Health unions’ ad sends a positive public solutions message to Canadian physicians

CMA delegates encouraged to reject health privatization, payment-by-results funding model

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“Public health care. Let’s look at the evidence” is the message that B.C.’s health care unions are sending to Canadian physicians in an ad placed in today’s Globe and Mail and Vancouver Sun as doctors from across the country meet in Vancouver this week for the Canadian Medical Association’s annual general meeting.

The unions’ ad encourages CMA delegates to champion proven solutions already at work in the public system – streamlined surgical clinics, improved long-term and home care, multi-disciplinary community health centres – and to reject privatization moves including a hospital funding model known as payment-by-results (PbR), or as some call it, patient-focused funding.

Newly-installed CMA president, Vancouver-based Dr. Brian Day, is promoting the competitive, market-based payment-by-results despite evidence from the United Kingdom showing that PbR pits hospital against hospital and treats people as consumers instead of patients.

Earlier in the week, British doctors from the National Health Service Consultants’ Association sent a letter to Dr. Day and the CMA warning of the trouble the United Kingdom’s public health system, the National Health Service (NHS), has had with that country’s privatization experiences, particularly payment-by-results.

In the letter, Drs. Jacky Davis and Peter Fisher write: “Your counterpart in the U.K. – the British Medical Association – recently voted at its annual meeting to oppose payment-by-results because it has not worked out as planned. The BMA has repeatedly voiced its opposition to the competitive model…”

Payment-by-results, they continue, “…creates profitable and unprofitable patients and services… The result is overdiagnosis and overtreatment of some patients and neglect and undertreatment of others. Particularly vulnerable are people who have chronic care needs or physical and/or learning disabilities… PbR has, ironically, resulted in less efficiency as greatly increased administrative costs add up for coding, billing, accounting, advertising, and combating fraud.”

The six unions – Hospital Employees’ Union, BC Nurses’ Union, Health Sciences Association, B.C. Government and Service Employees’ Union, Union of Psychiatric Nurses, and Ambulance Paramedics of B.C. (CUPE 873) – collaborated on the ad to urge not only doctors but also politicians to “look at the evidence” and stay away from PbR.

They are calling for “evidence-based innovations that will make public health care stronger for all Canadians.”