PAGE 4, WEDNESDAY, FEBRUARY 19, 1986, WHITBY FREE PRESS Published every Wednesday w h I BILL MCOUAT by M.B.M. Publishing Communhty and Photography [inc. K-f .1> Ç Phone 6-6e11 VALERIE COWEN '4iiu 4Iii mlii '~dd '~ The Free Press uilimng, Advertlslng Manager 131 Brock Street North, eodCasMi Voice of the County Town Michael Ian Burgess, Publisher - Managing EditoyP.O. 1 ox 20f, Whitby, Ont. Seaon No. Mail The only Whitby newspaper independet oned and operated by Whithy residents forWhity residents.1uitio r Speak out on Iroquois plan On Monday night, Whitby Council will have to make one of the most important decisions it has had to make In a long while. The question before the councillors is the expansion of the Iroquois Park recreation complex. One way or another that expansion is going to proceed. What they have to decide is how much they are willing to pay for recreational facilities and the extent to which those facilities are Important to this community. On the one hand, the councillors are looking at $6.2 million expansion including squash courts, a multl-purpose room, a new arena, first oclass gallery facilities for the swimming pool, a fitness area complete with indoor track and repairs to the swimming pool as well as new administrative of- fices. A staff report predicts this proposai could be financed through existing reserves, grants and the continued growth of the town but it cautions that alternative forms of financing such as debentures, and a reassessment of the town's capital priorities (ie roads and further recreation facilities for the north) may be necessary if that growth is lnterrupted. Operating costs for the facility and its programs would cost the town approximately $5 per year, per household. On the other hand, council must consider a considerable modified proposai which provides for a new arena, repairs to the swimming pool and alterations to the existing administrative offices. It is, too be sure, a less attractive proposail in ter- ms of the recreational opportunities it would offer Whitby but it has*one very convincing point in its favour. The modified proposai would cost the town only $2.5 million and à perating costs would actually be reduced-because of the economics of operating two arenas wifh existing equipment and a limited staff increase. The $6.2 million Iroquois proposai s apparently based on a feasibility study completed in 1984 in which random surveys and a polling of special in- terest groups indicated that fitness, skating and racquet sports were the activities most requested. By this yard stick, the $6.2 million complex would appear to be the one people in Whitby want. What nobody has asked thepepple of Whitby is whether or not they want to spend $6.2 million to build these facilities. We have stated in previous editorials in this paper that now is the time for Whitby council to begin spending to upgrade the community's roads and recreation facilities and we are proposing now that the expensive proposition is the way to go. It offers more to a wider cross-section of the community where the $2 million proposai mainly addressed Whitby's hockey and figure skating community. However, lt's a very costly proposai and if it is going to operate at a deficit, as staff predict it will, it will cost far more than the $6.5 million capital expenditure. So far it is only the special interest groups that have really had any significant input on this proposai and if council is to best represent the people of Whitby when they make their decision Monday night, they should hear from everyone who has concerns on the subject. The town clerk's department will be accepting deputations to the council meeting right ùp until Monday and this is your last opportunity to speak. If you have concerns about the Iroquois proposai you should phone your elected representative today or call the clerk's office and tell them that you wish to address council. The'iroquois expan- sion should serve Whitby as a whole and not the vanity of politicians and special interest groups. Letters to the editor: Extra billing To The Editor: The Health Care Ac- cessibility Act and the issue. of extra-billing have received a great deal of coverage in the media of late and will receive much more before the questions in- volved are answered. I wonder if the public in general realizes the dif- ficult moral dilema which this ill-advised and regretably phrased Bill forces physicians to face? While many of us cannot support extra- billing, at the same time we feel we must actively oppose the Act which would abolish it. Physicians truly want health care to be ac- cessible to all in this province and country. That is the reason we provide on-call systems, weekend and night coverage for hospital in- patients, carry pagers, use answering services, etc., etc., etc. That is why we are concerned about underfunding of hospitals, chronic care facilities and -so many other facets of health care. That is also the reason the great majority of us do not bill our patients above the O.H.I.P. rate: we would not wish to place. any hindrance in the way of a patient's ability to seek and achieve care. We are content with our current fee schedule in the majority of cases. Most of us would deplore any situation (if such existed) where all individual physicians, the O.M.A. or College of Physicians and Surgeons to address this problem and correct it. However, many of us cannot accept that it is the role of government to handle this issue and párticularly not in this manner. The Act pur- ports to improve ac- cessibility by banning extra-billing in any form and making it a criminal offence punishable by a fine of $10,000. This discriminatory Act which violates the heretofore accepted right of a professional group in society to set their fees commen- surate with their level of skill and experience and offset their particular practice expenses in- sinuates that extra- billing is the major (only) cause of ac- cessibility problems in the system. Indeed the government and other supporters of the Bill have stated this ex- plicitly. In fact the Act addresses a minor problem in accessibility (the major one being that we have a system which is incredibly ex- pensive, excludes private funds and is grossly underfunded from the public purse). The Act attempts to correct this perceived problem by violating physicians' freedom and exacting a punish- ment which is out of all proportion to the "of- fence". The Health Care Ac- cessibility Act also states that government "may" in future negotiate with the O.M.A. over physicians' fee schedules. In other words they "may not" negotiate with the O.M.A. and may just impose an arbitrary fee for service. We have seen this happen in other provinces and have had our own sad experience in Ontario with the validity of government contrac- ting. To add to our dilema, most doctors find the idea of strike action abhorent and are thus deprived of that commonly used negotiating tool. The issue here is not the absolute value of fees but, rather, what can happen if gover- nment has complete and absolute control of fees and abolishes the freedom of physicians to make their own contract with thefr patients. On- ce the government has complete control of fee schedules it is easy for it to manipulate the profession in. many ways; e.g. practice location, practice size, and encouragement or discouragement of procedures in practice. When one looks at what has happend in other provinces, - especially Quebec, one finds this scenario is not far- fetched at all. Somewhere along the line a balance must be achieved between government control, the physician's right and ability to make decisions and have a say in health issues (in- cluding those of his own role and renumeration), and the patients' right and priviledge to receive accessible first- rate medical care. The Health . Care Ac- cessibility Act and yet another facet of our lives competely con- trolled by government is not a step toward that balance. SEE PG. 23