July 22, 2012

The Dirty Little Secret Of Socialized Health Care

Nobody needs to be a doctor.

Ontario's Health Minister is still angered by the number of millionaire doctors populating the province.

"I was appalled when I saw how many were making in excess of $1 million," Deb Matthews said, referring to a list that counted over 400 names in 2010.

"Some doctors are getting paid too much. We need to address the issue of relativity. Some doctors in some specialties are earning a fraction of what doctors in other specialties are earning."

(h/t Bull)

Posted by Kate at July 22, 2012 7:57 AM

"Some doctors are getting paid too much."

She's a member of an incompetent, semi-corrupt government which has blown billions of dollars with nothing to show for it, and she has the gall to pontificate on how much doctors should make.
I don't now how much doctors deserve, but this slug deserves nothing.

Posted by: wyatt ironbridge at July 22, 2012 8:25 AM

She fails to mention how much McSquinty threw away to Hydro Exs, E Health, Orang biggies, their friends as in the change of hydro plans = $190 million and other scandels.

She has not addressed spiraling Lawyer costs nor the curtailment of services to the public.

Reminds me of just another NDP government in Red clothing.

Posted by: The LS from SK at July 22, 2012 8:31 AM

So specialists in areas where there are shortages of doctors get paid a lot, so the answer from this particular representative of a fiscallly disastrous govt is to reduce the attraction of these specialties, and of course lead to more shortages.


How much do hockey players and baseball players at the govt subsidised sports arenas make?

Posted by: Chip at July 22, 2012 8:37 AM

OK, so she's appalled and angered.
When are these destroyers NOT appalled and angered?

They spend their entire lives flitting about from one outrage to another, leaving nothing but devastating social carnage in their wake.

Posted by: Dystopian Optimist at July 22, 2012 8:39 AM

You know, if it wasn't for all the money Don Smith gave to the olpc, McGuinty would have shuffled Deer in the headlights Deb to a minor portfolio long ago.
That being said, here's what Deb meant to say.
"If you worked at setting up that practice and it became successful, you didn't do that...."

Posted by: Joseph at July 22, 2012 8:40 AM

You know, if it wasn't for all the money Don Smith gave to the olpc, McGuinty would have shuffled Deer in the headlights Deb to a minor portfolio long ago.
That being said, here's what Deb meant to say.
"If you worked at setting up that practice and it became successful, you didn't do that...."

Posted by: Joseph at July 22, 2012 8:40 AM

Ontario, and in particular - Toronto, deserve exactly what they voted for. If you're a health care professional, or any type of professional get out of that corrupt decadent deviant decaying socialist cess-pool while you can.

Posted by: Chris at July 22, 2012 8:47 AM

How dare she tell people how much they can make?
Oh, I forgot. Just as soon as the government took over healthcare they took over all other aspects of your life. Doctors and other healthcare workers are nothing more than civil servants.
Socialized medicine must go!

Posted by: Gaylord at July 22, 2012 9:06 AM

My,where did all this new-found concern come from, all of a sudden?

Oh, I know. She must be talking about the $1.4 million in salary and bonuses (plus $1.2 million in loans and cash payouts)that her Liberal friends shelled out to Dr. Chris Mazza, when he did such a stellar job as head of Ontario's air-ambulance service.

Posted by: Jamie MacMaster at July 22, 2012 9:11 AM

What a stupid carbon based bi ped who needs the lid down.

Posted by: Ford Prefect at July 22, 2012 9:16 AM

You can try to outlaw the workings of markets, but you really can't make them go away, can you?

Posted by: Iowa Jim at July 22, 2012 9:35 AM

The basic laws of economics hold that consumer subsidies (like "Free" health care)
create shortages and rationing, while producer subsidies (paying doctors well and
investing in high tech medical equipment) create more efficient surpluses of treatment.
Any incompetent egomaniac politician at any level who runs away from admitting
that is bedrock for solving our problems is just a con artist or worse, a eugenicist.

