July 14, 2005
Patients' Medical Freedom GrowsManitoba has shifted ever so slightly, but none the less significantly, control of health services from providers, including doctors, to patients.
Excessive control of health services by provider groups can make them more costly and less available for consumers. Not excepted are doctors, the pinnacles of the medical industry, who have an exceptional amount of say into how individuals organize their personal health matters.
Manitoba shifted that balance in favour of patients on June 16. A new law, patterned on similar measures in other provinces, quietly passed the Legislative Assembly. It reduces by a few degrees the power of professional health associations to regulate the behaviour of their members, in the process expanding the medical freedom of patients significantly. It is to the credit of all parties, particularly Health Minister Tim Sale and two Conservative MLAs, that this important amendment to the Medical Act passed.
Bill 207: The Medical Amendment Act reads: "[A doctor] shall not be found guilty of professional misconduct or of incompetence solely on the basis that the member practises a therapy that is non-traditional or departs from the prevailing medical practice, unless it can be demonstrated that the therapy poses a greater risk to a patient's health or safety than the traditional or prevailing practice."
Sponsored first by an Opposition member, Len Derkach, the MLA from Russell, and eventually by Tuxedo MLA Heather Stefanson, the amendment catches the momentum behind the provincial passage of similar laws. The first passed in Alberta in 1996, and similar measures are in effect in British Columbia and Nova Scotia. The wording of the Manitoba bill is identical to Ontario's, passed by unanimous consent in 2000, the work of Liberal MPP Monte Kwinter in a legislature controlled by Tories.
Such laws tend to be proposed by private members from opposing parties because it gives the government of the day cover on tricky issues by reducing the risk of alienating a powerful group. Even legislators who disagree with the law appreciate that the numbers of their constituents who seek natural health remedies are growing and more vocal.
This issue was a no-brainer. According to Helke Ferrie, owner of Kos, an Ontario-based naturalist publishing company, "Bill 207 decriminalizes the most fundamental principle of medicine, first expressed by Hippocrates, the father of medicine, 2,500 years ago. That principle requires that the physician explore new ways to treat illness effectively and that this exploration can only take place within the context of the doctor-patient relationship in which no third party may interfere."
Ferrie argues that the Manitoba Medical Association's quasi-judicial power to regulate alternate therapies might have been appropriate in a time when Canadians hunted for beaver pelts. Now the Internet contains all the latest medical research. We don't need as much protection because we have more information. She claims that many "chronically outdated clinical guidelines" have less to do with science than with agreements with food, drug, and insurance companies. She faults the process as too slow to adapt itself to a flood of new information on alternate therapies.
That can have real, very damaging consequences for those who dare to employ innovative treatments. In one remarkable case in Manitoba, Dr. Owen Schwartz; was hauled before his professional association about 20 years ago after a dispute with his colleagues over approved thyroid treatments. He was accused of using dangerous methods and his licence suspended. He eventually won it back, and now practices medicine in Calgary.
Far from unique, the injustice to Schwartz has parallels across the country. But the moral case may weigh less on our own legislators than the economic benefits of this law. The stodgy clinical guidelines mean that physicians must turn solely to approved treatments, usually much more expensive ones. Some advocates of reform claim the savings for provincial health budgets could amount to billions of dollars as consumers and physicians exercise their new freedom. They think these laws could save the system from eventual bankruptcy as medical costs escalate.
A Cure Worse Than the Illness, a 2002 Fraser Institute study discusses the economic case for loosening current fetters on the market for natural health products and cautions against new, national standards. It asks that all such proposed regulations be subjected to a rigorous cost-benefit analysis. In the United Kingdom, it notes, adverse reactions to herbal preparations represent only 0.38 per cent of all those reported, and in the United States only 7.4 per cent of the government's safety advisories concerned dietary supplements.
The analysis recommends letting the market supply information with information being made freely available, within a regulatory framework that kicks in only for that small percentage of natural health products that are high-risk or potentially toxic. Indeed, as health-care critics often remind us, the high cost of prescription drugs is swallowing more and more health dollars. Most of that cost is incurred in the irrational pursuit of the last few percentage points of safety. Why seek the same level of oversight for natural therapies?
In support of the new law, Manitoba's Health Minister, Tim Sale, cited "the evolution of appropriate new therapies which are not traditionally considered as part of the existing basket." Its bipartisan passage demonstrates that our politicians can share noble moments when public glare does not intrude.
The Frontier Centre for Public Policy
is an independent public policy think tank whose mission is "to broaden the debate on our future through public policy research and education and to explore positive changes within our public institutions that support economic growth and opportunity."