Vancouver to get first private ER in Canada

[HEyHEY]

http://www.cbc.ca/canada/british-columbia/story/2006/11/24/private-emergency.html

Canada's first private emergency room won't be allowed to accept patients from ambulances or let patients stay more than 24 hours when it opens next week.

The False Creek Surgical Centre, which already performs private surgeries for a fee, is slated to do a test run of emergency services on Monday and plans to be open for patients next Friday.

[angstlessk]

1. I recon their sole purpose is to show how private ER's have more

survivors than the national health care ones do...but since they only take abulatory emergencies their survival rate is already well above any other hospital?

[Nay]

2. HeyHey, why do you figure they've opened a private ER? Why

would anybody use it?

[HEyHEY]

3. There's a bunch of pricks

That are trying to discredit the social health system. This is another step in it all. Main thing is they are hoping to provide better care to try to further slander public health.

[Fenris]

4. They should come to Seattle and witness the glory of private health!

A 45 minute surgery at Swedish Hospital = $7,500+! If you don't have health insurance, expect to pay in full!

[rucky]

18. And all the surgeons in Seattle are too busy boinking each other...

[iverglas]

13. yup

I haven't actually checked into it, but I'd bet a fair bit that if you look behind this one, you'll find the BC group, and particular doctor, who were one of the main forces behind the Chaoulli decision of the Supreme Court in which the SCC found it to be contrary to the Charter to prohibit private insurance in Quebec.

Private insurance is the real issue, and it's what these people are really after in the endgame. No one can actually afford health care without insurance. $199 for an ER visit is one thing; try paying for bypass surgery out of pocket. Doctors are not so stupid as to forget what life was like when patients didn't have insurance.

Will employer-based supplemental insurance (which ordinarily covers prescription drugs, eyeglasses, semi-private hospital rooms ...) be covering the cost of these "ER" visits, i.e. will they be included when collective agreements come up for negiotation, or if non-unionized employers choose to incorporate this coverage? If they try to, then they will presumably be in breach of BC law.

Let's have a look. These were the interveners on Chaoulli's side in the SCC decision -- the Cambie guy is the big gun:

Cambie Surgeries Corp., False Creek Surgical Centre Inc., Delbrook Surgical Centre Inc., Okanagan Plastic Surgery Centre Inc., Specialty MRI Clinics Inc., Fraser Valley MRI Ltd., Image One MRI Clinic Inc., McCallum Surgical Centre Ltd., 4111044 Canada Inc., South Fraser Surgical Centre Inc., Victoria Surgery Ltd., Kamloops Surgery Centre Ltd., Valley Cosmetic Surgery Associates Inc., Surgical Centres Inc. (apart from a few right-wing asshole senators).

http://www.cbc.ca/news/background/realitycheck/sheppard/20060816.html

B.C. surgeon, Dr. Brian Day, president elect of the Canadian Medical Association, is facing an unwelcome challenge.

After five close-run ballots they chose Brian Day, a Vancouver orthopedic surgeon, to be their new president and, by extension, the president-elect of the CMA.

Day is an interesting guy. ... As the founder and chief owner of Cambie Surgery Centre, he is also one of the country's leading practitioners and promoters of private, for-profit health care.

So his elevation to the head of Canada's top medical lobby sends a powerful message to federal and provincial decision makers.

... Day's Cambie Surgery Centre survives largely by catering to injured workers, out-of-province visitors and others financed by private insurance, though over the last couple of years it has also won large provincially sanctioned contracts to help ease the backlog at some of Vancouver's larger public hospitals.

Ah, it seems to be one of the other Chaoulli culprits, for now:

http://www.theglobeandmail.com/servlet/story/LAC.20061125.BCEMERG25/TPStory/National

Patients will be charged $199 for a thorough examination and assessment. Further fees will be levied, as required, for additional tests and services.

Some will undoubtedly see the new clinic as yet another inroad by private entrepreneurs into Canada's medicare system. Mark Godley, founder of the Urgent Care Centre, already runs the private, for-profit False Creek Surgical Centre at the same site.

Centre spokeswoman Sherry Wiebe said the facility will not function as a private emergency ward, as some have styled it in the media.

The facility does not have an intensive care unit, and patients with real emergencies will be stabilized and speedily transferred to a public hospital, she said.

On that last point, many in the US will know how this already works there -- how patients without insurance/money are "stabilized" at private hospitals and shipped off to public/county hospitals. It happened to a friend of mine in Illinois. The nurse I spoke to at the public hospital shortly after he was transferred there explained how the private hospital in his case had broken US law by shipping him when he was not stable at all, but that it happens daily and nothing gets done about it.

Like private schools, private hospitals will skim the lucrative cream off the top -- the cases that don't need the expensive care, like the students who don't need the expensive special services -- leaving the public system holding the can.

[SoCalDem]

16. Kind of reminds me of homeschooling.. Homeschooled kids demand (and get)

access to the sports facilities, field trips & labs of the public schools, but don't have to rub shoulders with the riff-raff on a day to day basis

[moondust]

21. Surgery and advanced radiology.

Yep, that's where a lot of the big money is. These guys know how much their U.S. counterparts are making off private insurance.

[MrPrax]

5. Great news!!

While Vancouver loses clean drinking water , we gain a hospital....here we come 20th century!! Could electricity for the parts of the North Shore be far behind? I dunno, but Christmas IS just around the corner...