Posted by: Sgt Lejaune at July 22, 2012 9:54 AM

The costs of doctors are not a big driver of the overall cost of healthcare, just as the cost of barley is not an overall driver of the cost of beer.

Rather it is the inefficiencies of delivery and consumption that result because of the lack of accountability and rewards - read little or no price signal - applied on providers and consumers.

If anything lowering the compensation or the amount doctors can work - the only two options that this Clown has to reduce the number millionaire doctors - will reduce the supply of their services - perhaps dramatically so - and thus the system will become even more inefficient.

That she engages in this dogma and is the health minister tells you all you need to know about the future of healthcare delivery in Ontario.

Posted by: Gord Tulk at July 22, 2012 10:04 AM

"Some doctors are getting paid too much. We need to address the issue of relativity. Some doctors in some specialties are earning a fraction of what doctors in other specialties are earning."

Gosh. Some people make more than others. *This-this is my shocked face.

Posted by: LAS at July 22, 2012 10:25 AM

Doctors (some) may get paid a lot but at least they do something constructive to earn that money.
Here in B.C. the Ministry for Children just announced they would probably have to scrap a software program that cost 180 MILLION dollars because it didn't work. Are you kidding me . They spend 180 Million dollars when you can go down to Staple and for $59.95 get a database program that would probably do 40-50% of what they want. I am of the opinion that ALL bureacrats are overpaid, lazy, underworked asnd incompetent.They sit around doing as little as possible and make decisions completely detatched from reality. We hear about them every day. Every time you hear about a new govt policy that doesn't seem to make sense think"useless, lazy, incompetent bureacrat".

Posted by: Horny Toad at July 22, 2012 10:34 AM

Governments that operate slot machines, lotteries, casinos and monopoly alcohol outlets are in no position to moralize about how people earn their money and how much of it they make.

Posted by: JJM at July 22, 2012 10:40 AM

Horny Toad nails it, and I have some experience with them.

Gord Tulk, "just as the cost of barley is not an overall driver of the cost of beer." About .07 cents to .09 cents a bottle the last time I saw figures.

Posted by: Ken (Kulak) at July 22, 2012 10:48 AM

Simple, import more doctors from Kenya and other parts of the Third World so that our millionaire doctors go away, Duh.

He's not thinking clearly we can get rid of our doctors in many ways if we're imaginative enough.

Why don't we give our doctors a onetime buyout incentive to leave, then we can all be culturally enriched with a real doctor from the slums of Mumbai. We’ll never be happy as a society if we’re being catered to by white bread men with an accent we can understand, confusion and misdiagnosis is what makes us all stronger in the long run.

Posted by: Knight 99 at July 22, 2012 11:06 AM

Some professions, including doctors have been granted the monopoly priviledge of self regulation. They decide how many doctors will be allowed to practice and thus how much they can earn. I am not surprized that doctors from places like Germany, france, sweden or New Zealand can not come to Canada and practice medicine. Competition must be restricted. Monopolies of doctors, labor unions, marketing boards, utilities or government will always be abused, 100% of the time.

Posted by: m at July 22, 2012 11:11 AM

It's time for the Uprising of the Cabbies. "I was a doctor in my country!!!" (yeah, a witch doctor). Welcome to health care in Ontario - 21st century style...

Posted by: Brian M. at July 22, 2012 11:41 AM

Lecavalier makes $10 million a year playing hockey. The league minimum salary is $450,000. The worst hockey player makes almost half what the country's best surgeons make and you got a problem with the doctors?

Posted by: Hawkeye at July 22, 2012 11:45 AM

Speaking of socialized healthcare, Mark Levin had an interesting call the other day:

Posted by: Mkelley at July 22, 2012 12:05 PM

So it's wrong that somebody in the public system gets paid too much.
Then would it be okay then to let the doctors work in a private system?
Sounds like deer in the headlights deb has just handed the lawyers handling that constitutional challenge all the ammo they need.
The current system forces public employees to take a wage under the cost of living.
Let the unions ignore that one.

