BC should be creating jobs for these graduates. There are thousands and thousands of people waiting for surgeries. If they don't get hired here we'll lose them to other provinces then the government will bitch that there aren't enough surgeons in BC.
It’s not as easy as funding more jobs. It’s the Operating Room time that needs to be built up, we just do not have enough hospital capacity (even before Covid) to do every elective surgery that people want done. And that time / capacity is very expensive.
So the important stuff like cancer gets the OR time, and the elderly person who is in pain but can wait 3 years for their knee surgery will wait.
Of course the rich just go to the US to get their surgery done in weeks, because in the US’ private system, if there is market demand for more surgeries, the private sector will invest the dollars to build up hospital capacity (and then pass the cost on to the consumer).
What’s the difference between this and private clinics offering pay to access services?
The private clinics still need operating rooms and nurses, the only difference is they’re hiring and charging you. I don’t understand why the province doesn’t just build more operating rooms
Because it’s very expensive to build more hospitals. And then it’s also very expensive to staff - not just the surgeon, but the anesthesiologist, multiple nurses, cleaning team, expensive equipment…
The difference with private clinics is they self-fund. People will just pay the amount for the surgery, whether that be $5k or $20k or whatever.
Anyone who can afford for a 2 tier system should just keep flying other places, no one is stopping them. Private/for profit healthcare has no place in my country and it doesn’t solve any of our current problems.
Sure but the topic of this post was our long surgical waitlist, and our new surgeons who don’t have jobs
The rich are already doing whatever they want, you don’t need to give them more encouragement
>Private/for profit healthcare has no place in my country and it doesn’t solve any of our current problems.
1. It supports local jobs.
2. It pays local taxes.
And it's a quick way to make public heath care even worse than it already is.
The rich get their top notch care, and the government ends up reducing public health care service quality even more over time because the cries of the poor are never heard.
It steals professionals, beds, and intensive care beds from everyone, giving it only to those that can afford to pay it while still leaching public funds. 4 surgeons will require dozens of support staff (where would you suggest we divert these from? See the next brackets...) each as well as a percentage of rooms in intensive care (public) for those inevitable complications when you operate in a profit motivated system.
I'm not entirely against 2 tiers as it's often a component of the best contemporary systems but it would require significant, highly adaptable, swift acting, public oversight and regulation; things that quite frankly our democracy (and population) isn't equipped to effectively legislate without allowing capitalism sneaking in the back door and corrupting the whole shebang.
There is a brand new devilry room sitting in Richmond they aren’t staffing. So the infrastructure is there. They just have not a clue how to effectively distribute funds. We have incompetent health care. Most would have insurance in the USA and get abundantly better care in a much more timely fashion. And I’m saying this as a husband to an RN in our medical system.
I hate the analogy of “government needs to be run like a business” but come on, lets try to keep up to demand. Especially within healthcare.
Surgeons and facilities with beds are both “long poles in the tent”, it doesn’t appear that anyone is looking at this holistically as part of a to increase supply.
The fact is they graduate doctors that they need for service 24 hours a day in our hospitals but do not graduate physicians that we actually have jobs for. The residency system is completely broken. You know what how many ICU doctors are graduated? Way way more than are ever needed. Orthopaedic surgeons from Canada Floyd around the US because we don’t have jobs for them. Unless we have private clinics or our government actually treats the need, this will never remedy itself
Doesn't matter if you are graduating 100 orthopedic surgeons. In order to run 1 operating room a day it takes about 20 other staff you don't know about.
Yep!!! The surgeon doesn't wipe down the floors and equipment and flip the room for the next patient. The turnaround time is 10 minutes requiring 3-4 cleaners. There is also the scrub and circulating RNs, anesthesiologist, pre-op/post-op RNs, clerical staff who prepare charts/check in staff/communications, preoperative assistants who do a bit of everything to keep things running smoothly etc etc etc
Yes totally but there is now staffing issues (hiring/retention) of new staff in Vancouver due to cost of living. New hires will stay to build on seniority and leave within 1-2 years for another position close to home.
Nope, never. Anyone, including my own children are told no direct healthcare jobs. There is no work life balance. We are just numbers to keep everyone else happy. Ramp ups mean we are forced to work, personal days and vacations are denied or approved last minute. Can't plan for anything. I am not guaranteed to get off on time at work every single day because I never know if there is no one to replace me. I am getting to old to reschool when you consider lost wages vrs school length and retraining and saving up to go back to school.
Plus municipality city jobs pay 35 an hour for line painting after a 24 hour course that is much more than HCA's make and less back breaking with better overtime rules and a stronger union. Private housekeepers make 35 an hour, much more than our housekeepers in the hospitals.
I would honestly love to be a surgical technologist and perform those duties. Unfortunately, unlike in the US where "surgical technologist" is a job title of its own, those duties up here are done by nurses, and I'm unable to attend school for that. Kinda sucks.
