Advocacy & Health Policy / Défense des intérêts et politiques en santé

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able for the health system, and does provide some care that would otherwise be a charge on the public system”, wrote one. Another, a former Alberta health executive, was solicited as an expert even though he has left the country and was ruled by a judge to have caused an unnecessary enquiry and wasted over $10 million dollars. Another had written, “Medicare is being put on trial, and will likely be found wanting in many regards”. No wonder they have been withdrawn. We the taxpayers remain on the hook for their high fees. Like most provincial governments, BC has a web site to guide patients to available surgeons. I followed up with a BC Children’s Hospital surgeon whose profile on the government site showed just a handful of patients waiting a very short time. I asked the surgeon to check their records. In truth there were over 1200 waiting. A recent physician witness testified he had been asked to stop seeing patients, since it made wait lists longer. The Ministry had also ordered that patients in moderate pain be re-classified as being in mild pain, so as to improve the provincial statistics and benchmarks. In a recent ten-day period of court time, the government demanded eight days to argue about striking, rather than hearing evidence. Key words in applications to strike – a hand me down from ancient legal traditions – are hearsay, relevance, opinion, argument and expert. If you state your place and date of birth that’s inadmissible hearsay, except for the few of us who personally remember being born, and checking the calendar to confirm the date. The court is not credited by government lawyers with the ability to differentiate and apply weight to “relevance”, “opinion”, hearsay and “argument”. As government lawyers waste precious court time, criminals go free because of delays in the court system. In a demonstration of fiscal stupidity, our BC government volunteered to the federal government that they believed private clinics in BC were billing 16 million dollars a year. In response, the federal government deducted that amount from transfer payments. Other provinces that allow private MRI’s have not volunteered their estimated private clinic revenues and have suffered no deductions.

Our current NDP Health Minister, Adrian Dix, made a statement, ‘’The consequences of the failure of the previous government to enforce the law has cost patients millions of dollars”, ignoring the fact that private clinics operated without harassment for many years under the last NDP government (in which he was involved). Arithmetic is not a strong point with politicians, but it is estimated that private clinics in BC save the government $300 million a year by removing that burden of funding from the public system. As the delays continue, government lawyers who are unwilling or unable to argue the case on its legal merits, have been assisted in their filibuster strategy by a BC NDP government that appears to take its orders from public sector union leaders. They have altered the Act we are challenging in mid-trial, which will require another parallel costly court action before a different judge. I agree with them that their only chance of victory is through fiscal bullying and stretching us financially. We feel vindicated by the fact that public support is on our side. A March 2018 Ipsos poll, (see our supporting Canadian Constitution Foundation1) shows that 81% of BC residents support us. Further updates on the trial, which recommenced in April 2018, will be posted at www.charterhealth.ca and www.yourhealthcantwait.ca. Newly announced measures are even much more authoritarian, and include fines of $10,000 to $20,000 per patient treated in a private BC clinic. Just over a month ago, I spoke to an international group of international senior health executives. They were from countries as diverse as New Zealand, Holland, UK, Switzerland, Germany, Zimbabwe and Russia. None could believe that laws that make private health insurance illegal could possibly exist in Canada. The Russian delegate remarked, “This could not even happen in the former Soviet Union, where I was raised”. References 1. http://theccf.ca/wp-content/uploads/2018/03/2018-Constitution-Day-healthcare.pdf

Resident Morale is ‘Cautiously Reasonable’ While Graduate Underemployment Remains at the Forefront of COA Efforts Trinity Wittman, MSc, COA Advocacy and Development Manager Kevin Orrell, M.D., FRCSC, COA President Emil H. Schemitsch, M.D., FRCSC, COA Human Resources Committee Chair Bogdan A. Matache, M.D., C.M., FRCSC, PGY5, University of Ottawa David Stockton, BSc, M.D., PGY4, University of British Columbia

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n 2016, the COA reported on the job crisis, sharing our profound frustration at the unacceptably high rate of underemployment among Canadian orthopaedic graduates. Surgeon underemployment poses a threat to patient access to care as highly-specialized skills are underutilized and eroded while

COA Bulletin ACO - Summer / Été 2018

aging patient populations are underserviced in many regions. Graduates unable to find full-time employment in Canada are faced with chronic locum experiences, serial fellowships and continued studies, and some are still turning to job opportunities abroad, particularly in the United States. However, the versatility of the profession allows for a different path to entering practice than in the past, with the majority of surgeons able to make an interim living while looking for full-time employment, albeit sometimes for a longer time period than they had hoped. While the COA is limited in its ability to enforce certain practice changes, the Board of Directors will continue to take all possible actions within our purview to address this complex issue.