June 24, 2004

To the Evening News Editor:

Local physician, Dr. Cathy Felderhof has teamed up with David Zitner of Dalhousie University and the Atlantic Institute of Market Studies (AIMS) in proposing "patient co-ops" as a solution to problems in finding family physicians and reforming primary care.

It is important for Evening News readers to put this initiative in perspective, by looking for the hidden agenda here. AIMS has been on the privatized health care bandwagon for some time. In fact, AIMS President Brian Lee Crowley sat on the Mazankowski Commission in Alberta which recommended many health care privatization measures.

The ‘co-ops’ proposed are really not co-ops as Nova Scotians traditionally understand them to be. They are little more than a shallow attempt to shift the costs of running a physician’s office onto patients. His plan would see more of the government fee-for-service payments go directly into the physician’s pockets and less into administrative costs.

Most importantly, they would do nothing to lower costs for patients. On the contrary, these user fees cause patient costs to increase with no increase in real health care benefit.

If Drs. Felderhof and Zitner were really interested in setting up a co-op they would be proposing that members of the co-op elect a Board of Directors to run the business and to put doctors on salary rather than fee for service. Each member of the co-op would have a vote on how the co-op runs and what necessary services are provided – not just a smorgasbord of ‘extra’ services from which they can choose. And, of course, dividends would be returned to the co-op members. They are proposing no such thing.

Setting up a physician controlled "patient co-op" is not the answer to primary care problems in Nova Scotia. Multidisciplinary teams of health care workers are a good idea but they require a community health centre structure with health programs that serve the needs of the community and not just a few individuals. This cannot work without a province-wide plan to avoid continuing a patchwork of services.

The physician co-ops are little more than charging a "block fee" for services that physicians are obliged to do but find time consuming and irritating e.g., dealing with prescription renewals. Block fees do not make the physician more efficient or give them any more time.

Are essential health services strengthened by a physician’s co-op? No. By Dr. Zitner’s own admission all the services paid for are outside of Canada Health Act insured services. These extra services will detract from the real business of health care – providing health care for people.

Nova Scotians will not be duped by these ‘privatization through the back door’ schemes.

Sincerely,

Betty-Jean Sutherland

President, CUPE Nova Scotia

(902) 455-4180 (o)

(613) 791-1593 (Cell)

(CUPE is Canada’s largest health care union, representing more than 140,000 frontline health care workers, including several thousand here in Nova Scotia.)