It's late 2006, so I figure we will probably have water, electricity and a learn enough to operate these things called http://www.canada.com/vancouversun/story.html?id=0dbd290b-7c25-469c-832c-b245d97e4b57">trains by the time the Olympics come to town. :eyes:

[zanne]

6. uh oh.

The disease is spreading to the north.

[Swede]

7. Oh,fucking great!

I have never heard anyone say they want to do away with the health system. Sure we bitch about waiting times,but we have the USA next door to show us what a treasure we have here. Money hungry assholes don't give a fuck.

[ncabot22]

8. I have mixed feelings about this

On the one hand, I'm nervous about a private emergency room opening. I do like our health care system, even with its flaws, and in no way want to move to an American style health care system. On the other hand, I can't help but think if we did allow a two tiered system (a mix of public and private clinics), waiting times would lessen for people such as myself who cannot afford private health care.

[w4rma]

9. Waiting times will lengthen, because the wealthy will let the public health system deteriorate

while they use their pay as they use health system.

Also, if the anti-public health care interests get entrenched then they will fight harder for laws that decrease the quality of the existing health care system.

[arikara]

10. Two tier is not a good idea

There's still a finite number of doctors... any guesses as to how many would opt for the high profit tier? The rest of us would be stuck with the longer wait times and substandard care.

Lots of info at this site: www.canadians.org

[ncabot22]

11. Thanks, arikara

I honestly didn't consider the possibility of doctors opting out of the public system and into the private sector. Thanks for the link, too.

[iverglas]

14. anybody who doubts the wisdom of prohibiting two-tier

needs to talk to people who experienced how it worked in the UK after it happened there. The NHS was gutted, and people who needed services had little choice but to "go private".

When I visited in 1994, my London friend's partner happened to be in hospital with some serious gynecological problems. She was in a brand new west-end private hospital, choosing her meals from the room service menu and enjoying the sunny atrium and all the health care she could want. When my mother fell her head on pavement in Stoke Newington and my friend rushed us to the nearest ER, we waited 5 hours to be seen by a resident -- for a head injury -- during which time I had to cadge coins from the low-income, largely immigrant folks we shared the waiting room with (a waiting room that had blood on the floor the whole time we were there), to buy cold pop from the vending machine, because the ER had no ice for my mother to put on her head.

Bizarrely, when the resident told us to go home and put ice on my mum's huge goose-egg, and I turned to the nurse who had had no ice for us and said "ice, what a novel idea", he said "that's what you get when you have a single-tier system". Instead of saying "this is a two-tier system -- and that's the whole problem, you moron!" I just said "huh; in Ontario, we have a single-tier system, and we also have ice."

It is absolutely inevitable, and every expert who has ever studied the issue agrees: allow a second, private tier and it will be the death of the public tier, be it sooner or later.

The Supreme Court ignored all the experts in Chaoulli, and all the careful study of their evidence that the lower courts had done, and got it all wrong, this time. But the case is a (very long) interesting read anyhow:

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

From the summary of the dissenting reasons of the 3 judges who got it right (Binnie, LeBel and Fish JJ. -- hardly the most progressive judges on the bench, interestingly):

The Quebec health plan shares the policy objectives of the Canada Health Act, and the means adopted by Quebec to implement these objectives are not arbitrary. In principle, Quebec wants a health system where access is governed by need rather than wealth or status. To accomplish this objective, Quebec seeks to discourage the growth of private sector delivery of “insured” services based on wealth and insurability. The prohibition is thus rationally connected to Quebec’s objective and is not inconsistent with it. In practical terms, Quebec bases the prohibition on the view that private insurance, and a consequent major expansion of private health services, would have a harmful effect on the public system.

The view of the evidence taken by the trial judge supports that belief. She found that the expansion of private health care would undoubtedly have a negative impact on the public health system. The evidence indicates that a parallel private system will not reduce, and may worsen, the public waiting lists and will likely result in a decrease in government funding for the public system. In light of these findings, it cannot be said that the prohibition against private health insurance “bears no relation to, or is inconsistent with” the preservation of a health system predominantly based on need rather than wealth or status. Prohibition of private insurance is not “inconsistent” with the State interest; still less is it “unrelated” to it. People are free to dispute Quebec’s strategy, but it cannot be said that the province’s version of a single‑tier health system, and the prohibition on private health insurance designed to protect that system, is a legislative choice that has been adopted “arbitrarily” by the Quebec National Assembly as that term has been understood to date in the Canadian Charter jurisprudence.

[Ilsa]

19. Substandard care? I have some doubts about that.

Some of the best ERs are the county ones. The big, dirty, crowded ones. They have some of the best people there teaching med, nursing, and PA students and students of other medical disciplines. Yeah, you might get triaged into a line if your case doesn't have critical symptoms, but it can also be your best bet.

But yeah, I understand your concern about good docs opting for a high profit tier. Not all are like that, though. Some with the best hearts and minds love their jobs in county hospitals.

[newyawker99]

12. Hi ncabot22!!

Welcome to DU!! :toast:

[ncabot22]

15. Thanks, newyawker99! eom

[CHIMO]

20. Hope

That you gave a tip to that taxi driver. He may be operating on you.

[brentspeak]

17. The Powers-That-Be in the USA have done everything to prevent a national health care system

to the complete detriment of the nation. Hundreds of thousands of Americans in lifetime debt because of medical expenses. Could be millions, for all we know.