Pro-medicare DOCTOR SPEAKS FRANKLY ON PROS AND CONS OF MEDICARE QUESTION: What is the medical pro- fession’s view on medicare? ANSWER: They are very much op- posed to it generally. Some doctors would say they are not opposed to med- icare, but to some principles involved. Q: How do they describe their posi- tion? A: I think they feel medicare is op- posed to their way of life, to their free- enterprise principles. In other words, they are businessmen. Q: Does the doctor think-of himself as a businessman? A: I think many do. They feel they’re in it to make a living. Q: Like a lawyer? A: Like any professional man. Q: Does the doctor decide on his at- titude to medicare from the “profes- sional” point of view rather than from the “medical” viewpoint? A: I think most doctors feel medicare would deprive them, from their profes- sional point of view. Q: Dollars and cents? A: Yes. Q: I’ve heard that the doctor-patient relationship is a big factor in the med- ical profession’s attitude to medicare. What is this relationship? A: A definition of this term is dif- ficult. From a doctor’s point of view this relationship is strictly medical. He tries to establish an understanding, so that the patient has complete confidence in this man’s ability to help him with his medical problems. Q: Would this take one visit, or a number of visits to the doctor? A: A patient has his problem diag- nosed, is treated successfully, then per- haps confidence is established. It de- pends on the patient. It may take two or three visits. It may take more, de- pending on the seriousness of the ill- ness. Q: In other words, the idea of the family physician is good? A: Yes, I think so. Q: If you had to visit a clinic instead of a family doctor, where you might never see the same doctor twice, would this effect the relationship? A: I believe that in most countries they now feel there is a need for some- one the patient can see regularly, either one or two persons. A patient may have a problem that affects his personal life. The understanding of the doctor is im- portant, medically and psychologically. Q: You feel that a system of social- ized medicine should strive to preserve the doctor-patient relationship you des- cribe? A: As much as possible. Q: I’ve heard the argument that many . persons would take advantage of free medicare to abuse it. Do you agree? A: I’ve heard: there is this problem at - the outset. But this problem quickly re- solves itself. In England, at the outset, they had a lot of what the doctors thought were unnecessary visits. : Q: But this later clears up? A: Apparently it does. Q: Is there a different viewpoint in different sectors of the medical profes- sion? A: I do not think any one body takes any official stand for it. A lot have taken stands against it. But there are many in- dividuals who agree with it and are wil- ling to work under it. But these views are expressed infrequently in public, or even to any medical body. Q: Why? A: I don’t really know. Some doctors . feel it is going to come anyway and so they won’t argue about it at all. Others feel they can be ostracized in some way, especially specialists who depend very much on referral patients, if their view- points clash with others. This isn’t just in this case, but even in social life. If someone doesn’t like you he doesn’t send you his patients. This is a pretty tight group this way. Q: Do you think opposition to med- icare ‘is a blemish on the profession? A: I think so. Q: Do doctors realize their collective _ gtand is a blemish? A: Many do. Many, especially in Ont- ario, felt the doctors in Saskatchewan should not have gone on strike. There are others who now feel they should help to set up a system agreeable to the medical profession as a whole. _ Q: What would medicare do for the health of the country? A: When these things are free there will be more opportunity to practice preventive medicine. We have much: of it now as a matter of fact. This involves free vaccination, further investigation of different diseases such as cancer, heart disease. On the other hand, these peo- ple already get grants from many com- panies. - Q: And do they get grants from the government? A: Oh, yes. But I think most of the money they get is from private enter- prise. I think that if some of this work were done collectively you wouldn’t get repetition. You could save a lot of money this way. But some people would argue that repetition is good, that there are different aspects of the same work that are brought to life when different groups do the same type of work. A system of socialized medicine might improve research facilities available in Canada. Q: If the government paid for all the research, the public might have some control over what should be increased or decreased. A: Yes, but a Jot of these doctors and research workers feel they are doing good work and only they, and maybe. their confreres, know what should and shouldn’t be done. I think this is an area where there is an argument against so- cialized medicine. Doctors and scientists argue that there would be too much con- trol by laymen who don’t understand what should and shouldn’t be done. Q: Do you think we can eliminate the main diseases, such as heart disease and cancer, in the present medical setup? A: I don’t know if you'll ever defeat them all in any setup. As people grow older they present new problems. Cer- tain diseases, cancer for example, might better be treated and fought under some other system, and some of the infectious and veneral diseases. Certain diseases that require more research, and this de- pends on where the money is, fit into this category. : Q: Am I justified in concluding that the basic arguments for medicare are economic, not medical? A: I think most people who support medicare feel it means that some fellow who has a serious illness will not find himself financially bankrupt. Q: In other words, the present setup has been able to solve the problems of medical research, of combatting disease, but not the economic problem of a per- son who is a wage earner, who gets sick ‘and suddenly loses his income? A: Exactly. You should know that free medical care is available now. But be- fore a person can get it he has to be in- digent, or on his last legs, or own very little. All hospitals have provision for treatment of those who can’t pay. Q: If you are a working man with an auto and home in the suburbs you might july 30, .1965—PACIFIC TRIBU Why do doctors’ organizations oppose medicare? How do the medical men_ feel ' image of the CMA? Why 90? doctors who favor medical speak up? To get a mech man’s view on these questiol the Canadian Tribune inteWe, ed a Hamilton, Ont., doctor - name cannot be used for obvious reasons. > =e have to lose all that before you @ get this medical aid? A: Yes. This is what medicare people won’t become indigent of illness. Q: Under medicare, doctors would longer be private-enterprise pro™ people. They would be like g0¥® office workers. Would this have 4 ralizing effect? a A: Perhaps in- this country, yi doctors have been brought UP" the way they do. Maybe youns®! wouldn’t have that problem. Be. few younger people having 2 t0¥8 setting themselves up — g!@ Be tors who are interested in res" teaching, who situate thems® | large cities and university towns, of their time is spent teaching not very remunerative. I’ve he of them say “if the governme? over, so what? It means I get ®@ salary.” Older people don’t th way. They’re well-established. a good income and they dont giv be deprived of it. But it’s at © thing. Others couldn’t care 1es® Q: In other words, if medica introduced there might be 4 a period, with varying degzees 0 for different doctors? A: I think so, sure. Q: Would you say the medict sion is‘more demanding than ° fessions? A: I think it is. Mainly peca strain, They are dealing W! hes? death, and when death comes foe the people that usually havé nit explain it to the relatives. J , ) emotionally, it’s harder. YOU! thinking of a patient as a liv Most family physicians and § become emotionally involve® they try to divorce themselves it’s impossible. A lot of docit ne their problems home with | they are on call. If someth) they are responsible for the Q: What do doctors givé up? A: More of their social and than anyone else. Q: Does the doctor work : I think so. Q: More than 40 hours 4 A: Definitely. Q: What benefits does he g A: I don’t think he gets * benefits. ae Q: Just personal satisfacti™. A: I think so. He makes ae pending on the goals he sets ple can’t live on $40,000 460 some can live quite ha? $10,000 or $15,000. Q: #hd $5,000? vet A: Some people have t0 y oo less. But I’m not saying ose week et: NEW