Posted by: Joseph at July 22, 2012 12:12 PM

They don't make too much money. Someone else gave it to them.

Posted by: foobert at July 22, 2012 12:44 PM

Frankly I,m more appalled at what Government Ministers make. At least doctors are there to save lives not make them worse. She sets up roadblock, death panels & is paid a pension only Emperors could afford. Yet whines about working Doctors. More politics of envy.

Posted by: Revnant Dream at July 22, 2012 1:02 PM

I don't begrudge doctors their money at all, but since most doctors make their money by billing OHIP how is it that one doctor can bill 6.4 million when the average is under 1 million? If I understood it better it might make sense, but something doesn't smell right there. Does this guy work 180 hours a week while the others are only working 20?

Posted by: minuteman at July 22, 2012 1:10 PM

Ophthalmologists in the part of BC I live in are hard to find. The one my wife and I go to see has a huge staff so I assume her overhead is huge.

Posted by: Bruce at July 22, 2012 1:11 PM

Canada is stuck in a high cost model because of its proximity to the US. Doctors in other developed countries are paid much less. I knew an English schoolteacher who said she made more than her doctor husband. They moved to Canada. Wonder why?

Making cab-driver doctors into real doctors is only the answer if you want more doctors who have trouble distinguishing their anus from an excavation. Third world medical education is a better training ground for cab drivers than doctors.

Posted by: Scar at July 22, 2012 1:17 PM

Some loathsome member of the McGuinty government says that a few surgeons make too much money?
Well, if there were more they would be paid less. Easy for a government such as McGuinty's to exert pressure on certifying boards to allow more.
They don't really care about "unfairness", it's just that they don't want to pay.

What I object to is filthy little jackass politicians not only getting paid but using too much air and excreting too much carbon dioxide.

Let's set up a committee to reduce Deb Matthews's personal carbon dioxide emissions. Zero emissions will be our target.

Posted by: John Lewis at July 22, 2012 1:49 PM


Posted by: bob at July 22, 2012 5:04 PM

Now let's see, the Liberals, initiallly through Smitherman, gave the doctors a massive increase in 2003 and have increased their earnings by 85% over the years.

Matthews and McGuinty have just discovered that Ontario under their watch is broke so let's set up a few straw men and attack them to distract the public from our incompetency.

Unlike politicians doctors are useful and we all need them especially with our ageing population.

I never thought I would despise a politician more than Cretin but McGuinty is pure pond scum.

Posted by: dave at July 22, 2012 6:22 PM

Nobody knows what doctors in Canada should make because the market has been socialized. So there are no price signals, no response to supply and demand, no market signals whatsoever to determine fair remuneration. That's socialism for you.

Posted by: scf at July 22, 2012 8:23 PM

Hawkeye is right. To put it in terms Toronto Liberal supporters can understand, The best Surgeon in Ontario makes less than Dion Phaneuf!

Posted by: flurd at July 22, 2012 9:08 PM

Knight 99 said: "Simple, import more doctors from Kenya and other parts of the Third World so that our millionaire doctors go away, Duh."

Dude, been to an Ontario hospital lately? They did that little thing ten years ago. Didn't help, because now the physicians recruited from such stellar countries as Russia, Bulgaria, Kenya and Saudi Arabia are b1tching about the conditions in Ontario hospitals.

You think I'm kidding. Sadly, not so.

By the way, some specialists make over a million a year because they work 12 hours a day, seven days a week. You think there's a shortage now? Wait until McGuinty caps some of these doctors. They'll start working eight hours a day, five days a week and let the shortfall go pound salt.

Pure propaganda anyway. The real joke is we don't have a doctor shortage. There's plenty. What we have is a propaganda campaign to siphon ever-increasing amounts of money to provide ever-decreasing amounts of service.

Get ready for the day they tell you they're going to let Grandma die because she "doesn't meet the criteria for ongoing medical treatment". Coming soon to an Ontario hospital near you. Again, not kidding.

