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Lysiane Gagnon

Cash-for-care allegations roil Quebec Add to ...

Vivian Green and her sister slipped $2,000 into an envelope and gave it to a surgeon so that their mother, who had just been diagnosed with pancreatic cancer, would be bumped to the top of the waiting list.

A patient undergoing a medically required breast reduction was told on the morning of her surgery to leave $100 in cash under her pillow for the anesthetist. Women who want to be guaranteed that their own obstetrician will be there for the delivery are encouraged to fork over anywhere from $2,000 to $10,000 in cash.

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Charlotte Lintzel was suffering excruciating back pain and gave $400 in cash to a renowned neurosurgeon for a consultation, hoping he would operate on her. He didn't. But he had previously operated on a friend of hers, whose husband told Ms. Lintzel: "I paid and I paid plenty, that's all." Presumably, $400 was not enough.

These cases are among those uncovered last week by Montreal Gazette reporter Charlie Fidelman, whose story is still making waves.

The Quebec College of Physicians waxed indignant and launched an investigation on practices that are, in the words of its secretary, Yves Robert, "illegal," "unethical" and "totally unacceptable." The province's Health Minister, Yves Bolduc, was startled: He said he'd never heard of patients bribing doctors for fast-track service. But in the medical community, some wondered how the minister, a physician himself, couldn't have known what they describe as an open secret.

In a follow-up story, Mr. Fidelman quoted a "high-ranking physician who works with doctors at several Montreal hospitals." According to the physician, "hush-hush payments run from $5,000 to $7,000 to jump the wait list into the operating room," suggesting that "the practice of black market medicine," as Mr. Fidelman writes, "is more widespread than initially suspected."

On the daily hot-line radio program at Société Radio-Canada, many callers - far from condemning those who bribed doctors - insisted they would do the same if it were the only way to ensure faster care for their loved ones. That doctors accept bribes is one thing, but isn't it understandable that, when it comes to their own health or the health of a mother, a spouse or a child, people would use desperate tactics?

Indeed, such is human nature. When an essential service is unreasonably delayed - when health care is rationed by a system that can't meet the demand - people will try to force their way in.

Actually, the issue is more complex than it seems. Of course, offering cash is a crude, vulgar way to buy care. Apart from being illegal, it's demeaning for both the giver and the taker. But what about the sophisticated legal tactics used by those who have either a great deal of money or useful personal contacts?

Who can believe that a person who donates thousands of dollars to a hospital foundation would not have privileged access to care? What about those with family or close friends within the medical profession? Name recognition is also a powerful tool for opening the doors of a doctor's office or an operating room. Well-known people, whether they're high-profile politicians, popular artists or best-selling writers, don't even have to ask for preferential treatment - they'll get it automatically, especially if they appear regularly on TV.

The ultimate culprit is a system run by an outdated law. Fewer people would be tempted to bribe doctors if our health-care system was more flexible and more human.

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