Photos: Lyle Stafford |
I know it's early days, but
give us an assessment of how your presidency is going
so far. I'm just a couple of weeks in and most of
my time has been spent talking to the media in interviews.
But also I'm starting to try and strategize as to how
I or we, the CMA can achieve some of the
goals we set up for this year.
Like what? The number one
thing I'd like to see is an acknowledgement that the
status quo is not working. Secondly, some definitive
action that will achieve a significant reduction
or at least lead to a strategy to make a significant
reduction in all wait lists in Canada. I think
it's a realistic goal.
That's realistic? Really?
Yeah. I think one of the things Canadian governments
haven't realized is that it's cheaper not to keep people
waiting. Amongst developed countries, Canada and the
US are fighting it out for last place. I do resent when
people accuse me of wanting a US-style healthcare
I don't. The US has a ridiculous healthcare system that's
going bankrupt.
So what country's healthcare
system do you want then? The UK, France, Germany,
Belgium, Japan, Austria. None have wait lists for necessary
services, all have access based on need and not ability
to pay. By coincidence, or perhaps not, all have some
private components. Governments in Canada are starting
to look at what the positives and negatives are in each
country.
The British system isn't without
its detractors. True, they have made some mistakes
but we can learn from their mistakes.
In August you received a letter
from British colleagues urging you to do just that
"learn from our country's mistakes and reject market-style
policies leading to privatization." For some disgruntled
doctors to write a letter doesn't influence me at all.
NRM readers put Brian Day through
his paces
Dr
Chris Chan, from Lloydminster, AB, asks:
Do you think the controversy about public and
private healthcare has been overblown? Yeah,
I think the private-public debate is nonproductive.
Patients want excellent healthcare. They don't
care whether it is delivered privately or publicly
they just want access.
Dr
Johan L Van Zyl, from Melville, SK, asks:
Will public and private care coexist or do
you think one will eventually beat out the other?
They already coexist. We have private delivery
of public healthcare for the most part in family
practice in Canada. As we expand availability
and the scope of what we can do in healthcare,
tax-funded healthcare won't be able to offer everything
to everyone for free. That's the reality.
Dr
Roy Maroney, a South African IMG from Kelowna,
BC, asks: How can the CMA better
look after IMGs who are being exploited by slave
wages during their qualification? [Laughs]
As you know, I'm an IMG, so I'm obviously supportive
of IMGs. We have to understand that every College
has to be able to validate the qualifications,
but they don't have the capability to audit every
medical school in the world. It's a very complex
area there has to be a way to get more
doctors, and IMGs shouldn't be used as slave labour.
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As the owner of a private surgery
clinic, you'd stand to benefit from more private healthcare.
Isn't that a conflict of interest? One of the reasons
for unhappy doctors in Britain is that when you eliminate
wait lists, private businesses suffer. It's a paradox.
In Canada, by using patient-focused funding, not only
will it reduce demand for private healthcare, but it
will increase opportunities for unionized healthcare
workers, which is why it's strange they're in opposition
to the concept.
Um, that doesn't really answer
my question, but let's move on. Has your election boosted
your Cambie Surgery Centre's business? No. And it's
actually lessened it for me I've had to cut down
on my time there.
By how much? I don't know
yet, but significantly. I would think I'll have to cut
back between 50-60% of my clinical work compared to
before I got involved with the CMA, before last year.
I had to cut back already last year as president-elect.
What will be the biggest health
story of 2008? Michael Kirby. I have a lot of respect
for him. If his [Mental Health Commission] report comes
out next year, that's it. The hardest doctors to see
in BC are psychiatrists.
Do you want to slay the Canada
Health Act? I want it updated for the 21st century.
The trouble now is a minority government is unlikely
to want to dabble in it. I don't think the principles
of the Canada Health Act are being kept none
of them.
None? Is it equal with costs
for drugs? Is it accessible with massive wait lists?
Is it portable when Quebecers can't come to BC because
doctors won't take their health cards? Is it universal?
Not really, we have prem iums in some provinces. Is
it publicly administered - well, okay, that's the only
one.
Do you have any aspirations
to get into non-medical politics someday? No, I
think medical politics is a lot more challenging.
You hesitated just then.
Yes, but it depends what you mean. I wouldn't see myself
doing that at all. I do admire some politicians because
they take so much abuse. I take some abuse, but they
get a lot.
What caused the biggest stir
at this year's CMA meeting? Co-payments. This is
one of the myths I'd like to break - co-payments are
absolutely rampant in the Canadian health system in
every area. You can get a better cataract lens or better
hip replacements if you pay.
Are you pals with Jacques Chaouilli?
I get along well with Jacques. He's a very affable man.
We were at the Supreme Court together. We're not close
friends, but I don't think we have any bad words to
say about each other.
If you guys hang out, what would
you get up to? He's French, and French food is my
favourite, so if I was in Montreal, I might go to a
French meal with him.
Speaking of food, what's your
fave Vancouver eatery? I have two - no, three favourites
- no, four. One is Le Crocodile, pure French food. Another
is Cioppino's, which is Italian. Another, Il Giardino,
also Italian. Another is Bishop's, continental west
coast.
Have you ever been in a fight?
When I was a kid, many times. I used to box as a kid.
I stopped once I lost.
You must have lost badly.
I got my nose broken. That was pretty bad for an 11-year-old.
I still like watching boxing on TV, though it's probably
not supposed to be acceptable for Canadian medical leaders.
Interview by Sam
Solomon
See our earlier Q&A with Dr
Brian Day: "The
man behind the melee" (November 15, 2006)
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