Commentary MJA Insight: Henry Woo: Abuse of self-pay patient system widespread (ethics)

Note: sound familiar? 
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"....Sadly, the abuse of the self-pay system is widespread in the NSW public hospital system. We may be aware that it is happening, but nothing will change unless patients complain, and this is hardly likely.

Surgeons who aren’t happy with this arrangement appear unwilling to come forward in fear of political retribution, professional isolation and stymied career progression.

If we were to abolish self-pay, would we risk throwing the baby out with the bathwater? We have to balance the risks to our professional standing, our inability to regulate this behaviour and the financial risks to those who can least afford it against the risk of removing patient choice.

I would like to see this practice abolished, but if we cannot speak out about this when it involves unethical behaviour, the balance is heavily tilted against ever eradicating the self-pay system in our public hospitals."

CMAJ - Obstacles to health care transformation are numerous

The federal government's abandonment of health -- Canadian Medical Association Journal

Note: key excerpts; also interesting that until very recently the CMAJ was a proponent of privitisation and that fact will surely be on the minds and tongues of the critiques

"Stephen Harper has made no secret of his Conservative government’s
position on health care — health is a provincial matter.
Although this position has no basis in fact or law, many believe it,
especially when provincial and territorial leaders repeat and reinforce it.
The vacuum of federal leadership has resulted in a lack of overall
vision and coherent public policy, resulting in countless failures on
the part of national institutions and health systems coast to coast."

"To be fair, the status quo is not purely the fault of the federal government.
The list of challenges is daunting. Provincial and territorial leaders
have too readily adopted a “take the money and run” attitude rather than
collaborate to solve the major issues facing Canada’s health systems."

" The Harper Conservatives seem determined to focus on advancing a
law-and-order agenda, spending money on prisons and fighter jets as
well as tax cuts while ignoring health and health care. Regrettably, other
political parties have offered few if any substantive policy alternatives."

"A nationwide vision and action plan for health will require all
stakeholders to speak loudly with a common purpose — to remind
federal politicians that health is their responsibility."