Here are two letters I sent to the president of the Alberta Medical Association recently. I strongly believe that our healtcare system is floundering. Doing the same thing going forward, is unlikely to yield better results, so a complete rethink is required.
Dear Dr Warren
You might remember me as the outspoken president of the section of OBGYN a few years ago. I was responsible for putting the issue of the need for private capital in Alberta's healthcare system on the AMA agenda, leading to a session of discussion on this. Not surprisingly, the motion was defeated.
I believe that the current situation in Alberta has proven me right. I want to point out a recent article, ironically sent out today by the AMA:
The reality is that our system has been tested, and found wanting. It has proven to be an embarrassment of epic proportions.
It is my strong belief that the main reason for this is our absolute fixation on the monopoly of state control and denying the reality of the need for private capital.
I also believe that given that the AMA is supposed to stand up for the ability of the system to serve our patients and the public, and physicians' role in it, it has failed miserably in that role.
I hate to say: "I told you so", and that I predicted the current situation, and of course I didn't foresee a pandemic being the trigger; but I indeed did predict exactly this outcome: a collapsing system which cannot possibly satisfy the healthcare demands of our population.
It is a disgrace, a shame and a travesty, and the AMA is culpable of standing idly by, while the system collapses.
I urge you and the current leadership to look again at the AMA's position on this issue, since I believe there has never been a better time for systemic change. That change has to come by first admitting that there is a problem, and that the problem is of our own making.
Magnus Murphy FRCSC
Past President: ASOG and AMA Section of Obstetrics and Gynecology
Dear Dr Warren
First I would like to thank you for replying to my email. I know you are extremely busy and didn't really expect a reply, given the controversial nature of it.
I will try to keep my rebuttal to your reply brief:
I think this is the key point from your reply:
"The commercialization of medicare is challenging for the AMA, as clearly the Minister would be diverting limited Physician Services Budget dollars to another company (presumably the lowest bidder) for the purposes of providing insured services."
I think it is factual for me to state that the reply missed the point of my argument. I am not arguing for any diversion of public funds to private contractors. FAR from it and absolutely not. I strongly believe in public healthcare using public funds and for that to be equitably used to service the needs of the population.
I believe one of the problems is that our vision is simply too small. We are blinded by the limited public funds available, and completely missing the huge opportunities in private capital markets. There are trillions of dollars in capital markets looking for investment homes. What I am envisioning is let's call it a "Mayo Clinic North" or a 'Cleveland Clinic North'. Built by, operated by, and entirely sustained by PRIVATE capital. It will run completely separate from any public investment, funding or control. They will sink or swim by offering quicker, better and timelier services to the population, who will be allowed to spend their own hard-earned dollars directly, or through private insurance, to pay for this.
Yes - the Canada Health Act prohibits this currently, at least if a Province wants to access Federal dollars. But this is the albatros - the Canada Health Act is outdated and a stone on our shoulders sinking the entire system.
My suggestion is for the AMA to again debate a complete overhaul of our mindset and look for innovative solutions to lobby for. This will bring industry (perhaps a multi-billion dollar industry), jobs, capital, innovation and wealth to our Province and help diversifying the economy in a green and sustainable way through a whole new industry. If Alberta is the first, it might even become a National champion for drawing talent and capital to our Province. It will take pressure off the public system and improve access to services for everyone, even those who cannot, or will not, go to such a facility. It will then be up to the public, and especially us as the medical community, to keep the government from reducing spend on the public system. If there is no reduction in public funds, and a major inflow of private capital, how could the system possibly be worse off? The oft used boogie man of the private system drawing scarce human resources is also an argument of the small minded. We currently have such a scarcity because of goverment imposed rationing: too few ORs, too few nursing jobs, with physicians, nurses and others going elsewhere (to a large extent the US), because they cannot find jobs. Private facilities will create jobs, compete with the public sector for salaries and therefore be good for healthcare workers' incomes, including physicians.
Our problem is our small vision, or lack thereof. We need to think big, and out of the box. Continuing to tinker on the margin with what we have, and within our 'small' allowed and available public budget is a recipe for similar or worse outcomes. Everyone knows the saying: "The height of insanity is doing the same thing and expecting a different result.”
Unfortunately, that is exactly what we are doing.