The single payer Canadian Health System is the result of a protracted battle in the post war years between business groups and the medical profession on one side and the people on the other. The people won a resounding victory. The health system is consequently highly valued and attempts to meddle with it are politically sensitive. Canadians are well aware of the situation south of the border.
While private care was not prohibited and
continued in a small number of areas all Canadians had equitable
access to services paid for by taxes. Canada does not have for-profit
acute care hospitals, although the 'for-profits' do exist in the
long-term care sector. Canada has a system which is a Single-Payer
system; "publicly-funded, publicly-administered, and
The Canadian business sector and sections of its political establishment have readily adopted marketplace ideology. As in Australia there has been sustained and deliberate underfunding of the health system in some provinces. At the federal level and replicated at the provincial level, segments of health care have been contracted out to big corporations. Whole sectors of the system have been colonized by the private sector, such as rehab and laboratory medicine. Hospitals have been closed. In Alberta a perfectly good hospital has even been pulled down.
Professor Donna Wilson from the faculty of nursing at the University of Alberta has performed an analysis of the threat to the Canadian Health System and looked at the evidence. I am grateful for being allowed to include this here.
HERE -- to go to Professor Wilson's
Political process:- Ralph Klein, the premier of Alberta is a hybrid Joe Belke Perterson and Geoff Kennet. His charisma and paternalistic rhetoric have kept him in power. He has been particularly active in downsizing the public system. In the two largest cities hospitals were closed, and in Calgary three hospitals were closed, and one blown up.
At the same time privatisation and the contracting of care to private groups has been promoted as the solution to the problems in the health system.
Making corporate hospitals legal:- Klein has repeatedly made attempts to introduce legislation to make it legal for investors to own and operate acute-care hospitals on a for-profit basis. This would be a first for Canada. By renaming these institutions, 'clinics' (with overnight stays) he denies that they are hospitals and consequently would be prohibited under the Canada Health Act. Citizens have rallied in opposition and forced delay after delay.
International Trade Agreements:- Citizens are particularly worried, because under NAFTA (North American Free Trade Agreement), if USA investors are involved in Canadian companies contracted to provide services, Canada would have to entitle all USA healthcare investors to equal treatment. This would include access to public funds under Medicare.
Klein denies this but trade experts warn that it is not up to Alberta to decide how NAFTA would be applied. It would be up to an international trade tribunal to decide behind closed doors and with no public input and no public scrutiny.
Cataract Syrgery - a test case:- Cataract surgery is a publicly-insured service in all provinces of Canada. But a recent, independent study (January 2000) by the Alberta Chapter of the Consumers Association of Canada found that private clinics in Alberta were 'gouging' patients for so-called 'enhanced services', everything from prayers to foldable lenses.
This independent evaluation comparing care provided under the new and the old system was scathing about both the cost and the care provided. Newspapers which previously supported Klein have more critically examined his statements and come out strongly in opposition to his plans.
An executive summary of the report can be found at http://albertaconsumers.org/CanaryS.htm
Magnetic Resonance Imaging Scans:- Another study published in February 2000 by a highly respected Health Economist, Dr. Richard Plain, pointed out similar problems in the area of privately-delivered MRI scans. The full document and other material relating to Canada is available on the web site: http://www.healthcoalition.ca/priv-res.html
Public protests:- At the time of
writing 10,000 people have demonstrated in Alberta as Klein attempted
to force another bill through the parliament. About 2000 have
thronged the parliament during the debates, forced themselves into
the public galleries and called for the bill to be abandoned.
The privatisation of health services in Canada received a major setback in October 2000. Kings Medical Centre, one of the countries leading private for profit facilities was a flagships for the privatisation of health care in Canada. It was the largest private facility in the country.
The founder of King's Medical Centre, Ron Koval suddenly disappeared in October. Not only was King's not making money but Koval had defrauded King's and several other corporate groups of a sum in excess of 100 million dollars. Worse still the Canadian police, assisted by Interpol cannot find him.
CLICK HERE:- for an account of this scandal.
For the story of some of the forces behind Bill 11 and current debate on the implications of increasing reliance on private business and out-of-pocket charges (and ultimately private health insurance) to fund healthcare examine the following web sites.
