ae . tioners altogether or billing above the level that the govern- ment will reimburse the patient. Are doctors being made the scape-goats for inade- quacies__in provincial schemes? It’s impossible to make a blanket statement about all doctors in all provinces, but many of the strongest defenders of quality health insurance think that it si too easy to pin the Ibame on the medical profession. : Charles Bauer of the Canadian Labour Congress agrees that the public should not focus all of their grief; on the medical profession. Bauer points out that general practi- have _ legitimate grievances with the way they are being paid through medicare plans. “G.P.’s are falling behind in comparison to most specialists,’’ according to Bauer. ‘‘A typical general practitioner can make as little as $40,000 a year working 60 hours weeks. Most unionized workers would not accept that level of pay.’’ The CLC, one of the founding members of the recently organized Cana- dian Health Coalition, made up of church, labour, educational and consumer groups, is calling for a return to the old 50/50 cost sharing arrangement as a first step towards saving -our health care system. our health care system. They are also calling for the inclusion of- dental and prescription costs in fed- derally subsidized, pro- vincial plans so that the plan will live up to its _ original principle of ‘‘com- prehensive coverage’’. lf we returned to the old cost sharing arrangement, according to the CLC, proper funding for the system could be ensured and both doctors and patients would ~— receive fairer treatment without having to move outside of the plan. : _A great deal of the cost of returning to higher funding levels for medicare could be made up by_ improved management of our health system, says Bauer. “We are now using high priced physicians to do things that nurses could be ‘doing just as well. The problem is that under present medicare system, if those jobs were done by a paramedical person or auxiliary they wouldn't be funded by medicare, so patients have to have them done by the most expensive ey people in the medical ~ system. ‘Costly misjudgements in the number of chronic care beds needed for the elderly | have been made, resulting in chronic care patients being kept in emergency facilities at a great expense to the system, according to Bauer. : It doesn’t often happen that organized labour and federal governments are in fundamental agreement on social services issues, but in this case, the newly- elected Liberal government has at least given indica- tions that they share the CLC’s concerns. . In fact, The Other Press their own cabinets. the important thing is that money is missing from the pot of health,’’ was her assessment at the meeting. Begin’s unqualified de- nunciation of the provinces’ performance in the area of health spending, made -in the heat of the last federal election campaign, is pred- ictably a great deal stronger than official party policy. In . a recent _ policy statement, the Liberals indicated that any action that they would take in this area would be contingent upon the recommendations of the Hall Review. Justice medical insurance in Can- ada. Hearings for the review are expected to begin in March. Hall has said that he intends to keep an ‘‘open mind and closed mouth’’ on the hearings until his report is finished, but it seems unlikely that he wouldn’t recommend some strong revisions to the current system. : The major roadblock in the way of a return to provincial accountability in health care spending is the duration of the agreement . that we are now working under. It was agreed by the provinces and the federal page seven edicare has been shuffled aside the provincial governments through the intricate web of federal/provincial financial interdependencies, but it is not likely that the govern- ments of the larger provinces would part with an agreement which has provided ministries outside of the health and _ social services area millions of extra dollars every year. The provincial govern- ments have given no indication that the erosion ‘n Fe = Monique Begin, the federal health minister in the last Liberal cabinet, saw the shortcomings of the revised cost-charing plan soon after it was implemented in the spring of 1978. Begin now concedes that the Liberal government’s “well-intentioned gamble’ has failed. Just before the election she told a conference. on labour that the provinces had misappropriated $650 million last year alone that would have been spent on social services if the old 50/50 arrangement were still intact. “‘We should go back to the old way. Since block funding was implemented provincial health minister have become nobodies in YOUR SLIP 1S SHOWING! ae BED SHORTAGE Ps <= ety on gm WIRDERODS YY The Liberal governments will intentioned gamble has failed Emmett Hall, who was responsible for recom- mending the original prin- ciples of our medicare system, is conducting a health services review looking into the condition of government in 1977 that the . block funding agree- ment would run until the spring of 1982. Pressures could be brought to bear on b acrhue> Yr F Fa of our health care system due to abuses of the 1977 funding agreement will end until the financial incentive to spend in the area of health care is returned by the federal government, or until provincial electorates force health care spending to become an issue in upcoming provincial ele- ctions.