have already cunningly arranged in-
dexed pensions for themselves for the rest of
their lives - paid for by you and me. The
medical profession will certainly be hurt,
but will probably recover. Most doctors can
still double pr triple their income south of
the border, but much more importantly they
can thereby be permanently rid of the men-
tal midgets from Queens Park.
No, it is the sick and injured people of On-
tario who will be hurt most in the fight. I
spent about 10 years in a universal and com-
pulsory state medical scheme (the British
National Health Service) and believe me, I
know what it is like. 1 have seen a
bureaucracy grow so that there are now 16
civil servants for every hospital bed in Bri-
tain. I have seen people die on the waiting
list for an operation. I have seen "doctors"
who could not speak a word of English in
charge of a ward full of sick people. I do not
want to see these things happen again, in
Ontario.
But the issue is bigger even than that. The
issue is the independence and freedom of all
people in this province. It is the issue of the
right to compete, the right to trade, the right
to choose, and the right to find excellence.
That's why it's about everything.
Please help. For your own sake, not for
mine. Question authority. Write to the
Prime Minister, write to the Minister of
Health. Write to your Member of Parlia-
ment (and don't accept a form letter in rep-
ly). Duplicate and distribute this article if
you find anything that you agree with.
It is a cliche to say that any community
gets the medical services, and the govern-
ment, that it deserves. Lahink that you, the
people of Ontario, deserve the best of both.
Michael Watts, M.D., F.R.C.S.,
M.S., Ch.B., D.R.C.O.G., D.M.R.D.,
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• from page 1
the mill rate and totals $22,330. The residen-
tial mill rate for 1985 was 77.75 and jumped
to 83.97 for 1986. The commercial mill rate
was 91.74 in 1985 and is at 98.79 for 1986.
The Clinton Fire Area Board budget has
been set at $39,230, up $2,940 from 1985. The
budget is divided, according to use, between
Clinton, Goderich, Tuckersmith, Hullett and
Stanley Townships.
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