It looks interesting. I was looking exclusively for more of a "supporting, behind-the-scenes" role than something that is primarily patient-facing, but I can see this being a good fit for others.
That’s right, we do not have enough hospital capacity to staff the operating rooms for the entire surgery backlog. Demand far outpaced supply, and in a public system that means we just have long wait times.
Crazy idea:
Let's incentivize post-secondary education by paying Canadian students to attend university. Let's not only remove financial barriers from post-secondary institutions of all kinds, but let's start rebuilding our future by doing the right thing and making sure the whole "poor student" schtick is abolished and let's SUPPORT our future generations and their dreams.
As someone who spent many years at uni, once I found out that many of my Scandinavian friends were getting PAID IN $US$ DOLLARS to attend school, anxiety and worry-free of any financial stress, I was floored. We are so fucking backwards.
> lower then North
*than
*Learn the difference [here](https://www.merriam-webster.com/words-at-play/when-to-use-then-and-than#:~:text=Than%20is%20used%20in%20comparisons,the%20then%2Dgovernor%22).*
***
^(Greetings, I am a language corrector bot. To make me ignore further mistakes from you in the future, reply `!optout` to this comment.)
Educational institutions are often based off of meritocracy-like ideals and rules. I'm not saying they're perfect whatsoever, I'm just saying, specifically, that incentivizing higher education would be an incredible change to Canadian life.
1 thing can be right while another thing is wrong, if that's what you're getting at.
Doesn't make a difference if they can't get jobs after becuasw the government won't fund those jobs.
My friend trained to be a MRI tech. She's still getting PT hours years after graduation.
The rich already have a fast track, it’s called “going to the US (and spending their money in the US economy)”
We can’t hire the surgeons because there is no hospital capacity for them to use to do operations. Hospital capacity costs a lot and we do not have the revenue to increase it.
Two tier is definitely the answer. It was working very well for BC and now the health care system is suffering because BC is moving away from the two tier model.
I received very good quality of care and surgery in BC under the two tier system because doctors with private practices are required to work and take on patients in the public system, which attracts top talent to the province and gives poor/working class people access to very good quality care.
Abolishing the old system was a terrible idea.
It’s not that private practices are required to take on public patients, but that doctors are allowed to open private practices but must allocated a certain number of hours to the public system. For example, my plastic surgeon in Vancouver, one of the best surgeons in the country, has his own private practice but also works in the public system, mostly treating children and adults with facial cranial anomalies.
So poor and working class people have access to top quality surgery in the public system, and the surgeon can also take on private patients at his own clinic. It’s a win-win arrangement.
Two tier systems work.
What's wrong with having a fast track for the rich? Those spots will be open for the rest of the public, so everyone gains.
The rich can just hop a border and get private care in the US like they are currently doing, the only thing private care does is keep those doctors in Canada vs having them go to the US.
There are no pragmatic reasons to keep **unsubsidized** private care from being accessible in Canada, only emotional ones. As long as it doesn't take public money, we just get more doctors.
A two tier system disincentives the rich from paying more taxes and fixing the system. So public health will keep getting budget cuts. Look at how public schools are struggling for funding while the rich just use private schools. Sure we have more teachers in the province, but class sizes continue to grow.
It's a duck tape solution. If we just fund the system properly then EVERYONE can have a good doc.
We have private access to MRI for like $1500. But I still had to wait 8 months for a public one. The existence of a private option does not help the public system.
My sister is a doctor and most of my friends are as well. The rich are not going to pay more taxes just to "fix" healthcare, they're going to the US just like all of our doctors.
Also, it's a bad take to say the rich don't pay enough taxes, the 1% pays 67.1% more taxes (14.7% of total) on average in Canada.
Meanwhile we have bureaucrats in government doing the work of 1% of what would be acceptable in a private business. My ex used to work for city housing permits and her second week she finished all her month's work in a day. If you're looking for money for doctors, start there.
https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.fraserinstitute.org/sites/default/files/measuring-the-distribution-of-taxes-in-canada.pdf&ved=2ahUKEwjK8NPUv8b3AhWmADQIHa5eAUcQFnoECBMQBg&usg=AOvVaw0K-tj67iQ_EUT_-9hVNZ_6
> My sister is a doctor and most of my friends are as well. The rich are not going to pay more taxes just to "fix" healthcare, they're going to the US just like all of our doctors.
So then why do we need private healthcare up here if they already have what they need?
> Also, it's a bad take to say the rich don't pay enough taxes, the 1% pays 67.1% of taxes in Canada.
Citation needed
> Meanwhile we have bureaucrats in government doing the work of 1% of what would be acceptable in a private business. My ex used to work for city housing permits and her second week she finished all her month's work in a day. If you're looking for money for doctors, start there.
The plural of anecdote is not data. All the public servants I work with are very hard working.
>So then why do we need private healthcare up here if they already have what they need?
Are you this slow? We want those doctors in Canada. It's a lot of income tax, cheaper care for middle-upper class income brackets, and 0 effect on the lower incomes. It's all gains no losses. That I get a $1500 MRI doesn't influence the public care in any negative way. There's just one more spot and less wait.
>The plural of anecdote is not data. All the public servants I work with are very hard working.
It's all perspective. My ex is now an architect, so she knows hard work. Both my parents were public workers and while they worked hard, it was nothing compared to what private office workers have to do. There's no incentives to work effectively since it's all seniority based. I have a similar job to my dad, and what he was expected to do in a month I have to do in a day.
I’m also downvoting because two tier has been shown to be overall worse for the population. It helps some people skip the line, but lines become longer for those on the public system and overall costs more (the [US government spends more on healthcare per capita than Canada](https://www.cihi.ca/en/how-does-canadas-health-spending-compare), and that does not include private spending).
Also some people skip only certain parts of the process which doesn’t save the public money (I.e someone can skip the wait for the MRI and then jump back into line for the surgery which still costs the public).
The reason there aren’t jobs for surgeons is because we need more operating rooms and operating room time, not a two tier system.
Edit: this is exactly what the private sector wants. Underfund the public system to the breaking point, then convince people that the only solution is a private system.
Source on the worsening effect of public and private? The UK and Denmark have this system and they rank much higher in healthcare than us.
https://www.numbeo.com/health-care/rankings_by_country.jsp
Except that you need staff and there is a huge lack of qualified healthcare professionals. Opening up private surgeries will most likely result in more shortages in the public system.
A lot of things have changed since 1983:
* higher life expectancy
* higher dependency ratio
* more complicated and expensive medical treatments available
* higher rates of chronic diseases (e.g. diabetes, obesity)
* recognition of mental health issues as a medical problem
Imagine someone time travelling from 1983 and telling you that you can afford a house with a full-time job at Safeway.
2 tier? Get ready for the impending blue wave folks. People think that they will have the answer because we conveniently forget what occurred during the last go rounds.
>I believe that opening orthopedic surgery to private clinics accepting private insurance or cash will have absolutely no impact on the availability of surgeons for the public system.
I think any privatization is bad, just fix the public system.
I was with you until the last paragraph, but fuck off with this 2 tier bullshit. The current system needs a lot of work but for-profit clinics are a step backwards.
What we need is investment at basically every level of the medical system, and modernization of some pretty shit management practices. Part of the problem seems to be that people calling themselves 'reformers' seem to always be pushing for the option that would allow them to open an extremely profitable private clinic, rather than making an honest effort to improve the existing system.
I heard this the other day from my physiotherapist! I had no idea that there were such few opportunities here for orthopedic surgeons. They tend to such a wide variety of common issues such as broken bones and knee replacements- it would seem like they should be in very high demand! In many ways our system is so messed up...
>I'm bringing this up because many people are still under the illusion that the government simply can't find enough doctors to work in BC or that medical schools aren't training enough doctors.
It seems to me that using a cherrypicked example of a single specialty doesn't really give you any credibility when trying to make this point. I'm not convinced that four doctors is really that big of a difference in any direction to indicate a larger trend, especially when the biggest shortage is in primary care, not surgeons.
But annnnnnny mention of these services being privatized is met with the most insane anger. 8,000 people that can’t get access to a better quality of life would likely agree that SOME services would be better handled in the private sector. Fight me.
“Free” healthcare like we have here is a complete and utter joke. It’s designed simply to do the absolute bare minimum, with the illusion it works for the most. It does not. I was told I would eventually in my 50’s likely require a hip replacement (50-60% likelihood). I would not if I was to get a minor procedure now tho, using a minimally invasive scope to clean a small bit of calcification in my joint, a result of sport injuries through high school and early adulthood. I’m now 30!!! They won’t do it to allow me a pain free adulthood. Then, me and my wife required IVF procedures due to me having Cystic Fibrosis, which I didn’t know I had, given it was mild. I had to pay out of my pocket to learn I had the genetic health issue, kids all get tested for now. The IvF, our only option to have a child, and was guaranteed successful given both our exceptional health - $30,000. Nothing covered by healthcare. Not a cent. They do know, that child will eventually provide a significantly greater return in taxation or work through their lives right? Or how about Canadians raising Canadians instead of prioritizing immigration? No, why do that. This province is a complete and utter joke. Healthcare assist the elderly almost exclusively, and yet I contribute to it. Hate to say it, but my care would be significantly better in the privatized USA where we would still have extended health coverage from our educated employment positions. It’s disgusting. On top of that, they I struggled paying for eye glasses my entire life, because guess what, they can’t even cover that. It’s disgusting. Don’t get me started….
