Re: Two-for-one private health care: A Canadian compromise

I would disagree with Dr Kotaska’s opinion that charging double the cost for medically necessary treatment is a justified social policy. If medical care is a right and not a privilege, then imposing financial barriers of double the actual cost to subsidize a failing public system is mercenary. With competition and a market economy, costs approach value. Circumventing the Supreme Court’s decision that prohibiting necessary care is unethical with a scheme to charge double the actual cost for medically necessary care is illegal because the Canada Health Act prohibits extra billing. Charging double is also unethical since it runs counter to the prime directive and first order of the Doctors of BC Code of Ethics (www.doctorsofbc.ca/code-ethics) to “Consider first the well-being of the patient.” Any financial policy that delays treatment and prolongs suffering for an individual patient because they are unable to pay twice what the service is worth violates this edict. It’s also very optimistic to imagine a 100% tax would generate a net payoff. It’s like doubling down on a losing hand with stolen money.
—Mike Figurski, MD, CPHIMS
Big White

Mike Figurski, MD, CA-CPHIMS. Re: Two-for-one private health care: A Canadian compromise. BCMJ, Vol. 60, No. 4, May, 2018, Page(s) 188 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply