I knew this day would come. After being glowingly portrayed in SiCKO, health care insurers and the Canadian Medical Association (CMA), composed of doctors NOT nurses, are attacking Canadian health care. They are basing this on the hard work of a 2005 Supreme Court of Canada decision called Chaoulli v. Quebec (Attorney General). Previously to Chaoulli, I believe the CMA officially lobbied for Medicare.
I am very disturbed by unwarranted the national media attention on the CMA's (the doctors') plan for two-tier health care. For example, both the national Post[1] and Globe and Mail[2] had front page stories on the plan, called "Medicare Plus". The National Post says "Canadians ready to change medicare"; I'd like to assure you that this is in stark contrast to my experiences with Medicare in Ontario, my views on medicare, recent Ontario Acts to defend health care against the Chaoulli decision and decrease waiting times, and recent media depiction of Medicare (media used to be replete of horror stories; now that is gone, so the CMA report seems extremely unwarranted).
It is even more in contrast to the public reception in Canada and the US to Michael Moore's recent documentary "Sicko", which chronicles the many problems with privatizing health care versus the Canadian system.[3]
There are several problems with the CMA plan, that nations who used to have universal health care but turned to two-tier care have faced (like Britain and New Zealand):
- Doctors will work more in the private sector for higher profits; public sector actually suffers in terms of waiting times. Ergo, that doesn't 'fix' public health care, (which is what they're proposing two-tier health care will do!). Also, patients are paying twice: once in taxes, and again at the private office. What a waste of money!
- Costs increase, as we've seen in Britain, France, New Zealand, etc., who've all instituted two-tier health care, since it's not single-payer anymore.
- No universal access, denials based on insurance (Chaoulli's patient Zelioitis would never have been accepted by a private insurer!), etc.
- Canada already pays less for health care per capita than e.g., USA, so moving towards two-tier health will only increase health care spending.
- Problems with NAFTA, which states that a country can only keep an industry public if it remains public. Once privatised, as CMA is intending, the country cedes sovereignty and jurisdiction to corporations and the Canada Health Act is unmade. Once it's privatised, it can't return to the public.[5]
I'd rather turn to a made-in-Canada solution that Tommy Douglas's vision has described as "The Second Stage of Medicare", rather than a serious problem posing as the solution. I'd much rather engage in the "Second Stage of Medicare" endorsed by Tommy Douglas, the father of Canadian medicare, in which preventative health care and hospice and home care (and perhaps other health care like prescription drugs and dentistry) is funded to reduce waiting lists and increase access to health.
So the CMA is lobbying for two-tier health care. However, most nurses' organizations support Universal Medicare.
Dr. Jacques Chaoulli also invited US insurers to Canada, in a move could that move have pushed them to unduly influence the political and media discussion, from the Senate in 2005:
Hon. Marilyn Trenholme Counsell: Honourable senators, it is the following headline in The Globe and Mail on June 22 that moves me to speak: "Private-health activist a 'super star"' The article reads:
Obviously enjoying his new international fame, Dr. Chaoulli issued an invitation to U.S. companies eager for a piece of an emerging two-tier health-care system in Canada.[4]
Dr. Jacques Chaoulli was a French doctor who came to Canada and opposed medicare. He wanted to challenge Canada's single payer system, as set out in the Canada Health Act which gives federal funding to provinces who implement single-payer health care. The CHA grew from the province of Saskatchewan and its premier Tommy Douglas (of the CCF, which later turned into the NDP) who actually implemented a universal health care system (after having experienced the downsides of private health care, having almost lost a leg "were it not for a doctor who saw the condition as a good subject to teach his students and agreed to help for free." from http://en.wikipedia.org/... ) , with a positive budget. Douglas was VIGOROUSLY opposed by doctors in the province, who striked, campaigned against him, etc. After Saskatchewan was a success, the CHA passed in the 80s.