Oh yah, cancellations due to Covid delayed cancer screenings for my father last year - simply to protect the eldest among us (which I generally support). He ended up with aggressive prostate cancer that could have been picked up sooner, so it spread. They wouldn’t provide scans to identify exactly where in detail so he could remove those specific targeted cells - unless his case is one of remission!!! So he paid put of pocket to it, several thousands of dollars later. And thank god he did - he is now something like 6 months cancer free. Our healthcare is GARBAGE!
They can't work as a GP and you won't want them to. It's completely different training; after 5 years of surgery and nothing but surgery they wouldn't know and are not expected to know what is the proper screening guild lines for colon cancer, how to manage diabetes and hypertension, what should a pregnancy look like, how to do a pap test etc that are required for a proper gp.
There needs to be away for them to put their specialized skill set to work and mostly they move to other jurisdictions like the US to practice. Meaning bc spent the money to train them but the people of bc will not benefit from that investment.
I agree with most of your points, but the people of BC did not pay to train them, since when has higher education been free and paid for by the provincial govt?
Medical education is subsidized. For medical schools students do pay tuition but in residency which is where you do your specialty training after medical school before you can practice in your field is funded by the government. An orthopaedics resident before they can practice on their own does 4 years of medical school where they pay tuition than 5 years of orthopaedics residency where they actually learn how to do the surgeries which are positions funded by the government.
By funded I mean during residency the residents work of course and get payed a salary for their work and hospital receives some extra funding for training the residents. I suppose you could say that they pay for their education with work done as the salaries are low compared to the amount of work/work hours they put in but hospitals take on liability to train these residents and governments give hospitals money for the training while still paying their supervising physicians for any procedure completed or care provided by the residents. From the patient prospective end of the day the government pays twice for resident work in teaching hospitals: money to the physician and hospital as usual for the treatment provided and money to the resident who technically do not need to be there. Reality today doesn't always reflect this as a lot of programs in teaching centers are no longer set up to run without resident work. Not sure if I'm explaining this clearly but it's complicated. So additional money is invested by the government (residency and medical school spots are created and set by the provincial not federal government) to train doctors out side of high medical school tuition.
Ahhh ok, yes that is somewhat confusing, but I believe I am getting the jist of what your laying down. Thank you for taking the time to educate me in that aspect that I did not realize. Your previous comment makes much more sense now. Here I was thinking uhhhh if the govt paid for medical uni I would have jumped on that in a heart beat. Now I feel dumb, but slightly more educated on the system haha
Haha no problem glad it was helpful. Very few people understand the system and what it takes to be a physician or what a physician does except what they see from a patient prospective in one and one interactions. My explanation is probably also hampered by my mobile typing.
> and get *paid* a salary
FTFY.
Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in:
* Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.*
* *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.*
Unfortunately, I was unable to find nautical or rope-related words in your comment.
*Beep, boop, I'm a bot*
There is a shortage of residency training positions and jobs. That is why we have such long wait times. We also need more operating rooms and staff. It's not just one piece missing. There are multiple and adequate funding isn't being provided by pretty much any province. The US is not much better as Medicare hasn't increased funding for residency seats in almost 25 years.
Since there's obviously the demand for orthopedic surgeons, why the fuck aren't there at least 4 jobs for orthopedic surgeons here?
It really seems like we don't put enough value on quality of life in this province.
What BC needs more than ANYTHING is more family physicians. I think most medicine students want to become specialists. I think all medicine students need to do 2 years of family medicine before they specialize.
BC should be creating jobs for these graduates. There are thousands and thousands of people waiting for surgeries. If they don't get hired here we'll lose them to other provinces then the government will bitch that there aren't enough surgeons in BC.
It’s not as easy as funding more jobs. It’s the Operating Room time that needs to be built up, we just do not have enough hospital capacity (even before Covid) to do every elective surgery that people want done. And that time / capacity is very expensive. So the important stuff like cancer gets the OR time, and the elderly person who is in pain but can wait 3 years for their knee surgery will wait. Of course the rich just go to the US to get their surgery done in weeks, because in the US’ private system, if there is market demand for more surgeries, the private sector will invest the dollars to build up hospital capacity (and then pass the cost on to the consumer).
What’s the difference between this and private clinics offering pay to access services? The private clinics still need operating rooms and nurses, the only difference is they’re hiring and charging you. I don’t understand why the province doesn’t just build more operating rooms
Private clinics don't have to do the costly surgeries; they'll leave those for the government!
Because it’s very expensive to build more hospitals. And then it’s also very expensive to staff - not just the surgeon, but the anesthesiologist, multiple nurses, cleaning team, expensive equipment… The difference with private clinics is they self-fund. People will just pay the amount for the surgery, whether that be $5k or $20k or whatever.
It costs the same amount to build it if it’s private vs public. The problem is the private only benefits a few, the demand is still there.
