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Reform Group Formed
Letter published in Canadian Doctor, April 1979
The MRG is a recently formed organization of physicians and medical students. Its base is in Toronto, and the principles and goals which I will outline were decided on in meetings of the Toronto group. However, there are interested physicians in most major centres in Canada.
The MRG feels that there is a lot wrong with the present system of health care delivery. We believe that the present organization of health care workers is undesirably hierarchical. The whole system is bureaucratic and heavily concentrated in large and expensive institutions. This organization has led to an abuse of technology. The medical profession has given disproportionately little attention to the social situations out of which disease arises and consequently to the preventative aspect medical care. Finally, the system is at present hospital based and there is no setting outside the hospital where the patient's health care needs can be dealt with in an integrated way.
We also believe strongly access that access to a high quality of health care should be treated as a right and not a privilege. Based on this principle, we have some solutions to the above problems which we would like to suggest.
We believe that the most rational way to organize health care is around the community clinic. Such a clinic would financed by global budget and all employees, including physicians, would be paid salary. Decisions regarding resource allocation would be made upon consideration of the expert advice of those who knew most about whatever problem is being addressed and would made by the clinic staff and the community, each group having roughly equal representation. The clinic would attempt to provide a wide range of medical, social and educational services at the centre and in the community.
The advantages to the community from such a reorganization are fairly clear. I would like however, to emphasize the advantages from the doctor's point of view. There would no longer be pressure to see as many patients in as short a time as possible. There would be direct access to consultation and educational activities within the building where one worked. Social service and other aid to the patient would be immediately available. As well, the doctor would have security with regard to a guaranteed income, sick pay, paid vacation, paid leave for educational activities, and an appropriate pension plan, none of which are available at present.
The way we envisage the system, health insurance premiums would be paid out of general tax revenue with no deterrent fees. This coverage would include services presently taken care of by the provincial insurance plans as well as drug and dental coverage.
Finally, we believe that it is crucial for physicians to have an active role in working toward the elimination of conditions known to foster or cause disease. These would include poverty, as well as environmental and occupational hazards.
As a group, we are going to be working for the achievement of the above goals. We of course would like to have as many doctors as possible join us in our effort.
Readers of CANADIAN DOCTOR can get more information about the MRG by writing to the Secretary at the address below.
Secretary, Medical Reform Group
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Health Centres Drug
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Care Costs Health
Care Delivery Health
Care Finance & Fund-Raising Health
Care in Canada Health
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