People struggle to see how fee cuts could harm patients. It just does not make sense that the most vulnerable patients might be harmed by cuts. This post attempts to explain the impact by using a parable. I hope it helps.
There once was a wealthy man with too many children to count. The kids filled a whole village. The only other grown-ups in the tiny village were a small group of bakers. Each day, the wealthy man sent his children to buy bread at the village bakery. The bakers worked all night long so that the children would have fresh bread every morning. The wealthy man kept a tab at the bakery so that the children could pick whatever loaf they wanted, and he would pay for it all at the end of the month.
Every morning, the children showed up for fresh bread. Most of the kids picked rich, crusty bread. It was cheap, plentiful and delicious. Each baker’s loaf tasted slightly different. Each child had a favourite loaf and bought bread baked by the same baker each day.
But a few children could not eat the crusty bread. They were gluten intolerant. For these children, each baker made a few loaves of gluten-free bread. The special bread had a higher price because it cost more to make a loaf.
One day, the wealthy man fell on hard times. He had invested in wind machines that didn’t turn a profit. He had very little money left over to buy bread.
So, he told the bakers he could not pay extra for the gluten-free bread. The bakers complained. The children needed gluten free bread. It required extra time and expense to bake it. The wealthy man would not listen. He said that the bakers sold lots of bread and were well paid. They had no right to charge more for the special bread.
What were the bakers to do? The children needed gluten free bread, but their father refused to pay for it.
The bakers talked and talked. Finally, they came up with a plan. They would keep making gluten free bread for their current customers. The bakers would make enough gluten-free bread to meet the needs of the children they currently served.
But the man continued to have more children, and the children continued to grow. The bakers made more and more crusty bread to feed the hungry children but kept making the same amount of gluten free bread as they had before.
It came about that some children who used to eat the crusty bread became gluten intolerant. On top of that, some of the new children ended up gluten intolerant from the start. But there was no more gluten free bread for them to eat.
The bakers pleaded with the wealthy man. They begged him to cover the costs of making more gluten free bread so that the bakers could offer it to the children. The man refused, and the children went hungry.
Doctors will do everything they can to mitigate the impact of fee cuts. They will keep caring for their patients as before. But do not be mistaken; fee cuts harm patients. The government has responsibility to pay for the care they’ve promised to provide. We need to hold politicians to their word. Arbitrarily cutting fees compromises patient care for those who need it most.
photo credit: cbc.ca