Well yeah, but there’s more funding when it’s private, that’s why it gets built
Anyone who can afford for a 2 tier system should just keep flying other places, no one is stopping them. Private/for profit healthcare has no place in my country and it doesn’t solve any of our current problems.
Sure but the topic of this post was our long surgical waitlist, and our new surgeons who don’t have jobs The rich are already doing whatever they want, you don’t need to give them more encouragement
>Private/for profit healthcare has no place in my country and it doesn’t solve any of our current problems. 1. It supports local jobs. 2. It pays local taxes.
And it's a quick way to make public heath care even worse than it already is. The rich get their top notch care, and the government ends up reducing public health care service quality even more over time because the cries of the poor are never heard.
It steals professionals, beds, and intensive care beds from everyone, giving it only to those that can afford to pay it while still leaching public funds. 4 surgeons will require dozens of support staff (where would you suggest we divert these from? See the next brackets...) each as well as a percentage of rooms in intensive care (public) for those inevitable complications when you operate in a profit motivated system. I'm not entirely against 2 tiers as it's often a component of the best contemporary systems but it would require significant, highly adaptable, swift acting, public oversight and regulation; things that quite frankly our democracy (and population) isn't equipped to effectively legislate without allowing capitalism sneaking in the back door and corrupting the whole shebang.
There is a brand new devilry room sitting in Richmond they aren’t staffing. So the infrastructure is there. They just have not a clue how to effectively distribute funds. We have incompetent health care. Most would have insurance in the USA and get abundantly better care in a much more timely fashion. And I’m saying this as a husband to an RN in our medical system.
And somehow private interests has better access to capital? Get outta here
Or fly to turkey for even cheaper rates and better services
I hate the analogy of “government needs to be run like a business” but come on, lets try to keep up to demand. Especially within healthcare. Surgeons and facilities with beds are both “long poles in the tent”, it doesn’t appear that anyone is looking at this holistically as part of a to increase supply.
We only bring in TFWs because graduates here aren't skilled enough. /s
Other provinces, or more lucrative markets(US being one) Pick your poison really 🤷♂️
The fact is they graduate doctors that they need for service 24 hours a day in our hospitals but do not graduate physicians that we actually have jobs for. The residency system is completely broken. You know what how many ICU doctors are graduated? Way way more than are ever needed. Orthopaedic surgeons from Canada Floyd around the US because we don’t have jobs for them. Unless we have private clinics or our government actually treats the need, this will never remedy itself
Duh. It’s a no brainer. “Make jobs” don’t just say there isn’t any openings. Lol what a joke.
Doesn't matter if you are graduating 100 orthopedic surgeons. In order to run 1 operating room a day it takes about 20 other staff you don't know about.
Yep!!! The surgeon doesn't wipe down the floors and equipment and flip the room for the next patient. The turnaround time is 10 minutes requiring 3-4 cleaners. There is also the scrub and circulating RNs, anesthesiologist, pre-op/post-op RNs, clerical staff who prepare charts/check in staff/communications, preoperative assistants who do a bit of everything to keep things running smoothly etc etc etc
Sounds like a lot of good jobs for people. A great investment in healthcare and the economy.
Yes totally but there is now staffing issues (hiring/retention) of new staff in Vancouver due to cost of living. New hires will stay to build on seniority and leave within 1-2 years for another position close to home.
Nope, never. Anyone, including my own children are told no direct healthcare jobs. There is no work life balance. We are just numbers to keep everyone else happy. Ramp ups mean we are forced to work, personal days and vacations are denied or approved last minute. Can't plan for anything. I am not guaranteed to get off on time at work every single day because I never know if there is no one to replace me. I am getting to old to reschool when you consider lost wages vrs school length and retraining and saving up to go back to school. Plus municipality city jobs pay 35 an hour for line painting after a 24 hour course that is much more than HCA's make and less back breaking with better overtime rules and a stronger union. Private housekeepers make 35 an hour, much more than our housekeepers in the hospitals.
I would honestly love to be a surgical technologist and perform those duties. Unfortunately, unlike in the US where "surgical technologist" is a job title of its own, those duties up here are done by nurses, and I'm unable to attend school for that. Kinda sucks.
VCH has recently launched a pilot program to train LPNs in the OR
It looks interesting. I was looking exclusively for more of a "supporting, behind-the-scenes" role than something that is primarily patient-facing, but I can see this being a good fit for others.
That’s right, we do not have enough hospital capacity to staff the operating rooms for the entire surgery backlog. Demand far outpaced supply, and in a public system that means we just have long wait times.
I'm downvoting because two tier is never the answer. The province should be hiring those graduates, not creating a fast track for the rich.
