Washington Post, March 7, 2018
Seriously, could this EVER happen in the United States?
Who the heck refuses extra cash. Wow those Canadians really are nice.
Most of the U.S. working class have been voting against their own economic self interest for decades.
Gold star for you.
"The physicians group said it could not in good conscience accept pay raises when working conditions remained difficult for others in their profession — including nurses and clerks — and while patients “live with the lack of access to required services because of drastic cuts in recent years.”
“Lack of access to required services”?
You mean the Canadian health care system isn’t entirely sunshine and rainbows??
The linked article has this line further down the page:
…annual salaries of the province’s 10,000 medical specialists…
If 700 complained about their pay that would only be 7%. Hope
this works well for everyone.
“What do we want?
LESS MONEY!
When do we wan . . .wait, guys, WTF? Let’s talk this over, k?”
You’d think someone would disagree and fight the idea.
You’re getting the poetic, abridged version.
The health system in Québec works, but is not efficient. It’s been inefficient for many years, with people waiting many hours to see a doctor at the emergency room and many months for non-urgent surgery. Nurses are overworked, with mandatory overtime having become routine in many hospitals. The system’s costs are always increasing way beyond inflation. The population is aging, etc.
Hard to pinpoint a single cause for the inefficiency, but most agree that doctors are too essential for basic procedures, and are not available enough. One possibility would be to increase nurses’ ability to make decisions without a physican present, but that might insult the doctors who would move to other provinces, go into private practice or simply retire.
The current minister of Health, Gaétan Barrette, is an anesthesiologist and the former head of the federation of specialist physicians. The prime minister, Philippe Couillard, is a neurosurgeon. Supposedly, they know how the system works and how it should work. The minister of Health is a loud, assertive person, not unlike a certain prominent politician in the States. He likes to take center stage and present his own version of reality and of how effective his reforms are. Some of his reforms have been logical (like minimum patient rolls for general practitioners), but many have been in keeping with this government’s obsession with budget cuts. So services that were supposed to improve the system, like home care visits, are underfunded.
This is an election year. Here as elsewhere, it means “stop cutting and start looking generous”.
A pay increase for specialists was announced a few weeks ago. The amount of the increase is on the order of 700-1000 million dollars a year. It’s part of a long negotiation to get doctors’ pay in this province to match other provinces (whatever that means), to keep them from moving away. Nobody but the minister believes it will make the system more efficient. Specialist doctors, it’s said, already have a somewhat princely regime where they get a bonus for showing up on time… but can afford to go play golf instead. So the move is perceived publically as taking the money that he’s removed from the health system for years and giving it to his buddies, and people are starting to blame the doctors for the system’s woes.
The 700 doctors who signed the letter agree that the money should have been spent elsewhere.
Some of what I’ve written above is simplified opinion, and it’s all based on what the media are reporting. I’m sure the Fédération des médecins spécialistes would be saying something very different.
Warren Buffett is always claiming his taxes are too low.
There are a number of Canadians on this board and I don’t think you’ll find anyone of them claiming we have some sort of medical utopia up here.
In fact if the US system didn’t stagger about like a drunkard escaping from a brewery we’d actually compare our system to better ones and, hopefully, make improvements. The US example encourages a fair bit of self satisfied inertia.
And that is relevant how?
Even so, I can’t imagine any percent of American doctors saying under ANY circumstances, “The US health care system is totally screwed up and inefficient, and the disparity in pay among medical personnel is particularly bad, but with more funds, it could be improved, so therefore, I’ll take a pay cut.”
This, exactly.
The Canadian system isn’t great - when compared to the health systems of other comparable industrialized nations (though to be fair, they are all coming under pressure from ever-increasing costs, and every system has its own special flaws).
The real gap though is between ‘every other advanced industrialized nation’ and ‘the United States’.
The Canadian system, flaws and all, only looks great when compared with the system south of the border.
Granted, the Canadian system has merits and flaws. My point is, when would any US professional in any industry (private, non-profit, government) make a public statement, “Don’t give me a raise! I’m already being paid too much!” I find the stand these Canadian doctors are taking remarkable, regardless of the nuances expressed here.
It’s been said about the UK NHS that’s it as close as we have to a national religion and the Canadian situation chimes with that. If you work in that environment you tend to believe in universality, and it does become embarrassing to see others struggling when you have enough. Doesn’t make you socialist, but it does mean you’re probably more engaged and compassionate.
My understanding is that the negoiations for this pay raise began when Quebec specialists were suffering a bit of a wage gap with Ontario but other factors closed the gap before its implementation. It would be most unseemly to accept the raise when other parts of the system are lacking.
Given that the specialist per capita in Canada ratio is around 30% lower than the OECD average it might be a good thing to raise salaries to attract more people to the profession.
Only if you assume we need more specialists rather than more general practitioners. There’s already strong financial incentive for doctors to become specialists.
That kind of snark isn’t helpful in objectively assessing the good and bad of Canada’s many different health care systems – every province and territory has its own system with its own funding and service levels – or in objectively comparing them with the costly unmitigated disaster that is US health care. Broadly speaking, though, as in every civilized country on earth, all are successful in providing universal access to medically necessary services and enjoy strong popular support.
The system in Quebec is one of the weaker ones in terms of criteria like ER wait times which have often been cited as the worst in Canada, and this has to do with a variety of policy and funding issues. In my view, although no doubt there are many immediate reasons that can be found for this, it fundamentally arises from language policies and other political factors going back to at least the 70s that were hostile to business and drove some of the largest corporations out of Quebec. The loss of this tax base has made Quebec the poor cousin of other large provinces in terms of health care funding, and although its per capita expenditures are only marginally lower than other large provinces, as of 2013 data they were in fact the lowest in Canada, and total health care spending was about half that of Ontario.
I’ve seen a UAW local be extremely cooperative with plant management on cost control. That included wages and benefit demands that fell outside the national contract. I worked for an outside logistics company that supported that plant with just in sequence parts; their willingness to compromise and approve outside support contracts to reduce costs, like the one I was working under, was also similar. My Teamster warehouse workers made less than half of what the UAW workers inside the plant would have made.
They did it because, like in the case you cite, the system was under genuine financial pressure. In their case, they worked in a 100 year old plant that had serious issues increasing costs. Neither the UAW local or plant management wanted the plant to be closed and torn down for a more modern facility built elsewhere. They found a way to get along, make quality cars, and still be profitable.
The spirit of cooperation once resulted in me driving up the ramp into the building with my Nissan pickup truck. Who would have thought UAW workers could ever not care about that?
Kudos to the doctor’s who don’t want the raise. They can buy more doctors, nurses and diagnostic equipment with the savings. A truly admirable gesture.
And for those Canadians who left the country last year because they got sick of waiting… you’re always welcome here.