Other Press February 4,.1987 — Pace 3 Med students leave Canadian University Press VANCOUVER -- A recent B.C. Supreme Court decision has left medical students thinking of leav- ing the province after graduation. And doctors arguing that Canada’s universal medical — care system is at risk. In a Jan. 7 decision, Justice Ken- neth Lysyk ruled the provincial government has the right to con- trol the number and location of B.C. doctors” by restricting billing numbers. Without a billing num- ber, a doctor cannot collect fees from the provincial health plan. On Jan. 21, two — groups representing both B.C. and Cana- dian interns and_ residents an- nounced they would appeal the tuling. Although the long-term effects of the decision are uncertain, other provinces such as Alberta, Mani- toba, and Quebec have been ex- amining the act as a way to cut health care costs. The immediate impact of the ru- ling on medical students is easier to assess. “Already people are seriously considering leaving the province when they graduate,” said Pete Tonseth, president of the medical undergraduate society at the Uni- versity of British Columbia. While emphasizing the need for more information, Tonseth said higher numbers of medical stu- dents are paying $100 to write American board exams to keep their options open after gradua- tion. If graduating students fail to get billing numbers in their areas of choice, or fail to receive numbers at all, Tonseth said many will likely leave for other provinces, or countries like the U.S. or New Zealand. Tonseth was quick to refute the idea, advanced by the provincial government, that the legislation is motivated largely by a desire for doctors to practice in remote regions lacking adequate health care services. “This scheme is not directed at rural areas and getting doctors out there -- it is a scheme to save mon- ey,” he said. Tonseth and others see the So- cial Credit restraint program be- hind the legislation, thus: linking it with the massive and controversial cutbacks in social services begun in 1983. In that year, the government introduced legislation which eventually resulted in the firing of 10,000 public employees, the lay- off of 3,000 teachers, and substan- tial cuts to educational budgets. Although billing numbers legis- lation was initially introduced by the government in 1982, Lysyk’s ruling was the first to uphold the policy. In his 65-page decision, Lysyk ruled Bill 41 did not violate the Charter of Rights and Free- doms by denying the right to mo- bility. A 1985 ruling by Chief Justice Allan McEachern, however, said such legislation was “Draconian,” “Orwellian,” and “short of im- prisonment, the greatest depriva- tion of liberty.” Likening the legislation to “a cancer which spreads from _pro- vince to province,” Dr. David Mathews, president of the Profes- sional Association of Residents and Interns of B.C., said the ruling could be the “beginning of the end of medicare.” He said doctors with billing numbers will continue to practice within the system, while others, forced to practice outside, will be accessible only to those “ who can afford to pay fees priv- ately. But Morris Barer, a_ professor and health care economist at UBC who helped prepare expert evi- dence for the B.C. government’s case, said it is extremely unlikely that the ruling would lead to such a two-tiered system. Barer said patients would only choose to see doctors outside the plan if there were problems of access, such as unreasonable waiting times for appointments. He added this need should be perceived by local committees which will correct the situation by recommending new billing numbers. But Mathews argued this is not currently the case. He cites the ex- perience of Christianne Maxson, a doctor who wished to practice in the interior city of Kelowna. Al- though Maxson had already ob- tained admitting privileges to a lo- cal hospital and the statement of need from the relevant committee, she was denied a billing number. “In Kelowna, if you want to see a female doctor, you must wait from six months to a year,” he said. “(She) has patients who want to see her and a doctor who wants to go into practice with her, but the government won’t give her a bill- ing number.” At the heart of the issue is mon- ey. With net health care expendi- tures of $2.8 billion, or 35 per cent of the 1986/87 provincial budget, Barer said limiting the number of doctors is a balanced, reasonable way to control health care costs. British Columbia, which has tradi- tionally had more doctors per capita than other provinces, curr- ently has one doctor for every 511 residents, compared to a_ national average of one for every 577 peo- ple. Barer said economists have ob- served the demand for medical services increase in proportion to the number of doctors added to the system, with additional costs for hospitals and drugs also incurred. He cited a Manitoba study of solo general practitioners in Win- nipeg during the period between 1971 and 1981. During that time, the number of physicians doubled and the number of services per capita almost doubled as well, as patients were seeing more differ- ent doctors. But Mathews, critical of the strategy of limiting doctors, said, “The logic goes like this -- if you have no surgeons, therefore you have no surgery. Therefore you don’t spend any money. And you don’t spend any money on_ the nurses or IV’s or the other things associated with an operation.” riefly’ A brief submitted by the CIEA (College-Institute Educators’ Ass-- ociation) to Advanced Education and Job Training Minister Stan Hagen in December calls for in- creased funding for student aid, reinstatement of the grant pro- gram, establishment of need as the primary basis for financial aid and raising of the minimum wage. Student society by-elections last Thursday saw the return of Mike Bouchard, a university transfer rep disqualified because of by-election irregularities last semester. Bouchard won by a narrow margin in the Yes-No vote with Maple Ridge campus votes putting him over the top. Other successful candidates were Sandra Glass for music/arts and Dieter Hinz for the business house. They will serve on the DCSS senate until next September. REGULAR TRAIN UNIVERSITY WARWICK *& IN THE HEART OF ENGLAND % 5500 FULL TIME STUDENTS %& STRATFORD 15 MILES, LONDON 70 MINUTES BY SUMMER SCHOOL 8th July - 7th August, 1987 British studies courses for credit or audit taught by resi- dent faculty of an outstanding British university. Mature students welcome. Courses in — archaeology art history english political science history theatre studies business studies For illustrated brochure by air mail, write or phone Dr. D. Mervin, University of Warwick, Coventry, England CV4 7AL. Tel. 011-44-203-523113 (24 hrs). OF Triple ‘A’ Student Painters is now recruiting for Territorial Managers this summer. Apply now at the Student Placement Centre (Rm. 2710) or phone us at 732-7273. Hurry! Areas are going fast. Wanted: 15,000 young Canadian volunteers to fast during Water for the World weekend, February 20-22, to help save the lives of children around the world. To apply, call toll-free: 1-800-268-3950 No Experience Necessary Call Now! Water For The World ~ the Other Publications Society The OPS is accepting nominations fo. the position of Member- at-Large on the society's Board of Directors. Nominees must be students of Douglas College in good standing and be willing to meet weekly to administer the affairs of the OPS. Nomination forms can be obtained in rm. 1602 between | 2:00 noon and 4:00 pm Mon.-Fri. Nomination forms must be signed by five registered members of the society and be submitted to rm. | 602 by 4:00 pm. February 4th, 1987. ee tt Tey Fa es Tey Tey Tey Tey, Try Try a Campus-Wide elections will be held on polity ED Feb. 19th “Ah Wanted: Persons with back- ground in constitutional pro- cedure to preside as Chairper- son of the Board of Directors of the OPS. Interested appli- cants should present a resumé detailing experience to: Room 1602, New Westmins- ter campus.