Wrong prescription [user fees]

TheStar.com – Opinion/Editorial
Published On Sat Sep 25 2010

In Canada’s health-care wars, user fees refuse to die. Almost since the dawn of medicare, a bitter (and often sterile) ideological battle has been waged between two rival visions: health care that is barrier-free versus user fees that would discourage alleged patient abuse.

Quebec is the most recent example. The province announced a controversial $25 fee per visit in its March budget. This week, the government dropped the idea as unworkable. Finance Minster Raymond Bachand admitted the prescribed cure was worse than the suspected disease: “Everyone told us it wasn’t a good idea.”

Quebec’s proposed experiment was being quietly watched by proponents of this panacea. Other provinces might have followed suit. Even the federal Liberals embarrassed themselves by initially giving their blessings to the Quebec plan.

But doctors, nurses, patients, health administrators and researchers argued against any fees. The notion that rising health-care costs can be curtailed by making the sick pay — or stay away — is based on the flawed premise that patients are wilfully abusing the system. Sick people can’t write their own prescriptions or get in to see specialists without referrals from their GP. The big ticket items in the health budget — prescription drugs, specialist fees and hospital procedures — are determined by doctors, not patients.

User fees don’t save money. But by discouraging the poor from seeking early treatment or follow-up care, they can exacerbate illnesses. The health-care system needs to achieve greater efficiencies, not false economies.

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