CSA News Issue 54 Spring 2005

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Bird talk

Featuring the letters & concerns of our members

SEND YOUR LETTERS TO
Bird Talk, c/o CSA News
180 Lesmill Road, North York,
Ontario M3B 2T5

or by e-mail:
csawriteus@snowbirds.org

Dear Mr. Don Slinger,

You sound like a man of action, so this letter is coming to you. If that's not your department, I'm sure you will send it to the right place.

Enclosed is a copy of a letter received from my doctor. He explains why he is leaving his practice. I felt the well-put reasons might be useful when confronting the government.

This is the THIRD doctor we have lost in about the last 12 to 15 years. Kitchener/Waterloo Ontario needs more doctors and specialists. Here's hoping the CSA can do as good a job in this area as they have in others.

We have been members for many years. Whenever I read the CSANews, my admiration soars for all the workers and negotiators.

Thank you for the good work. Being a very private person, I would appreciate remaining anonymous.

The reason for this letter is to further the cause for more good doctors in Ontario and all of Canada.

Letter from Physician

Dear Patients,

I am writing this letter to you to inform you of my decision to leave the practice of family medicine as of February 28, 2005. I announce this with little regret as this decision has been two years in the making. I can no longer practice medicine the way I was taught or would like to without suffering financial hardship. I have searched long and hard for reasons to be optimistic, that the working environment for family physicians in Ontario would improve, and have come up empty. There are many reasons why I am leaving family medicine and I will share some of them with you.

Poor Compensation – The average visit to your family physician pays your doctor only $17.30 - $28.50. A full annual physical earns your doctor $54.10. The fee paid to your doctor for counseling or psychotherapy is $50.45 per half hour of time. Many forms I have to do for free or am paid very poorly as per government regulations. To pay for rent, staffing and supplies costs me over $70 per hour. I do not have any health benefits, paid vacation or pension. What OHIP pays me to look after your medical care does not come close to what I should be receiving given my 11 years of university education, my work responsibilities and workload/complexity.

Government Control – Doctors are not protected by the Labour Relations Act and are not permitted to strike. In addition, we do not have access to binding arbitration in the event of an impasse in negotiations with the government. OHIP rigidly controls how much doctors are paid for their insured services, a situation not encountered by any other independent health care in this province. Dentists and veterinarians charge whatever the market will bear. Even chiropractors, when they were covered by OHIP, were allowed to charge extra fees to their patients.

Lack of time for my family – For most of the last 3 1/2 years I have worked 6 to 7 days per week. I have had one week off in that period and that was the week that my son was born. I spend at least two hours per night on paperwork and, at least twice per week, am up into the morning filling out or writing numerous government, insurance and legal forms and letters. The time that I have devoted to my career has left me worn out and has greatly impacted my role as a father and husband.

Access to Diagnostic Tests – Many times per day I deal with patients who need very quick access to ultrasounds, CT scans, MRIs or other tests in order to make a diagnosis and proceed with proper treatment. These patients often suffer physically, emotionally and financially while their conditions do not improve or continue to worsen. I witness their anguish and sometimes proper treatment is delayed while awaiting necessary tests.

Access to Specialist Care – There is a significant shortage of many specialists in Ontario that is not just limited to our community. This results in long waiting lists for referrals, often after a long wait for a diagnostic test. Even if I have made the diagnosis, often patients require specialist care that I cannot get them timely access to. The result is that I see these frustrated patients back in my office often and can bring little relief to their symptoms.

Family physicians are leaving their practices, retiring or moving out of province in growing numbers. In addition, fewer students are choosing to train as family doctors and those that do are increasingly not setting up family practices. For the last five years, I have been working in a deteriorating system that is not of my making, nor my responsibility. It is not my job to fix the system or subsidize it with my low fees and income.

Thank you for your kudos and your support. It would appear that the health-care crisis in Canada, let alone Ontario, is far from over. Lack of funding and support coupled with the bureaucracy that physicians have to endure in order to get paid is compounded further by the "brain drain" of opportunity just south of our border.