Posted by: The Phantom at July 22, 2012 10:14 PM

Ironically, surgeons don't actually make the big bucks as far as physicians go. Normally, they only have operating time for a max of 2 days per week. And then the Provincial Health Authority usually limits the number of procedures per year (think knee and hip replacements).

Radiologists are among those physicians that bill the big dollar amounts. However, any X-ray performed in Alberta must be billed under the name of the physician that is responsible for the test. Therefore, in Alberta, the Radiologist appears to bill for thousands of tests that they review but they normally only receive 30% of what they bill (for reading the test) and then they have to pay their staff, their equipment and their building out of the 30%. What is left over, is theirs. Ever wonder why the governments trot out the huge billing figures.

Ultimately, physicians can work wherever. Anywhere you look, the jurisdiction needs additional physicians.

The only reason I could cheer the madness of McGuinty's government is that we need more doctors in Alberta. I am confident that if the Ontario government continues on this path, we will see an influx of doctors moving westward.

Posted by: TJ at July 22, 2012 10:16 PM

The real joke is we don't have a doctor shortage. There's plenty. What we have is a propaganda campaign to siphon ever-increasing amounts of money to provide ever-decreasing amounts of service.

Phantom that is somewhat true but I can tell you in Alberta; there are a lot of smaller cities and rural areas that have physician shortages.

You are correct that the absolute number of physicians is probably sufficient but one, they are not located in the right places and two, new physicians are not at all interested in working as hard as the physicians they are replacing. Therefore, even though, there are more graduates coming out of school, they will not cover the workload of those retiring.

Posted by: TJ at July 22, 2012 10:25 PM

The doctor billing $6.4 million/year is probably the one whose name is used on all lab test billings. There was a similar outcry about "overpaid doctors" in BC and suddenly the moonbat politicians learned a lesson about how lab tests are billed. I'd assume that for a medical lab the overhead is somewhere on the order of 80% given the equipment and staff that are required.

Ophthalmologists are the biggest billers and they also have a very high overhead office practice. Presumably the Ontario governments response to the upcoming ophthalmologist shortage will be to distribute free white canes and run an advertising campaign about drivers watching for an increasing number of blind pedestrians.

IMO, a good cardiac surgeon is definitely worth $1 million/year. Same with good specialists of all kinds. Hospital administrators are a drag on the system and have negative worth. Nurses can make more than GP's if they sign up for double time shifts which are often the result of other nurses being "sick". Union jobs in the medical system are a far greater expense than doctors billings but one won't hear about that from a socialist government.

The socialized medicine system has the perverse effect that good GP's make a lot less than crappy GP's that crank patients through their practices. A free market system would ensure that the latter group of GP's would be billing far less for a quick visit than a very comprehensive GP. It's possible to be fast and do good medicine, but not in a setting where one often sees a patient with congestive heart failure, diabetes and hypertension and one wants to do good medicine. Usually when I seem them the patient has decompensated after some high volume GP has decided to treat their gout with indomethicin and put them into renal failure as well.

The only solution to this problem is to get rid of socialized medicine and let people pay a premium for better medical care. That's where we're headed whether or not the statists agree.

One of the ways of getting better distribution of doctors is to have differential fees depending on where one is located. Personally, I'm very glad to be out of the world of the Vancouver worried well and practicing in an area where 95% of people I see actually have a real medical problem.

And the nicest thing about being a doctor is that if one is competent one can practice pretty much everywhere in the world. Human physiologic systems have a distressing tendency to malfunction and people who can fix the malfunctions are in very high demand, or at least will continue to be so until we get autodocs as described by Larry Niven.

Posted by: Loki at July 23, 2012 2:43 AM

My dad's cardiologist gets audited every year because he is consistently in the top 5 in billing. His patient list is humongous due to the very large senior demographic in our area. He takes 2 weeks vacation a year and more often than not cuts those short if he is informed that a patient of his has been hospitalized with a serious problem, heart related or not. Dad has told him many times that he is going to need his own services soon if he doesn't slow down and do you know what his answer always is? 'I became a doctor to help people and I'll continue to help people as long as I can and I couldn't care less what the province thinks.'

