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User Fees Hurt Sick

August 19, 1994

Doctors who see no problem with asking patients to pull out their wallets before receiving medical treatment need to be educated about the negative effects of user fees, says the Medical Reform Group.

Delegates to the Canadian Medical Association's annual meeting voted this week to strike down a policy opposing user fees, despite warnings from some delegates that they would be seen as self-serving and greedy.

The Medical Reform Group, a physicians' group which believes that health care should be available to all without financial deterrents, repudiates the stand taken by the CMA delegates.

"There is clear evidence that user fees hurt the sick and the poor," said MRG spokesperson Dr. Rosana Pellizzari.

Studies on the effects of user fees have repeatedly shown that people with low incomes are less likely to seek medical treatment for themselves or their children when user fees are charged.

When Saskatchewan instituted user fees under a previous government, physician visits by the poor and the elderly decreased by 18%, while physician visits by higher-income people actually increased. This finding is not surprising when one considers that a substantial proportion of patient visits are initiated by the physician rather than the patient.

The evidence on user fees in other jurisdictions, including the United States, is similar.

An in-depth analysis of user fees by health economists Greg Stoddart and Robert Evans, published by the Premier's Council on Health last September, demonstrated that user fees are ineffective in reducing overall health care costs, but they do hurt the sick and the poor.

"User fees should be unequivocally rejected once and for all," said Dr. Pellizzari. "Doctors who favour user fees should be clear that they are putting their own pocketbooks ahead of their patients' welfare."

For more information contact:

Dr. Rosana Pellizzari

Dr. Gordon Guyatt

Ulli Diemer, MRG Administrator

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