If our government would simply allow doctors to do what they are trained to do, help people and save lives, then perhaps the issue of being under-funded for services would be that much less of a burden on them.

As our population ages the demand for well trained experienced doctors will multiply exponentially. Currently 47% of our Canadian health-care budget is absorbed by persons over the age of 65. As the boomers age we will need more doctors and more funding in order to maintain the Canadian way of life that was envisioned when our national medicare program was created. It is obvious that we are not starting off on the right foot, and action to remedy the problem must be taken now!

Dear Bird Talk,

Reading the winter issue of CSA News, I noted the various efforts on recruiting new members. After showing the issue to friends, most of them mentioned the many pictures of loving couples (front and back covers, inside pages, all the advertisements), arms around each other in affectionate poses. Wonderful if you are in that particular situation of married bliss, but not so great if you are alone. Is your magazine only geared to couples? Remember that we will all be widows and widowers sooner or later. Maybe a bit more inclusiveness would help magazine circulation.

Best wishes for future issues.

Maureen Applewhaite
Victoria, BC

Our first priority in the production of CSANews, and our special events, has always been to appeal to our loyal membership, some 75% of whom are married. We are very aware that CSA members lead many diverse lifestyles. As the CSA matures, it also evolves, and we believe that more and more people from Canada's diverse population will choose "snowbirding" as their lifestyle. We have already seen hints of this in our surveys and at our special events. Over time, we expect the "face" of the CSA will evolve as well. We hope you find this and future issues of CSANews to be a little more reflective of our association's diversity. Thank you for your support and your comments.

Dear Bird Talk,

There has been a drastic increase in Medicare premiums for alien permanent residents (formerly Green Card holders) in the United States. This affects persons over the age of 65 such as myself and my wife.

For the past ten years I have been paying a premium of $340.00 per month, annually $4,080. This covered 80% of most hospital and doctor charges.

I have just been notified that my premium, for slightly less coverage under a revised Medicare plan for hospital and doctors charges, has been increased to $805.80 per month. This amounts to an astounding $19,339.20 for myself and my wife (who is over 65). We cannot afford this which leaves us with no Medicare coverage.

I am sure that this information will be of great interest to CSA members living in the USA over the age of 65.

G. Austin Underbukke
Conway, SC

The average travel medical insurance premium, while expensive, is nominal when compared to the Medicare premiums in the U.S. Snowbirds should definitely investigate the cost of medical insurance coverage if they are considering the U.S., or any other destination, as a new full-time home. Maintaining your residence in Canada "pays off" in more ways than one. Living the snowbird lifestyle grants us the best of both worlds.

Dear Bird Talk,

My wife and I are members of CSA and I have my Travel Emergency Insurance with Medipac for U.S. travel (5 months).

We will be in British Columbia for 10 days this summer.

RBC Insurance says that we need emergency medical insurance and that OHIP won't cover us.

Are the RBC people correct?

Thank you.
Gary Garner
Thunder Bay, ON

P.S.	(1) A 67 year old friend of mine had an emergency heart by pass operation in Calgary last fall. He DID NOT have emergency medical expense coverage. OHIP paid with no questions asked – estimated cost $50,000 +
	(2) Based on CSA's policy letter from British Columbia, it appears that BC residents travelling to Ontario retain their BC coverage!

OHIP and any other provincial plan will certainly cover you, anywhere in Canada. All doctor's and hospital expenses are fully paid by your province of residence even if health care services are provided in a different province. However, certain non-health-care expenses are not covered and can be costly. The most frequent of these non-covered expenses is the cost of an ambulance. We recently heard from an Ontario member who was charged $600 for an ambulance bill in Nova Scotia. The real risk is if you travel to, or travel through, remote areas. If you have a medical emergency, an air ambulance (usually a helicopter with high level medical equipment) may be required to get you to a medical center quickly. You could be billed several thousand dollars and your provincial health insurance program will not pay this bill.

The risk may be remote, but if such an emergency were to occur, the costs can be high. This is one of the reasons Medipac added this inter-provincial coverage to thier Annual Plan Add-On; it will cover those very unexpected expenses anywhere in Canada for up to 60 days, automatically.

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