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The following item appeared in a recent issue of the Huronsville Gazette


UNPLEASANTNESS AT THE ROYAL
Basil McClure
Special to The Huronsville Gazette


The plush premises of the Royal Windsor Hotel was the scene of quite unseemly behaviour last night. Humana Corp., a recruiting firm from Mammon, Fla. had been discreetly organising seminars for local physicians to "acquaint" them with the benefits of practising "real" medicine south of the border. Tasteful dinners had been laid and doctors' wives had an opportunity to savour the joys of living in a warmer climate with year-round leisure activities. Dr. Marcus Whelpy had discussed fairly and frankly the "Calling" of the Physician and pointed out that a doctor should really do what is best in the interests of a patient rather than be dictated to by anonymous bureaucrats. Immigration lawyers were at hand as well as real estate agents to answer any questions that the physicians may have. Matters went smoothly till members of the local chapter of the Medical Reform Group began asking awkward questions. They referred to a number of studies published in prestigious U.S. journals such as the New England Journal of Medicine comparing favourably the Canadian model with the American one. They demanded that Dr. Whelpy explain how the entrepreneurial system would provide equitable access to health care and noted that Clinton's new proposals involved HMO's to provide comprehensive coverage. The urbane Dr. Whelpy brushed aside their comments as meaningless socialist rhetoric that had now been discredited by entire nations. "Oh, yes," he noted, "I am well aware of those slogans and shibboleths such as Health for All by 2000. The Alma Ata Declarations are totally unrealistic. How can you achieve them if you manacle doctors who practice the best possible medicine?" This was greeted with enthusiastic applause. Unfortunately for the organisers, a group of concerned citizens had infiltrated the gathering. They demanded that the doctors who wished to emigrate pay back substantial sums of money to compensate the taxpayers for the money spent on their education. This led to an incredible shouting match between several of the doctors and their families. A spouse shouted "Pay you back? WE killed ourselves, saving every cent and dime. What did YOU have to do with it?" The organisers abruptly closed the meeting--hoping for quieter sessions in Manitoba and Saskatchewan.

Comments: This problem was written at a time when the Clinton administration was proposing a "different" model for U.S. health care. At that time, newspaper reports appeared about recruiting drives to entice Canadian doctors to more lucrative positions south of the border. This problem served to focus attention on the contrasts between two expensive systems of health care and in particular the role of the taxpayer in educating physicians. Since a number of students in the class were interested in applying to medical schools, I was particularly interested in their discussing such issues. These issues are still current as judged from media reports.


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