The Healing of America by T.R. Reid

Author:T.R. Reid
Language: eng
Format: mobi, epub
Tags: Nursing, Medical, Health Care Policy, Health Care Planning, United States, Health Policy, Health care reform, Health Care Delivery, Medical care, Medical policy
ISBN: 9781594202346
Publisher: Penguin Press HC
Published: 2009-08-20T09:36:48.314000+00:00

“IT’S SO REWARDING, and soooo frustrating, to work in this system,” Dr. Steven Goluboff said to me, smiling at a baby girl he had delivered a day before.“It is rewarding to provide anybody the medical care they need, without worrying about bills or paperwork or malpractice problems. But it’s so frustrating, just the day-to-day frustration of the waiting lists. If my patient needs an MRI or a psychiatric evaluation or shoulder surgery, all I can do is put her on the list and tell her to wait. It could be months. It could be a year. That’s kind of ”—here he stopped for a minute to choose the right adjective—“kind of ... scandalous, is what it is, that people have to wait so long for the treatment they need.”

Dr. Goluboff, an energetic sixty-year-old bantam with a balding pate and a light gray beard, has no doubt that running a family practice in the heart of Saskatoon, Saskatchewan, is exactly what he wants to do. The son of a doctor—his dad, in fact, was one of those who struck against Tommy Douglas’s Medicare plan in 1961—Goluboff always knew what his life’s work would be. As a child, he dressed up as a doctor on Halloween. As an adult, he routinely sees fifty or more patients per day—and that’s after his morning rounds at the city’s three hospitals and a few early surgical procedures, such as vasectomies and circumcisions.

Goluboff works in a cramped corner office across the street from Saskatoon City Hospital. The walls are adorned with his diploma, the plaque he won for being named Family Physician of the Year, and a poster that sets forth ONE HUNDRED WAYS TO LIVE TO ONE HUNDRED. Tip #100, in bold print: LISTEN TO YOUR DOCTOR. The office has a chart listing the prices of procedures not covered by the Medicare system: circumcision, $100; IUD, $100; cautery of warts, $40. The bookshelves are stacked high with boxes of drug samples Goluboff has received from pharmaceutical salesmen: Robaxacet, Uremol HC, Nasonex, Detrol. “If a patient doesn’t have a [private insurance] plan, paying for prescriptions is tough,” the doctor says.“The more I can give them for free, the more likely they are to get the medicine they need.”

Like almost every doctor in almost every country, Goluboff complains that he isn’t paid enough for his hard work; in fact, his income is about half as much as an American family doctor might expect to earn. Still, he drives a BMW convertible and belongs to the town’s leading country club. And Canada’s system gives him certain advantages that American doctors would envy. He carries malpractice insurance but has no idea how much it costs, because the provincial government pays the premium for him. His office has no file cases full of patient records, because Canada’s coordinated system has made all medical records digital. He never has to deal with money. Patients pay nothing to see him; the provincial Medicare office pays all his fees at the end of each month.

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