The most current independent HEALTH studies
The Consumer Experience with Cataract Surgery and Private Clinics in Alberta: Canada's Canary in the Mine Shaft, by Wendy Armstrong,
The Alberta Chapter of Consumers Association of Canada Jan. 2000This retrospective history of the emergence of privately controlled "hybrid" surgery clinics in the 1970s documents the impact of the growth of these clinics on the cost, quality and accessibility of cataract surgery in Alberta - as well as providing peripheral information on other services decanted from traditional acute care hospitals. To order contact the Consumers' Association at 426-3270 or firstname.lastname@example.org. ($15.00 Can)
Executive summary available on Alberta Consumers' Association Web-site. http://albertaconsumers.org/CanaryS.htm
The Privatization and the Commercialization of Public Hospital-Based Medical Services in Alberta, an Economic Overview from a Public Interest Perspective, Richard Plain, PhD., Health Economist, University of Alberta. Mar 2000.An insightful look at the impact of current Alberta policies and practices surrounding private surgery clinics and private pay-as-you-go MRIs. Full document available on web site http://www.healthcoalition.ca/priv-res.html
Private Highway, One-Way Street : The Deklein and Fall of Canadian Medicare? Robert G. Evans, et al Health Economist, University of British Columbia. (Morris L. Barer, Steven Lewis, Michael Rachlis, Greg L. Stoddart) Mar 2000Noted Canadian health economists and health policy analysts evaluation of current proposals in Alberta regarding contracting out for inpatient hospital care in a larger Canadian context. Full document available on web site: http://www.chspr.ubc.ca (link gone 2005)
Clear Answers. The Economics and Politics of For-Profit Medicine, by Kevin Taft, PhD. Business, Taft Research & Communications and by Gillian Steward former editor of The Calgary Herald. Feb. 2000. Published by Parkland Institute, available at Parkland and bookstores for $9.95 Can.A look at why markets fail in healthcare and the conflicts-of-interest in Alberta's restructured health care system. http://www.ualberta.ca/~parkland
Shredding the Public Interest, Kevin Taft, Published by Parkland in 1997.The Parkland Institute is a non-partisan Alberta research network through the Faculty of Arts at the University of Alberta. It operates within the established and distinctive tradition of Canadian political economy. Available at Parkland Institute $5 Can. http://www.ualberta.ca/~parkland
Taking Stock (1996) Armstrong, W., Alberta Consumers Association:A look at the impact of health reforms in Alberta in consumers (and their employers) which documents significant shifting of families' healthcare expenses from the public health plan to private insurance and out-of-pocket payments. To order contact the Consumers' Association at 426-3270 or email@example.com
Caring for Profit, How Corporations are Taking Over Canada's Health Care System, by Colleen Fuller, published in 1998 by New Star Books and the Canadian Centre for Policy Alternatives - ($18 Can) http://www.policyalternatives.ca
Save Medicare Campaign : http://www.savemedicare.org (link gone 2005)
Friends of Medicare A non-political citizen group committed to preserving a single comprehensive public health care system accessible to all citizens. http://www.friendsofmedicare.ab.ca
United Nurses of Alberta - Stop Private For-Profit Health Care : http://www.una.ab.ca
Calgarians for Ethical Health Authorities http://www.
ALBERTA INFORMATION - re conflicts of interests:
"HRG: the Calgary clinic's corporate connections" SEE Magazine weekly paper, March 2-8, 2000 p 6-7, HRG chart, Richard Cairney at SEE Magazine http://www.greatwest.ca/see/Issues/2000/0302/cover1.htm (not found 2005)
Council of Canadians, http://www.canadians.orgThe council Is committed to the protection of social programs (Health, Culture, Environment) by opposing corporate rule and by promoting Democracy. It is the largest non-government organization (NGO) in Canada with over 50 chapters. The www site contains articles regarding WTO and NAFTA.
Canadian Centre for Policy Alternatives, http://www.policyalternatives.caAn independent, non-profit research organization.
Canadian Healthcare Coalition, http://www.healthcoalition.ca
An excellent resource with a large collections of studies and other material as checked Aug 2005
"Ensuring Medicare's Future", a submission to the Department of Finance and to the Alternative Federal Budget Process) Includes the 5 Principles of the Canada Health Act.
Defiant former health minister blows the whistle. Diane Marleau says back-benchers must defend health care for all Canadians, by Colleen Fuller, Straight Goods; http://www.straightgoods.com/item190.asp (not found 2005)
The Government of Canada : http://www.gc.ca/
Canada Health Act : http://www.canada.justice.gc.ca
Health Canada : http://www.hc-sc.gc.ca/
The Provincial Government of Alberta : http://www.gov.ab.ca/
Alberta Health : http://www.health.gov.ab.ca/
CUPE legal opinion on Bill 11: http://www.cupe.ca/indexe.asp
Ralph Klein's Bill 11 will be the death of Medicare. Under NAFTA, Alberta's Private Health Plans put Canada on a road of no return.
World Health Report: http://www.who.int/en/
Globalism and its challenges: - research project involving Australia, Mexico, Norway and Canada. Full document available on web site: http://www.ualberta.ca/~parkland