So Chaoulli found a patient unhappy with the province of Quebec's health care. This patient (Zeliotis) was a senior who said he waited too long for a hip replacement. Two courts found against him, in favor of the public interest of medicare. Then, he appealed to the Supreme Court, and seven justices heard it (two seats were vacant). Their decision was released in 2005. They were tied 3-3 on whether Medicare violates the Canadian Charter of Rights and Freedoms, and 4-3 in favor of Chaoulli on whether they violates the Quebec Charter (So it only seems it applies in Quebec; also, I wonder whether the entire court could re-hear the issues of the case en banc with another case). The decision essentially says that the monopoly on health care is bad, if it unreasonably violates a person's human rights because of long waiting times. Provincial governments attacked this by setting up funding to track and reduce waiting list time, etc., ostensibly to ensure that access was reasonable.
The Supreme Court decision was based on evidence from private health care opponents of Medicare, the aforementioned CMA, and Chaoulli himself was funded by conservative court challengers, very set up. It doesn't take into account the virtues of universal access, the public interest, the fact that Zeliotis would never have got a hip replacement with private insurance with his health and age (heart issues AFAIK), etc.
There are now court cases based on Chaoulli pending in Ontario and several other provinces.
So now, the CMA recently elected a private health practitioner (and obviously, a huge advocate), whose doublespeak campaigning in the US and in Canada you can read all about in great newspaper The Tyee, at reference 3 below in references.
What it boils down to is that he and the CMA is currently for private care. What that means is nothing less than the destruction of single-payer universal health care, because of its effects, which I detailed above.
Here's where the attack comes in. Today, I was shocked to see the National Post, an influential nation-wide daily newspaper, call for two-tier health care. Background: National Post was owned by the infamous Conrad Black, who sold it to CanWest (who are so consolidated in terms of newspapers, stations, etc that would be broken up under anti-trust if they were in the US; in BC particularly, this is a huge problem since they own all the newspapers there).
http://www.canada.com/... "Doctors’ group prescribes private health care"
OTTAWA -- Canadians should be allowed to use private medical insurance to pay for health services normally available under medicare -- if governments can't guarantee timely access to publicly funded treatment, says a new report by the country's largest doctors' group.
The Canadian Medical Association (CMA) also said provincial governments should contract out public health services to the private sector and pay for patients to obtain treatment in other cities or countries, as a "safety valve" means of easing the strain on waiting lists in the public system.
"Changes need to be made to bring about a new vision for medicare," said the CMA policy statement, titled Medicare Plus.
The National Post, which as you can see from their website, is having a bonanza on the subject.
Michael McBane of the Canadian Health Coalition, a health-care lobby group, called Monday's report a "radical departure away from Medicare" by the CMA.
"They're prepared to sacrifice the public health system for personal financial benefit," said McBane. "Doctors are putting their own financial interests ahead of the public system and the public interest.
"They'll treat on a preferential basis patients who can pay to jump the queue -- that's what private access means."
Not so said John Carpay of the Canadian Constitution Foundation, a Calgary-based charity that supports private health care.
Don't you just love when newspapers are so pithy with their viewpoints, that only one paragraph out of all the rest is an opposite view? Of course, a one sentence throw-away in the face of an entire front page article is very fair, and I for one feel very chided for ever thinking that two tier healthcare could be a disaster...not.
The problem is, there haven't been many 'health care is doomed' articles that we've seen in the past. I certainly haven't had bad experiences. it used to be, maybe 6 years ago, that there were all sorts of articles on a shortage of doctors (due to a stupid decision to cut funding to doctor training in the mid 90s when it was thought there would be too MANY doctors), waiting lists ..... but recently, nothing bad. And now this report comes out of nowhere.
In the wake of Sicko (and Chaoulli), the Canadian health care system is under attack.
REFERENCES
[1] http://www.canada.com/... "Doctors’ group prescribes private health care". Richard Foot. National Post. July 31, 2007.
[2] http://www.theglobeandmail.com/... "Public, private health should co-exist, says CMA". Globe and Mail. July 31, 2007.
[3] http://thetyee.ca/... "Dr. Day's Doublespeak: How Canada's top MD views medicare." By Michael McBane. The Tyee. July 19, 2007.
[4] http://www.parl.gc.ca/... "Debates of the Senate (Hansard) 1st Session, 38th Parliament,
Volume 142, Issue 76. Thursday, June 23, 2005. The Honourable Daniel Hays, Speaker"
[5] http://www.thestar.com/... "A hybrid health-care system". Antonia Maioni. The Star. February 2, 2007.