Wednesday, August 20, 2008

Re: Betting your health on Canada's doctor lottery - National Post

Kelly McParland's August 7 editorial, "Betting your health on Canada's doctor lottery," suggests that doctors leave Canada because of the health care system. Undoubtedly some do, and some highly trained surgical specialists can earn significantly more in the United States. But what about U.S.-trained physicians who come to Canada because of the system? They exist and I am one of them.

According to the Canadian Institute for Health Information, more doctors returned to Canada than moved abroad in 2004, 2005 and 2006. Perhaps they were lured by low administrative costs, low malpractice insurance rates, and guaranteed payments. And if Canadian doctors think "government interference" is a problem in Canada, wait until they have to struggle with insurance companies for payment, have their patients' treatment dictated by insurance industry bureaucrats, or find they must treat patients for free. The U.S. is the only industrialized country that relies on charity care for a large proportion of its population. In Canada, I can treat all patients without having to worry about whether they have insurance coverage.

The assertion that all or even most U.S. physicians "practice the best medicine possible without government interference" is wrong. The U.S. government funds close to half of health care, and that money comes with many strings attached. The insurance industry has plenty of strings attached to the remainder of health care financing. I've been there, I know, and I'm glad I'm now in Canada.

Randall White, M.D., FRCPC