Although Dr Geoffrey Appleton, BCMA president, has concluded that the Conversation on Health failed to provide any consensus (“Consensus? There is no consensus,” BCMJ, 2008;50(1):10, Health Minister George Abbott suggests otherwise. In his greeting on the web site www.bcconversationonhealth.ca, Mr Abbott mentions four points that he has taken from the government’s process to elicit opinions from British Columbians about their health care system.
The first is that the citizens want “A strong and sustainable public health care system that delivers services to all British Columbians regardless of where they live, their incomes or their backgrounds and cultures.”
Dr Appleton, the BCMA, and the government have stressed that the Canada Health Act be amended with a sixth principle of sustainability. According to the summary of input, which has a meagre paragraph on the reactions to this proposal, consensus was in fact elusive on this proposal. If sustainability means health care should not overwhelm provincial budgets, many citizens would likely agree.
If it means “determining the scope of publicly funded services [and] implementing cost sharing arrangements,” as the BCMA said, agreement would be more difficult to reach given that BC has a budget surplus.
Public spending for health care in Canada is already on the low end of the spectrum among OECD countries. Physiotherapy, dental care, eye care, and many medications are not covered by Health Insurance BC, a situation about which participants in the Conversation complained.
How much more cost does the BCMA leadership suggest be shifted to the individual, along with the burden on physicians of collecting payments from patients and insurers?
—Joanna Cheek, MD
—Margaret McGregor, MD
—Francois Proulx, MD
—Randall F. White, MD
—Robert F. Woolard, MD
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