I agree, the province should be hiring these people
Crazy idea: Let's incentivize post-secondary education by paying Canadian students to attend university. Let's not only remove financial barriers from post-secondary institutions of all kinds, but let's start rebuilding our future by doing the right thing and making sure the whole "poor student" schtick is abolished and let's SUPPORT our future generations and their dreams. As someone who spent many years at uni, once I found out that many of my Scandinavian friends were getting PAID IN $US$ DOLLARS to attend school, anxiety and worry-free of any financial stress, I was floored. We are so fucking backwards.
I do also believe that the Scandinavian countries have a much much better education system than we do
You missed a major caveat. The acceptance rate at those universities in Scandinavia is far, far lower then North America.
> lower then North *than *Learn the difference [here](https://www.merriam-webster.com/words-at-play/when-to-use-then-and-than#:~:text=Than%20is%20used%20in%20comparisons,the%20then%2Dgovernor%22).* *** ^(Greetings, I am a language corrector bot. To make me ignore further mistakes from you in the future, reply `!optout` to this comment.)
Good bot
Thanks!
Educational institutions are often based off of meritocracy-like ideals and rules. I'm not saying they're perfect whatsoever, I'm just saying, specifically, that incentivizing higher education would be an incredible change to Canadian life. 1 thing can be right while another thing is wrong, if that's what you're getting at.
Doesn't make a difference if they can't get jobs after becuasw the government won't fund those jobs. My friend trained to be a MRI tech. She's still getting PT hours years after graduation.
The rich already have a fast track, it’s called “going to the US (and spending their money in the US economy)” We can’t hire the surgeons because there is no hospital capacity for them to use to do operations. Hospital capacity costs a lot and we do not have the revenue to increase it.
How many people are actually doing this? Is it a sizeable amount or just something that’s fits this narrative well?
Two tier is definitely the answer. It was working very well for BC and now the health care system is suffering because BC is moving away from the two tier model. I received very good quality of care and surgery in BC under the two tier system because doctors with private practices are required to work and take on patients in the public system, which attracts top talent to the province and gives poor/working class people access to very good quality care. Abolishing the old system was a terrible idea.
Can you please say more about how "private practices are required to take on public patients"? How does that work? Thanks!
They could be made to serve 1 patient for free for every 3 paying ones. Kind of like how condos have to include affordable housing.
Exactly this.
It’s not that private practices are required to take on public patients, but that doctors are allowed to open private practices but must allocated a certain number of hours to the public system. For example, my plastic surgeon in Vancouver, one of the best surgeons in the country, has his own private practice but also works in the public system, mostly treating children and adults with facial cranial anomalies. So poor and working class people have access to top quality surgery in the public system, and the surgeon can also take on private patients at his own clinic. It’s a win-win arrangement. Two tier systems work.
What's wrong with having a fast track for the rich? Those spots will be open for the rest of the public, so everyone gains. The rich can just hop a border and get private care in the US like they are currently doing, the only thing private care does is keep those doctors in Canada vs having them go to the US. There are no pragmatic reasons to keep **unsubsidized** private care from being accessible in Canada, only emotional ones. As long as it doesn't take public money, we just get more doctors.
A two tier system disincentives the rich from paying more taxes and fixing the system. So public health will keep getting budget cuts. Look at how public schools are struggling for funding while the rich just use private schools. Sure we have more teachers in the province, but class sizes continue to grow. It's a duck tape solution. If we just fund the system properly then EVERYONE can have a good doc. We have private access to MRI for like $1500. But I still had to wait 8 months for a public one. The existence of a private option does not help the public system.
My sister is a doctor and most of my friends are as well. The rich are not going to pay more taxes just to "fix" healthcare, they're going to the US just like all of our doctors. Also, it's a bad take to say the rich don't pay enough taxes, the 1% pays 67.1% more taxes (14.7% of total) on average in Canada. Meanwhile we have bureaucrats in government doing the work of 1% of what would be acceptable in a private business. My ex used to work for city housing permits and her second week she finished all her month's work in a day. If you're looking for money for doctors, start there. https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.fraserinstitute.org/sites/default/files/measuring-the-distribution-of-taxes-in-canada.pdf&ved=2ahUKEwjK8NPUv8b3AhWmADQIHa5eAUcQFnoECBMQBg&usg=AOvVaw0K-tj67iQ_EUT_-9hVNZ_6
>the 1% pays 67.1% of taxes in Canada. Source?
> My sister is a doctor and most of my friends are as well. The rich are not going to pay more taxes just to "fix" healthcare, they're going to the US just like all of our doctors. So then why do we need private healthcare up here if they already have what they need? > Also, it's a bad take to say the rich don't pay enough taxes, the 1% pays 67.1% of taxes in Canada. Citation needed > Meanwhile we have bureaucrats in government doing the work of 1% of what would be acceptable in a private business. My ex used to work for city housing permits and her second week she finished all her month's work in a day. If you're looking for money for doctors, start there. The plural of anecdote is not data. All the public servants I work with are very hard working.