On the other hand, my family doctor operates a clinic with 2 other general practitioners and they each have to take off 1 week per month because they will not get compensated by the province for anymore time spent with patients. He told us that if he worked a regular 40 hour week he would run out of billable hours by the middle of September. He is a super nice guy who makes hospital visits on his own time and does what he can but the rules are different for him than for specialists.

How much of the backlog in hospitals would be taken care of if GP's were allowed to work as much as they wanted to thereby saving money in the process because clinics have far less overhead to deal with than hospitals do?

Posted by: Chris at July 23, 2012 5:53 AM

Loki said: "The socialized medicine system has the perverse effect that good GP's make a lot less than crappy GP's that crank patients through their practices. A free market system would ensure that the latter group of GP's would be billing far less for a quick visit than a very comprehensive GP."

This brings up a very important point. The present system in which family docs/GPs are considered "gatekeepers", and the patient can't get in to see a specialist without a GP's referral, this is one of the things that keeps medical care expensive and bad. A GP can only make a decent living by seeing >30 patients a day. GPs average five minutes per patient. That's not enough time to do a decent job, on average. But that's where a great deal of money gets spent, maintaining this curtain wall of waiting lists and non-treatment to keep people out.

If the "gatekeeper" arrangement was removed and people had to spend their own money, most GPs would be out of business in weeks. Patients would go direct to the specialists, because there's no reason to pay a guy just to have him tell you to go see some other guy. But that's what we're doing.

That's why I say there's not a shortage of doctors. There's a shortage of useful treatment. Reason being, the system sees treatment as a cost and patients as a financial drain, not as its source of income. Its backward.

Please understand that this is not an indictment of GPs. They are constrained by the system to practice in this way, they really have no choice in the matter. Well, other than to leave the country or take up another trade.

Posted by: The Phantom at July 23, 2012 11:29 AM

Gee, Becoming a physician requires a Minimum of 12 years of post-secondary education; even more for specialists. Furthermore, just because a doctor bills more than $1 million per year does not mean that's what they take home as income. There's something called 'overhead'; a concept that I don't expect some political hack to understand. Stupid b***h.

Posted by: Marty at July 23, 2012 4:44 PM

Phantom, in my experience some of the worst care I've seen for patients has been delivered by a herd of subspecialists who are focused only on their one little area of superspecialization. What is needed to deliver good care is a generalist who has a complete picture of the patients pathology and this function is carried out by general internists in large cities and GP's in small centers.

Specialists are not interested in longitudinal care of patients (although that does depend on the specialty). They will either come up with a diagnosis for a patient that they will see only once or perform a procedure on a patient. The function of GP's, where they are truly providing a service, is to provide longitudinal care for a patient and patients like having someone around who has a global picture of their medical problems as well as the often decades long relationship that patients have with GP's.

What I found when I moved into the interior is that country docs are highly skilled and far more knowledgeable than the average city GP. A lot of that is because in order to survive in a solo practice environment in the middle of nowhere one has to learn a lot of things that city GP's will delegate to specialists and one also has to be willing to improvise to treat people when the nearest specialist is many hours away.

The worst GP's are the doctors that figure they'll work in a walkin clinic in a large city where the vast majority of their work is refilling prescriptions for patients who can't get an appointment with their regular doctor. One of the ER docs at St. Paul's couldn't believe when a GP at one of the nearby walkin clinics sent a case of uncomplicated tonsillitis to the ER! Nothing erodes ones medical skills faster than not using them.

The self-referral to specialists is the US model and I've dealt with US patients who bring in very nice photos of their colons or total body CT scans but they have absolutely nothing to do with their primary medical problem. I believe people should be allowed to spend their money on such things but I also consider generalists to be the best physicians to be involved in patients care.

Posted by: Loki at July 23, 2012 10:05 PM