Med students wary of private system: poll

Deana Stokes Sullivan
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While some medical students across the country are receptive to the idea of private health clinics, a report being released today says Newfoundland and Labrador medical students are firmly against the development of a parallel, private system, fearing it could tap resources and erode the public system.

A national debate over private versus public health care was sparked in June 2005 by a Supreme Court ruling on a case launched by Dr. Jacques Chaoulli. The court said Quebec's ban on private health-care insurance violated that province's charter of rights.

While some medical students across the country are receptive to the idea of private health clinics, a report being released today says Newfoundland and Labrador medical students are firmly against the development of a parallel, private system, fearing it could tap resources and erode the public system.

A national debate over private versus public health care was sparked in June 2005 by a Supreme Court ruling on a case launched by Dr. Jacques Chaoulli. The court said Quebec's ban on private health-care insurance violated that province's charter of rights.

Later that year, at a Canadian Medical Association (CMA) conference, delegates were divided on the issue.

The Canadian Association of Interns and Residents tabled a motion asking the CMA to endorse the principle that access to medical care must be based on need and not ability to pay.

That motion was endorsed, but another motion was also approved, stipulating when timely access can't be provided in the public system, patients should be allowed to use private insurance.

Since then, the Canadian Federation of Medical Students (CFMS), which represents 13 medical schools and more than 6,500 medical students, has been soliciting the views of its members.

The federation concluded future doctors in the country overwhelmingly support access to health care for all, whether they can afford it or not, but some are "comfortable" with a move toward private clinics.

"This is probably the most important debate affecting medical students today," said Philip Brost, CFMS president.

"Changes to the system today will affect our profession for decades to come."

Brost said his feeling from the polling and consultations is that overall, "medical students do echo or mirror the thoughts of their more senior colleagues."

They want patients to have access to necessary health services based on need, not ability to pay, but at the same time, Brost said, "We must find ways to ensure that people are also getting timely access.

"I think there was a lot of support for a continued public system, as long as people are getting timely access to the health care that they need, because, obviously, health care is as much about the timing as it is about the service."

In St. John's, about 20 students on the executive of Memorial University's Medical School Society engaged in a discussion and debate after reviewing several documents on this topic.

A statement, developed after the debate to reflect the views of members of the society, states while they endorse the principle of access to medical care on the basis of need and not ability to pay, they don't endorse the development of a parallel private health-care insurance system. "Canada should, instead, maintain a strong, publicly funded health-care system that is capable of meeting the needs of all Canadians."

The society said this statement means that "we do not think private health care is the answer to the current problems with the system. Instead, these problems should be fixed within the current public structure."

Most agreed

Allison Meiwald, a fourth-year MUN medical student who was involved in this process, said this position statement and information documents were circulated to the medical student body for feedback and most agreed with it.

At a CFMS meeting in 2006, Meiwald said, MUN med students actually proposed another position statement which was adopted as the national federation's summary statement on health-care reform.

That statement reads: "The CFMS asserts that access to health care must be based on need, regardless of ability to pay. Any changes to the current structure should be evidence based, and must not compromise the quality of public health care or medical education in Canada."

Meiwald, who's also vice-president of communications for the CFMS, said now that the federation has obtained the views of its members, it will be better prepared, when these issues arise again, to offer an opinion on how health care can be improved, knowing that it has the support of medical students right across the country.

dss@thetelegram.com

Organizations: Canadian Federation of Medical Students, Canadian Medical Association, Supreme Court Canadian Association of Interns Medical School Society

Geographic location: Newfoundland and Labrador, Quebec, Canada St. John's

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