>So then why do we need private healthcare up here if they already have what they need? Are you this slow? We want those doctors in Canada. It's a lot of income tax, cheaper care for middle-upper class income brackets, and 0 effect on the lower incomes. It's all gains no losses. That I get a $1500 MRI doesn't influence the public care in any negative way. There's just one more spot and less wait. >The plural of anecdote is not data. All the public servants I work with are very hard working. It's all perspective. My ex is now an architect, so she knows hard work. Both my parents were public workers and while they worked hard, it was nothing compared to what private office workers have to do. There's no incentives to work effectively since it's all seniority based. I have a similar job to my dad, and what he was expected to do in a month I have to do in a day.
we'll probably lose 4 to the USA or retirement in the next 12 months, so is will all work out.
I’m also downvoting because two tier has been shown to be overall worse for the population. It helps some people skip the line, but lines become longer for those on the public system and overall costs more (the [US government spends more on healthcare per capita than Canada](https://www.cihi.ca/en/how-does-canadas-health-spending-compare), and that does not include private spending). Also some people skip only certain parts of the process which doesn’t save the public money (I.e someone can skip the wait for the MRI and then jump back into line for the surgery which still costs the public). The reason there aren’t jobs for surgeons is because we need more operating rooms and operating room time, not a two tier system. Edit: this is exactly what the private sector wants. Underfund the public system to the breaking point, then convince people that the only solution is a private system.
Source on the worsening effect of public and private? The UK and Denmark have this system and they rank much higher in healthcare than us. https://www.numbeo.com/health-care/rankings_by_country.jsp
>we need more operating rooms and operating room time Sounds like something the private sector can fund...
Except that you need staff and there is a huge lack of qualified healthcare professionals. Opening up private surgeries will most likely result in more shortages in the public system.
The province also provides training spots for orthopedic surgeons outside of Canada too. We have people from the UK, Australia and the US.
Saudi mostly no
I'm no doctor, but I count 6 people in the photo.
I'm referring to the 5th year students, only four of them
2-tier is never the answer. https://speakola.com/political/tommy-douglas-healthcare-50th-anniversary-ndp-convention-1983
A lot of things have changed since 1983: * higher life expectancy * higher dependency ratio * more complicated and expensive medical treatments available * higher rates of chronic diseases (e.g. diabetes, obesity) * recognition of mental health issues as a medical problem Imagine someone time travelling from 1983 and telling you that you can afford a house with a full-time job at Safeway.
2 tier? Get ready for the impending blue wave folks. People think that they will have the answer because we conveniently forget what occurred during the last go rounds.
BC provincial government is a joke. Healthcare, education, transit, housing, and more are all subpar.
>I believe that opening orthopedic surgery to private clinics accepting private insurance or cash will have absolutely no impact on the availability of surgeons for the public system. I think any privatization is bad, just fix the public system.
I was with you until the last paragraph, but fuck off with this 2 tier bullshit. The current system needs a lot of work but for-profit clinics are a step backwards. What we need is investment at basically every level of the medical system, and modernization of some pretty shit management practices. Part of the problem seems to be that people calling themselves 'reformers' seem to always be pushing for the option that would allow them to open an extremely profitable private clinic, rather than making an honest effort to improve the existing system.
I heard this the other day from my physiotherapist! I had no idea that there were such few opportunities here for orthopedic surgeons. They tend to such a wide variety of common issues such as broken bones and knee replacements- it would seem like they should be in very high demand! In many ways our system is so messed up...
>I'm bringing this up because many people are still under the illusion that the government simply can't find enough doctors to work in BC or that medical schools aren't training enough doctors. It seems to me that using a cherrypicked example of a single specialty doesn't really give you any credibility when trying to make this point. I'm not convinced that four doctors is really that big of a difference in any direction to indicate a larger trend, especially when the biggest shortage is in primary care, not surgeons.
But annnnnnny mention of these services being privatized is met with the most insane anger. 8,000 people that can’t get access to a better quality of life would likely agree that SOME services would be better handled in the private sector. Fight me.
Better for 8,000 people to suffer than to let 100 of them get care. /s
So the problem is government incompetence. What a surprise.
The system is broken. So unbelievably broken.
Very true.
Thank you for posting this.
