Professor,Hannah Chair of the History of Medicine,Queen's University,Kingston,ON,Canada.
Health Econ Policy Law. 2018 Jul;13(3-4):450-474. doi: 10.1017/S1744133117000470. Epub 2018 Feb 20.
Physicians are deeply involved in Canadian medicare because it is through medicare that they are paid. However, from its origins to the present physicians -as a profession - have not been strong supporters of medicare. Fearing loss of income and individual autonomy, they have frequently opposed it with criticisms, strikes, threatened job action and lawsuits. Some opponents are unaware that medicare was a boon to physician income, and many fail to connect medicare with responsibility for improving the health status of the country. This paper will trace physician involvement, support and opposition to medicare from its inception to the present, with special attention to small physician organizations that have supported medicare. It will close with a proposal for how doctors could display greater stewardship.
医生在加拿大的医疗保险中扮演着重要角色,因为他们的收入是通过医疗保险获得的。然而,从医疗保险的起源到现在,医生这个职业本身并不是其坚定的支持者。出于对收入损失和个人自主权的担忧,他们经常通过批评、罢工、威胁采取法律行动等方式来反对医疗保险。一些反对者没有意识到医疗保险实际上增加了医生的收入,许多人也没有将医疗保险与改善国家健康状况的责任联系起来。本文将追溯从医疗保险制度建立之初到现在,医生对其的参与、支持和反对情况,特别关注一直支持医疗保险的小型医生组织。最后,本文提出了一个建议,即医生如何更好地承担责任。