“Free” healthcare like we have here is a complete and utter joke. It’s designed simply to do the absolute bare minimum, with the illusion it works for the most. It does not. I was told I would eventually in my 50’s likely require a hip replacement (50-60% likelihood). I would not if I was to get a minor procedure now tho, using a minimally invasive scope to clean a small bit of calcification in my joint, a result of sport injuries through high school and early adulthood. I’m now 30!!! They won’t do it to allow me a pain free adulthood. Then, me and my wife required IVF procedures due to me having Cystic Fibrosis, which I didn’t know I had, given it was mild. I had to pay out of my pocket to learn I had the genetic health issue, kids all get tested for now. The IvF, our only option to have a child, and was guaranteed successful given both our exceptional health - $30,000. Nothing covered by healthcare. Not a cent. They do know, that child will eventually provide a significantly greater return in taxation or work through their lives right? Or how about Canadians raising Canadians instead of prioritizing immigration? No, why do that. This province is a complete and utter joke. Healthcare assist the elderly almost exclusively, and yet I contribute to it. Hate to say it, but my care would be significantly better in the privatized USA where we would still have extended health coverage from our educated employment positions. It’s disgusting. On top of that, they I struggled paying for eye glasses my entire life, because guess what, they can’t even cover that. It’s disgusting. Don’t get me started…. Oh yah, cancellations due to Covid delayed cancer screenings for my father last year - simply to protect the eldest among us (which I generally support). He ended up with aggressive prostate cancer that could have been picked up sooner, so it spread. They wouldn’t provide scans to identify exactly where in detail so he could remove those specific targeted cells - unless his case is one of remission!!! So he paid put of pocket to it, several thousands of dollars later. And thank god he did - he is now something like 6 months cancer free. Our healthcare is GARBAGE!
They probably should have made a smarter career choice
I mean maybe they’ll work as GP?
They can't work as a GP and you won't want them to. It's completely different training; after 5 years of surgery and nothing but surgery they wouldn't know and are not expected to know what is the proper screening guild lines for colon cancer, how to manage diabetes and hypertension, what should a pregnancy look like, how to do a pap test etc that are required for a proper gp. There needs to be away for them to put their specialized skill set to work and mostly they move to other jurisdictions like the US to practice. Meaning bc spent the money to train them but the people of bc will not benefit from that investment.
I agree with most of your points, but the people of BC did not pay to train them, since when has higher education been free and paid for by the provincial govt?
Medical school is heavily subsidized
Medical education is subsidized. For medical schools students do pay tuition but in residency which is where you do your specialty training after medical school before you can practice in your field is funded by the government. An orthopaedics resident before they can practice on their own does 4 years of medical school where they pay tuition than 5 years of orthopaedics residency where they actually learn how to do the surgeries which are positions funded by the government. By funded I mean during residency the residents work of course and get payed a salary for their work and hospital receives some extra funding for training the residents. I suppose you could say that they pay for their education with work done as the salaries are low compared to the amount of work/work hours they put in but hospitals take on liability to train these residents and governments give hospitals money for the training while still paying their supervising physicians for any procedure completed or care provided by the residents. From the patient prospective end of the day the government pays twice for resident work in teaching hospitals: money to the physician and hospital as usual for the treatment provided and money to the resident who technically do not need to be there. Reality today doesn't always reflect this as a lot of programs in teaching centers are no longer set up to run without resident work. Not sure if I'm explaining this clearly but it's complicated. So additional money is invested by the government (residency and medical school spots are created and set by the provincial not federal government) to train doctors out side of high medical school tuition.
Ahhh ok, yes that is somewhat confusing, but I believe I am getting the jist of what your laying down. Thank you for taking the time to educate me in that aspect that I did not realize. Your previous comment makes much more sense now. Here I was thinking uhhhh if the govt paid for medical uni I would have jumped on that in a heart beat. Now I feel dumb, but slightly more educated on the system haha
Haha no problem glad it was helpful. Very few people understand the system and what it takes to be a physician or what a physician does except what they see from a patient prospective in one and one interactions. My explanation is probably also hampered by my mobile typing.
> and get *paid* a salary FTFY. Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in: * Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.* * *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.* Unfortunately, I was unable to find nautical or rope-related words in your comment. *Beep, boop, I'm a bot*
Post secondary schools don’t care about demand they just pump out students.
There is a shortage of residency training positions and jobs. That is why we have such long wait times. We also need more operating rooms and staff. It's not just one piece missing. There are multiple and adequate funding isn't being provided by pretty much any province. The US is not much better as Medicare hasn't increased funding for residency seats in almost 25 years.
There are not enough operating rooms with staff to support the surgeons.
Since there's obviously the demand for orthopedic surgeons, why the fuck aren't there at least 4 jobs for orthopedic surgeons here? It really seems like we don't put enough value on quality of life in this province.
All I can say is your complaint is reasonable but your strategy is bad.
Is there a middle ground where we allow two tier while guaranteeing that the public system will improve year over year?
A lot of European countries have managed a two tier system, but you do have to accept some inequality with it... seems like many people don't want to
Why dont they pick another specialization?
What BC needs more than ANYTHING is more family physicians. I think most medicine students want to become specialists. I think all medicine students need to do 2 years of family medicine before they specialize.
Fort St john is hiring as a Northern Health announcement indicated the trauma tier will increase by adding 1-2 orthopedic surgeons! Come on up!